根據世界衛生組織（WHO）預估，2020年醫療照護及觀光相關產業可能成為全球第一、二大產業，占全球GDP之22%，發展國際醫療體系成為各醫療院所甚至各國經濟發展的新藍海策略。各醫院除合乎本國評鑑要求外，皆積極參與並通過國際級醫療評鑑。本研究旨在以衛生署「醫院評鑑資訊公開專區」中，台灣地區12家已通過JCIA之基準組與36家未申請JCIA之參考組為研究樣本，整合設限變數（Bounded-Variable）與共同邊界（Meta-Frontier）資料包絡分析法，進行國內（新制醫院評鑑）與國外（JCI國際醫院評鑑）兩種不同評鑑制度對營運效率之攸關性分析。實證結果顯示：1.在JCIA群組投入產出皆大於參考組下（雖然兩群組投入產出沒有顯著差異），發現有通過JCIA之醫院的技術效率（TE）顯著高於未申請JCIA之醫院。而由TE平均值介於0.901~0.746顯示各群組內部尚有 9.9%~25.4%之醫療資源改善空間。2.在去除JCIA之異質性後所推估之技術缺口比率（TGR），有通過JCIA之醫院其TGR顯著小於未申請JCIA之醫院，表示醫院若希望獲得JCIA，必須提高其TE。3.兩群組之共同邊界技術效率（MTE）並無顯著差異。由MTE平均值介於0.734~0.698顯示台灣的醫院尚有26.6%~30.2%之組織再造可能。4.國內新制醫院評鑑分數越高之醫院其技術效率值反而越低，建議醫策會能進一步檢討與修改國內新制醫院評鑑制度，以期許醫院提供高品質醫療服務來吸引病患求診就醫。5.國內新制醫院評鑑分數對技術效率具有顯著之負向影響，而JCIA對技術效率具有顯著之正向影響，故建議醫院管理者在規劃和發展營運策略時，可採取JCIA之標準，除了能提升技術效率之外，更能與國際接 軌增加國際競爭力。 The World Health Organization (WHO) estimates that, by 2020, the medical care and tourism industries will dominate as the first and second sectors worldwide and account for 22% of global GDP. Development of an international medical system becomes an inevitable issue for each country. In Taiwan, many hospitals have hence sought for accreditation by both local and global institutions. This study analyzes 12 JCIA and 36 non-JCIA hospitals and compares the relevance of two accreditation systems (domestic accreditation and JCIA) with operating performance through bounded-variable and meta-frontier data envelopment analysis (DEA). Major findings are as follows. 1. Technical efficiency (TE) appears significantly higher for JCIA hospitals, with a room for improvement by 9.9% to 25.4%.2. The technical gap ratio (TGR) adjusted with the heterogeneity inherent in the JCIA subsample is smaller for JCIA hospitals, implying that hospitals seeking for accreditation should raise their TE. 3. There is no significant difference in meta-frontier TE whose sample average suggests a room for organization transformation by 26.6% to 30.2%. 4. TE at hospitals that obtain higher scores by the domestic accreditation system is controversially lower. This system may require further correction to better reflect the quality offered by the hospitals. 5. The scores obtained from the domestic accreditation system exert a negative influence on TE, while the scores by JCIA show a positive impact. Hospital managers are hence encouraged to refer to the standards set by the JCIA to design strategies that both increase TE and enhance international competitiveness.
