在本研究中，我們發展一個系統性程序去確認決策基準/績效指標，及建構一個量化模式去評估與比較台灣醫院醫療科技設備績效。多準則決策分析與資料包絡分析兩種方法，在本研究中被整合互補使用。德菲法在多準則決策分析過程中被應用於確認決策基準/績效指標。一個專家小組，包括兩位政府官員，兩位醫管學者以及十二位醫院管理者所組成之團體，受邀作為本研究調查之對象。 發展這樣一個模式方法之目的是想要去幫助台灣醫院實務管理者用於醫療科技設備之(1)“事前評估”:協助新投資的規劃與選擇;及(2)“事後評估”:監控及改善現有設備使用績效。三個實證應用，已在本研究中被建構去探索及檢驗此模式之可行性與可應用性。 第一個是“事後評估”之實證案例。資料包絡分析法之投入導向CCR 模式被應用於分析中台灣某三家大型醫院之35 個現有醫療科技設備單位之績效。 第二個是結合“事前評估”與“事後評估”之實證案例。在此案例中，一個動態評估模式被發展。資料包絡分析及其修正模式被應用於支援決策流程。當一系列新醫療科技設備被提出時，經由一個動態過程，每當一新科技設備被選入並當成現有設備被比較時，整個投資組合需再重新評估。 最後一個則是“事前評估”之實證案例。此案例描述如何處理新醫療科技評估與分配資源而不會衝突。當新科技所需之資源不可分割時，傳統之資料包絡分析被放入一個總體資源限制模型中，績效最好的先完成，接著依序完成，直到資源用盡。當新科技所需之資源未必不可分割時，則將標準之資料包絡分析模型加至一組資源總限制式中求解。 本研究之結果顯示，此量化評估糢式確能幫助台灣醫院實務管理者用於醫療科技設備之事前及事後評估。 In this research, we developed a systematic procedure to identify decision-making criteria/performance indicators and constructed a quantitative model to evaluate and compare the performance of medical technologies in Taiwan hospitals. Multi-Criteria Decision Analysis (MCDA) and Data Envelopment Analysis (DEA) were used complementarily. The Delphi method was applied to identify the decision-making criteria/performance indicators within the processes of MCDA. An experts panel comprised two governmental officers, two scholars and twelve hospital executives was formed as the surveyed subject group. The aim of developing such a modeling approach is intended to help hospital executives (1) evaluate and choose new medical technologies (ex-ante evaluation), and (2) monitor and improve the performance of existing technologies (ex-post evaluation). Three empirical studies have been conducted to explore and test the feasibility and applicability of the model. The first study is an ex-post evaluation. We employed input-oriented CCR model of DEA to analyze 35 medical technology units of three large medical centers in central Taiwan. The second is a study of combining ex-ante and ex-post evaluation. A quantitative dynamic evaluation model of DEA and its modification was employed to support the decision process. When a series of new medical technologies were proposed, the entire portfolio needs to be re-assessed each time when a new technology is selected and severed as an “old” one to be compared. The third study is an ex-ante evaluation. The study described how to deal with ranking the new medical technology projects and allocating resources to them without any conflict. Firstly, when all projects were indeed “indivisible”, the conventional DEA rankings were embedded inside a global resource-constrained program with binary (accept/reject) variables. Secondly, when these projects are not necessarily indivisible, a set of global couplings laying down the overall resource constraints was jointed to the standard system of DEA programs. The results of this research showed itself a promising tool to help Taiwan hospital executives in both ex-ante and ex-post evaluations.
