| Summary: | 碩士 === 高雄醫學大學 === 公共衛生學研究所碩士在職專班 === 91 === Since the National Health Insurance(NHI) started on March 1,1995 in Taiwan,the hospital operation in Taiwan deepen in difficulty especial in Chi-Mai District ,where of Kaohsiung country six district hospitals built about 300 beds located in the large land area─Chi-Mai district. The patency of No.10 freeway begins on Nov. 14,1999, which about mid-point during six years study period. The No.10 freeway let traffic convenience and commute from Kaohsiung city to Chi-Mai district of Koahsiung country,it let the citizen visit hospital available and physicians recruit to Chi-Mai district work. The relationships between hospital operation performance and traffic convenience will be studied.
The primary data of six hospitals are collected per month from Jan.1997 to Dec. 2002, total about 21 different variables including input variables x11(plus patency of No.10 freeway), output variables x7, and 3 variables of hospital operating Performance( including OPD-ER Part, Admit Part,and Whole hospital).Our study has 21 variables, and 72 samples per variable. Then the one-way ANOVA, repeated measures two-way ANOVA, or multiple regression of SPSS for Windows 10.0, is used to analysis the data..
The major findings of this study are shown in the following:
1.”A” hospital’s OPD-ER part, Admit part, and Whole hospital operation performance simply affected by patency of No.10 Freeway, shows p<0.005(p=0.000), significant advanced change in “A” Hospital and ‘A+B’ hospital. ‘B’ hospital as the same, advanced change except performance of Admit part. Adjusted by 5 input variables, the ‘A’ hospital’s operational performance shows no significant change in OPD-ER, Admit and whole part of hospital operating performance.(p>0.05); ‘B’ hospital shows as pre-adjusted. ‘A+B’ hospital operating performance shows no significant change in OPD-ER, Admit and whole part. The crude significant change of hospital operating performance is due to the increase of 5 inputs.
2.mulitple regression of SPSS for Windows 10.0 give us three equalizations in each hospital including OPD-ER, Admit, and whole part of hospital operating performance.(1) In OPD-ER part , regress to four co-factors: visitors of hemodialysis, other hospital workers, visitors in OPD, nursing staff. (2) In Admit Part, regress to four co-factors: visitors of Admit, visitors of operation, work of hemodialysis, other hospital workers. (3)In Whole part, regress to four co-factors: visitors of hemodialysis , visitors of Admit ,other hospital workers, nursing staffs.
3. Repeated measures two-way ANOVA for the definite effects in patency of No.10 freeway to “A”, ‘B’, or ‘A+B’ hospital operating performance in Chi-Mai District. The patency of No.10 freeway effects “A”, ‘B’, and ‘A+B’ hospital in the changes of OPD-ER part ，Admit part and Whole part of hospital operating performance.
4. Adjusted by four co-factors respectively in OPD-ER, Admit or Whole, using repeated measures two-way ANOVA, the patency of No. 10 freeway affect hospital operating performance significant except in Admit part of performance between hospitals.
5. In multiple regressions, affect ‘A’ hospital factors─ Increase Int. Med. Staff or other specifics staff and less beds, nursing staff, or other hospital workers. Affect “B” hospital factors─increase nursing staff or other hospital workers, less other specifics staff; affect “A+B” hospital facors─increase Int. Med. Staff or other specifics staff, less nursing staff.
The patency of No.10 freeway as traffic convenience affect the different hospitals in hospital operating performance significantly.
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