The Relationship between Environmental Factors and Operational Performance among Nursing Institutions of Residential Care

• Main Authors: Yung-Wei Ku, 古永瑋
• Other Authors: Jin-Yuan Chern
• Format: Others
• Language: zh-TW
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/05141360204703766333

碩士 === 長榮大學 === 醫務管理學系(所) === 99 === Objectives The rapid increase of ageing population has led to a higher demand for long-term care service, which subsequently entails a prosperous growth of long-term care industry. In 1998, there were only 237 long-term nursing institutions in Taiwan, but in 2009 the number climbed up to 1,080, of which 969 (89.7%) were nursing institutions of residential care. The rapid growth of nursing institutions has caused a fierce competition which calls for better resource allocation decisions for the managers of nursing institutions. Therefore, the main purpose of this study was to explore pertinent resource allocation strategies contingent upon environmental characteristics to help enhance operational performance for institutions. Methods The 969 nursing institutions of residential care in Taiwan were the targeted research subjects. Through a series of data collection activities, 202 (a 20.8% response rate) institutions were retained for further analysis. The efficiency scores for operational performance were calculated based on the data envelopment analysis. The operational environments and resource allocation modes were classified by the cluster analysis into four environment types and three resource allocation modes, respectively. In addition to ANOVA and Chi-square statistical testing, multiple regression modeling was also conducted to examine the predictive power of independent variables. Results The efficiency scores differ among the three resource allocation strategies in four operating environments. Relatively speaking, large-scale institutions showed better performance in every operational environment than small-scale institutions; the medium-scale institutions could only perform better in the operational environment of low development. According to the results of multiple regression analysis, the foundation-typed institutions could improve their operational performance by either reducing direct labors or increasing the number of institutional residents. For the private small-scale institutions, they could achieve better performance efficiency scores by lowering their size, increasing the number of institutional residents or trying to be accredited as Grade A+ in the highly-developed operating environments; and, by reducing indirect labors or trying to be accredited as Grade A in the sub highly-developed operating environments. In the mid-developed or low-developed operating environments, reducing direct labors, increasing the number of accommodation, or trying to be accredited as Grade A would help improve the operational performance. The multiple regression modeling shows that the ownership, foundation-typed status, and the low-developed environment had positive influence on the operational performance. Specifically, variables related to direct labor, indirect labor, and institutional size showed negative effect, but the number of institutional residents and accreditation grade had positive impact with the Grade A+ being the best target. Conclusions Low-developed environments are most suitable for the institutions to survive and highly-developed environments are relatively competitive. Consequently, it is suggested that managers dedicate their efforts to using resources more efficiently in the more competitive regions; and more operating strategies could be considered in the less competitive regions. In consideration of the national policy of community nursing care service, small-scale organizations might be the trend in the future. Managers should endeavor to improve the accreditation grade, which would have a positive influence on operational performance. As the long-term nursing care industry gets more mature, consumers would pay more attention to the service quality. Therefore, quality service is the key aspect that managers should emphasize in the future.