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題名:建構以HKMS-DMAIC程序評估國家醫療資源分配效率之機制
作者:沈聖倫
作者(外文):Sheng-Lun Shen
校院名稱:元智大學
系所名稱:管理學院博士班
指導教授:鄭雅穗
學位類別:博士
出版日期:2015
主題關鍵詞:HKMS-DMAIC程序醫療資源效率HKMS-DMAIC processHealthcare resourceEfficency
原始連結:連回原系統網址new window
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HKMS-DMAIC程序為一種應用各項分析技術與模型,用以設計與建立知識集的方法論,而本研究欲建構以HKMS-DMAIC程序作為評估醫療資源分配效率之機制。在HKMS-DMAIC程序所包含的五個階段中,「定義」階段為規劃定義出四種層級的研究問題,「衡量」階段為規劃對研究變項的定義與衡量方針,「分析」階段為規劃分析效率與其應用結合之技術,「改善」階段為規劃改善「定義」及「衡量」階段之方針,「控制」階段為確認整體機制有效性並彙整知識集。而台灣為因應亞太地區全球化的快速發展,於2009年推動縣市合併政策,藉此整合地區間的醫療資源為此政策要點之一;因此,本研究以台灣進行縣市合併前後醫療資源於2000年至2013年的資料作為案例進行HKMS-DMAIC程序之實證。於案例之研究結果發現,縣市合併前的醫療資源長期集中於某些地區上;然而,在縣市合併後雖然被進行合併的縣市效率降低,但從空間圖探索出資料的結構中,發現縣市合併的確有助於縮小縣市間醫療資源分配效率之差異。
The HKMS-DMAIC process is a methodology which applies various analytical skills and models to design and develop knowledge sets. This research attempts to build a mechanism for the assessment of efficiency in healthcare resource allocation. Among the five phases in the HKMS-DMAIC process, the “define” phase is to draw up definitions of the research issues in four levels; the “measure” phase is to scheme the definition and evaluation principles for research variables; the “analyze” phase is to plan for efficiency analysis and application of combined techniques; the “improve” phase is to design how to improve the principles in the “define” and “measure” phases; the “control” phase is to confirm the overall efficiency of the mechanism and organize the knowledge set. To cope with the fast-growing globalization of the Asia-Pacific region, in 2009, Taiwan promoted the city-county consolidation policy with one of its key courses as inter-region integration of healthcare resources. Hence, this research collected empirical evidence for the HKMS-DMAIC process based on the case study using data between 2000 and 2013 on healthcare resources before and after the city-county consolidation policy was implemented in Taiwan. Through the case study found that healthcare resources were always centralized in specific regions prior to the city-county consolidation; however, although efficiency had become lower in the cities and counties after they were consolidated, as reflected from the data structure in the perspective map, we could see that city-county consolidation did help reduce the efficiency gap in healthcare resource allocation among cities and counties.
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