醫院實施聯合採購現況分析
Analysis of Current Status for Hospital Group Purchasing
中文摘要 全民健康保險在 84 年 3 月實施、總額預算陸續上路、並在 91 年 4 月份全民健保 藥價給付調降後，藥價基準實施使得藥價透明化，醫藥分業使病患在醫院取藥的 機率降低，醫院的利潤也可能因此減少；醫院大型化及連鎖式的陸續設立，許多 中小型的醫院已陷入艱苦的經營地步。 本研究主要目的為了解醫院實施聯合採購現況、探討醫院加入聯合採購的整體滿 意度、調查聯合採購供貨品質的穩定度、瞭解醫院施行聯合採購的採購成本下降 情形、無論現在是否有參與聯合採購，在未來(繼續)參與聯合採購的意願。本研 究採橫斷性研究，本研究之對象為行政院衛生署八十九至九十二年度醫院評鑑暨 教學醫院評鑑合格名單，等級為地區醫院(含)以上之醫院為主共 515 家。問卷調 查的主要對象為醫院採購主管採用郵寄問卷調查；各層級的內外科醫師計 8 人採 專家訪談方式進行。回收問卷共計 211 份，其中因有 3 份回答不完整而捨棄，有 效問卷為 208 份，回收率為 40.3%。其中參與聯合採購醫院為 109 家(比率為 52.4%)。 研究結果顯示：(一)聯合採購的品項及金額的分配情形並未因醫院經營型態不同 而有顯著差異。(二)不同經營型態醫院對參與聯合採購電子化的程度有顯著差 異。(三)不同經營型態醫院對聯合採購的適當醫材品質有顯著差異。(四)不同經 營型態醫院對聯合採購績效(成本下降)未有顯著差異。(五)有 90.4%醫院會在未 來(繼續)參與聯合採購。 英文摘要After implementation of the National Health Insurance (NHI) in Taiwan in 1995, the medical environment was dramatically changed. Furthermore, the NHI of Taiwan adopted a global budget payment system for hospital reimbursement in 2001, maknig the medical environment more complicate. Additionally, the expansion of medical centers and hospital systems also makes many middle to small size hospitals more difficult to survive. Therefore, hospital administrators developed many strategies, such as group purchasing, to cope with this changing environment.
The purpose of this study was to understand the current status for hospital group purchasing in Taiwan and to evaluate degree of satisfaction and stability of product quality in group purchasing. In quantative study, a questionnaire was sent to the directors of purchase department of 515 hospitals, which were accredited as the level of district hospitals or above, to collect data related to group purchasing. In the part of qualitative study, 8 physicians were interviewed. Finally, 208 valid questionnaire were
obtained. The return rate was 40.3%, among them, 109 hospitals (52.4%) had participated group purchasing.
The results showed: 1. There were no correlation between number of items, dollar amount of group purchasing and hospital alliance strategies. 2. There were significant correlation between hospital alliance strategies and the degree of computerization of group purchasing system. 3. There were significant correlation between hospital alliance strategies and quality of products from group purchasing. 4. There was no significant correlation between hospital alliance strategies and cost reduction from group purchasing. 5. There were 90.4% hospitals, which planed to join or continue participating group purchasing in the future.
