醫院實施聯合採購現況分析

醫院實施聯合採購現況分析

 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。

Analysis of Current Status for Hospital Group Purc hasing

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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 bud get payment system for hospital reimbursement in 2001, maknig the medical environment mor e complicate. Additionally, the expansion of medical centers and hospital systems also makes many middle to small size hospitals more difficult to survive. Therefore, hospital administrato rs developed many strategies, such as group purchasing, to cope with this changing environme nt. 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 purchasi ng. In quantative study, a questionnaire was sent to the directors of purchase department of 51 5 hospitals, which were accredited as the level of district hospitals or above, to collect data rel ated to group purchasing. In the part of qualitative study, 8 physicians were interviewed. Final ly, 208 valid questionnaire were obtained. The return rate was 40.3%, among them, 109 hospit als (52.4%) had participated group purchasing.

The results showed: 1. There were no correlation between number of items, dollar amount of g

roup purchasing and hospital alliance strategies. 2. There were significant correlation between

hospital alliance strategies and the degree of computerization of group purchasing system. 3. T

here were significant correlation between hospital alliance strategies and quality of products fr

om group purchasing. 4. There was no significant correlation between hospital alliance strateg

ies and cost reduction from group purchasing. 5. There were 90.4% hospitals, which planed to

join or continue participating group purchasing in the future.