隨著醫療服務環境的轉變，基層診所唯有提高經營效率、強化醫療品質與提昇病患滿意方能維持競爭力。回顧過去績效評估文獻多偏重以大型醫院為研究對象，仍然缺乏針對小卻佔市場大比例的診所從事研究。基層診所由於受到先天營運規模的影響，除了彼此的競爭外，還需面對醫院的優勢等問題。根據過去研究顯示，作業之績效對於顧客滿意是有正向的影響。因此如何有效降低成本與增加醫療服務品質，進而提昇病患就醫的滿意，基層診所確實需要藉由一個公平客觀之績效評估模式指引資源的分配。為達成此目的，本研究首先依據病患就診近用特性進行分類與運用分析層級程序法進行診所間的滿意度評量，藉以釐清不同類別病患滿意度之差異；其次，利用資料包絡法將不同病患類別的滿意與診所輸入資源相連結，進一步驗證輸入資源之多寡與不同病患類別之就醫滿意將如何影響診所間相對的作業績效。研究對象係根據賀芬達指數(HHI<1,000)，選定台中市南區四家健保特約西醫診所為實證對象，調查樣本係選取年度內至各診所的就診病患為資料來源。資料結果顯示，不同診所的病患滿意度與輸入資源的關連，除了可以藉由本作業績效模式得到驗證外，對於個案診所在病患就診滿意的因素中，可就其輸入資源的狀況加以調整與改善，以提升競爭優勢。
With the change in medical environment, the primary clinics can only survive if they strengthen the quality of their medical services and promote patient satisfaction. While much literature has been done on large-scale medical service organization, few focus on primary clinics. In this study, we developed a patient satisfaction and operational performance model for primary clinics to be used to access the operational management of primary clinics. To do this, we first used the Analytic Hierarchy Process (AHP) to evaluate the degree of customer satisfaction. The satisfaction scores, which were used to classify patients, and then used as output variables in Data Envelopment Analysis (DEA), which uses linear programming to measure the relative performance of primary clinics. In addition, we used the Herfindahl index (HHI<1,000) to measure competition among primary clinics. Further, we administered an annual questionnaire to characterize the patients. We found that the difference between resources put into operation and degree of patient satisfaction affected the relative performance and competitive advantage of the primary clinics we studied.
