title: Cluster analysis of medical service resources at district hospitals in Taiwan, 2007-2011.
abstract: BACKGROUND
  A vast amount of the annual/national budget has been spent on the National Health Insurance program in Taiwan. However, the market for district hospitals has become increasingly competitive, and district hospitals are under pressure to optimize the use of health service resources. Therefore, we employed a clustering method to explore variations in input and output service volumes, and investigate resource allocation and health care service efficiency in district hospitals.
  
  
  METHODS
  Descriptive and cluster analyses were conducted to examine the district hospitals included in the Ministry of Health and Welfare database during 2007-2011.
  
  
  RESULTS
  The results, according to the types of hospital ownership, suggested that the number of public hospitals has decreased and that of private hospitals increased; the largest increase in the number of district hospitals occurred when Taichung City was merged into Taichung County. The descriptive statistics from 2007 to 2011 indicated that 43% and 36.4% of the hospitals had 501-800 occupied beds and 101-200 physicians, respectively, and > 401 medical staff members. However, the number of outpatients and discharged patients exceeded 6001 and 90,001, respectively. In addition, the highest percentage of hospitals (43.9%) had 30,001-60,000 emergency department patients. In 2010, the number of patients varied widely, and the analysis of variance cluster results were nonsignificant (p > 0.05).
  
  
  CONCLUSIONS
  District hospitals belonging to low-throughput and low-performance groups were encouraged to improve resource utilization for enhancing health care service efficiency.
authors.affiliation: Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan, ROC; Nursing Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Shu-Fang
authors.initials: SF
authors.lastname: Tseng
authors.affiliation: Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan, ROC.
authors.forename: Tian-Shyug
authors.initials: TS
authors.lastname: Lee
authors.affiliation: Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. Electronic address: cydeng@ym.edu.tw.
authors.forename: Chung-Yeh
authors.initials: CY
authors.lastname: Deng
mesh_terms: D016000:Cluster Analysis; D006295:Health Resources / Q000706:statistics & numerical data*; D006767:Hospitals, District; D006801:Humans; D013624:Taiwan; D013997:Time Factors
keywords: cluster analysis; district hospital; hospital market; resource utilization