Cluster analysis of medical service resources at district hospitals in Taiwan, 2007–2011

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). Conclusion District hospitals belonging to low-throughput and low-performance groups were encouraged to improve resource utilization for enhancing health care service efficiency.