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E90068
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臺灣地區醫療機構策略聯盟之型態及其績效評估
Evaluating the Impact of Different Types of Strategic Alliance on Hospital Performance in Taiwan
1.郭乃文
1.Nai-wen Kuo
1.臺北醫學大學醫務管理學系
1.Department of Health Care Administration, Taipei Medical University
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1.臺北醫學大學醫務管理學系
1.Department of Health Care Administration, Taipei Medical University
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1.行政院國家科學委員會
1.National Science Council
A.14 計畫執行期間(起):2001-08-01
A.14 計畫執行期間(訖):2002-07-31
A.16 收到日期:2002-10-30
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民國85年至88年度經行政院衛生署醫院評鑑及教學醫院評鑑,地區教學醫院以上評鑑合格之醫院

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C.2 聯絡日期:2002-11-04
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1.臺北醫學大學醫務管理學系
1.Department of Health Care Administration, Taipei Medical University
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C.7 資料公開日期:2004-08-01
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1.策略聯盟
2.績效評估
3.聯盟績效
4.聯盟類型
5.醫院管理
6.醫療服務業
1.Alliance Performance
2.Alliance Type
3.Health Care Industry
4.Hospital Management
5.Performance Evaluation
6.Strategic Alliance
本研究以國內醫院為研究對象,探討醫院所採取策略聯盟類型與其 經營績效之間的關係。本研究目的如下: 1.了解現今台灣地區醫療院所 參與策略聯盟之型態與模式; 2.探討醫療機構採行策略聯盟對其醫院經 營績效的影響; 3.希望藉由本研究之量化分析,了解在台灣地區,醫療 機構參與何種型態的策略聯盟,對醫院的績效會有最正面的助益。 本研究之研究對象為八十五年至八十八年度經行政院衛生署醫院評 鑑及教學醫院評鑑,地區教學醫院以上評鑑合格之醫院。所以,本研究 總樣本醫院家數包括醫學中心及準醫學中心17家,區域(教學)醫院35 家,準區域(教學)醫院14家,地區(教學)醫院61家,共127家。 本研究針對樣本醫院管理階層,如醫院院長、醫療或行政副院長、管理 中心主任、院長室幕僚(如特別助理、高專等)等高階主管進行問卷調查。共發出問卷127份,回收之有效問卷47份,回收率達37.0﹪。 研究結果發現: 1.本研究之樣本醫院所參與的策略聯盟類型,最多為實施清潔廢棄物的外包,其次為實施洗衣房的外包。 2.樣本醫院中只有半數醫院實施藥品及衛材的聯合採購。3.藥品聯合採購與衛材聯合採購是醫院參與策略聯盟較久的類型,有超過百分之五十的樣本醫院參與此 類型的策略聯盟達五年以上。4.參與各類型態的策略聯盟對於樣本醫院的主觀財務績效沒有顯著的影響,但對於市場佔有率、顧客滿意度或是醫院的風評、口碑及 員工工作量、員工離職率方面有顯著的影響。5.「實施洗衣房外包管理」及「實施藥品聯合採購」對於平均每位員工住院人數、平均每位員工門診人次有統計上之 正向影響外,其他各類型的策略聯盟對於四項醫院績效指標並無統計上之顯著影響。 本研究基於研究結果對於醫療機構管理者有三點建議: 1.並非所有類型的策略聯盟類型都具有效益。 2.注意大環境的發展。 3.長期績效的評估。 對於醫療政策制定單位有兩點建議: 1.鼓勵醫院採行合作經營方式。 2.訂定策略聯盟的制度規範。 對於後續研究者的建議為以下四點: 1.將醫療機構本身的組織文化、管理者的領導風格等因素納入本研究中。 2.做多年持續性且縱貫(longitudinal)的觀察。 3.將中小型的地區醫院納入研究範圍。 4.可以探討更多不同類型的策略聯盟型態及其對醫院的影響。

This study examined and discussed the correlation between various types of hospital strategic alliances and hospital performance. The specific aims of this study include: (1) to understand types and models of hospital strategic alliances currently practice in Taiwan;(2) to examine the effects of hospital strategic alliances on hospital performance; (3) to understand which types of hospital strategic alliances are most helpful for healthcare organizations in Taiwan. The study population of this study includes all teaching hospital accredited by the Department of Health in Executive Yuan from 1996 to 1999. There are total of 127 hospitals in the study population, including 17 medical centers, 49 regional hospitals, 61 district teaching hospitals. The questionnaires were mailed to the executives of these hospitals, such as president, vise-president, director of management center, or executive assistant. Finally, there are total of 47 valid questionnaire collected. The response rate in approximately 37.0%. According to the results, there are several findings. First of all,the most popular types of strategic alliance in sample hospitals are contracted inflectional material disposal and contracted linen services. Second, about half of the sample hospitals already implemented group purchase of medicine and other material. Third, group purchase of medicine and other material is the kind of strategic alliance which last longest in sample hospitals, more than 50% of sample hospitals have joined the group purchase for more than five years. Fourth, in terms of subjective (perceived) performance, those hospital implemented strategic alliances doesn\'t have significantly influences on their financial performance. However, there are significantly influence on market share, customer satisfaction, hospital reputation, and improvement of staff work loading and personnel turnover rate. Fifth, those hospitalsimplemented \"contracted linen service\" and \"group purchase of medicine and other material\" has significant influences on hospitalization days per FTE (full-time equivalent) and outpatient visits per FTE. However, for other types of hospital strategic alliances, there is no significant influence on the four indicators of hospital performance. Based on the research results, there are three suggestions for health care administrators. First, not all types of hospital strategic alliances are effective. Second, the development of market environment should be pay attention while implement strategic alliances. Third, the long-term evaluation of performance of strategic alliances should is important. There are two suggestions for policy makers. First, hospital strategic alliances should be encouraged. Second, the rules and standards of strategic alliances should be established. Finally, there are four suggestions for further researches. First, some factors, such as organization culture and administrators\' leadership should be included in future research. Second, a longitudinal study is preferable. Third, it\'s better to include more hospitals, such as the small district hospitals in future research. Fourth, more types of strategic alliances and their impacts on hospital performance can be steadied in future research.

D.16 完成檢誤日期:2005-08-02
D.17 預定釋出日期:2004-08-01
D.18 初次釋出日期:2006-06-23
D.19_1 最新版釋出日期:2006-06-23
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10.6141/TW-SRDA-E90068-1
http://efenci.srda.sinica.edu.tw/webview/index.jsp?object=http://efenci.srda.sinica.edu.tw:80/obj/fStudy/E90068
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