少子化下婦產專科醫院經營關鍵成功因素之探討

根據內政部的人口統計數據顯示，臺灣總生育率持續下滑，在面對少子化，生育率逐年降低的同時，婦產專科醫院該如何在當前高度競爭的環境、不斷改變的健保政策制度以及其他社會經濟法律的限制下，找出本身關鍵成功因素及競爭優勢，以期達到良好的績效與生存發展的空間，讓醫院永續經營。目前有關醫院營運績效的文獻相當多，但缺乏有關婦產專科醫院經營策略之文獻，尤其是婦產專科醫院關鍵成功因素之相關文獻，故本研究針對高雄市婦產專科醫院之經營關鍵成功因素做探討，瞭解其在少子化趨勢下能產生較佳績效之經營模式的成功因素，並對婦產科未來發展有實質上的幫助。本研究旨在以高雄市婦產專科醫院中之經營或高階管理者為研究訪談對象，進行深度訪談分析，並結合 Miles & Snow（1978）對策略型態之定義所發表之健康維護組織（HMO）的經營策略量表，透過相關文獻探討，以半結構式訪談﹙Semistructured interviews﹚方式，進行資料蒐集。本研究從深度訪談中進行質化研究，針對經營理念、硬體特色、企業形象、教育訓練、行銷通路、市場區隔、服務特色、地理位置及其他因素九大項構面進行探討；最後，總和經營管理者對於自身關鍵成功因素描述加以得到統合性之婦產專科醫院經營關鍵成功因素。本研究結果顯示：1.在策略型態與經營績效分析，高雄市婦產專科醫院中以採取「前瞻型與分析型」策略佔多數，且依其經營績效(包含：每月每位婦產科醫師平均門診看診人數、每月平均生產人數、每月婦產科病床平均佔床率、人事成本支出佔總支出比率及自費收入佔總收入百分比)，對四種不同策略類型者做排序比較，經排名後發現：前瞻者排名第一，其次為分析者，防禦者再次之，反應者最差。2.在關鍵成功因素彙總分析，高雄市婦產專科醫院經營共同關鍵成功因素包含經營理念、硬體特色、企業形象、教育訓練以及服務特色五個構面，其中醫護人員專業技術能力排名第一，其次為顧客滿意度，工作團隊向心力與配合度再次之；而有關行銷通路、市場區隔及地理位置則較不重視。另外，在企業形象及教育訓練兩項構面中成功因素項目多於其它因素項目，這顯示婦產專科醫院經營管理者對於醫院之經營管理，仰賴企業形象與教育訓練兩個構面可能重於其他三個構面。本研究提出以下建議：1、醫院未來在擬定經營策略時，應將競爭醫院之優劣勢、經營策略模式與績效納入考量；成功關鍵因素的擁有只代表著醫院擁有的潛在競爭優勢，若成功關鍵因素沒有合理的運用與發揮，那它們只是具有這些優勢卻不能顯現其功能。2、建議經營管理者未來應針對市場區隔及行銷管道予以強化，形成差異化以提昇醫院經營之競爭優勢，達成永續經營的目標。3.對後續研究之建議：未來的研究可採量化的實證研究調查法，以較多之樣本數來檢驗或評估本研究所提出之關鍵成功因素進行全面性調查，以求客觀之研究結果。4.對一個成功的醫院而言，內部員工與顧客的意見亦相當重要，故建議後續研究可將研究範圍與對象擴展到醫院內部員工與顧客層面，以不同觀點來探求醫院經營之關鍵成功因素。

關鍵字

少子化；策略型態； SWOT分析；關鍵成功因素；績效評估

並列摘要

According to the population statistics published by Ministry of the Interior, the overall birth rate in Taiwan keeps declining. Encountering the trend of fewer children as well as birth rate decline year by year, an obstetrics and gynecology hospital should deeply ponder how to discover its keys to success and competition superiority, hoping to achieve satisfactory performance and keep a space for survival so as to operate sustainably under current restriction of highly competitive environment, variable changes in health insurance policy and other socioeconomic regulations. At present, there are plenty of reference literatures about successful operation performance of obstetrics and gynecology hospitals, but lack of those about business strategy in the field of obstetrics and gynecology hospitals, especially the key factor for success. Therefore, this study is aimed at exploration on key factors for success in obstetrics and gynecology hospital management in Kaohsiung to find out the key factors of operation mode for their success on superior performance under the trend of fewer children, consequently being substantially helpful for future development of obstetrics and gynecology hospitals. The purpose of this study is to collect information through interviewing managers of obstetrics and gynecology hospitals in Kaohsiung to carry out In-Depth interview analysis. Furthermore, integrate HMO (Health Maintenance Organization) management strategy measurement based on strategy types identification proposed by Miles & Snow (1987). Through exploration on relevant literatures, the study is carried out by Semi-structured Interviews to collect information. In this study, qualitative research is executed through In-Depth interview, aimed at exploration in nine aspects, i.e., management concept, hardware features, corporate image, education and training, marketing channel, market segmentation, geographical location and other factors. Finally, the key factors of their own success described by the managers are synthesized into integrated key factors for success in managing an obstetrics and gynecology hospital. The result of this study shows: 1. In terms of strategy type and business performance, Prospectors Strategy and Analyzers Strategy are applied by most of the obstetrics and gynecology hospitals in Kaohsiung; and the results indicate that Prospectors ranks No.1, secondly Analyzers, then Defenders and Reactors the last. 2. In terms of synthesized analysis based on key success factors, the key success factors of management in obstetrics and gynecology hospitals in Kaohsiung are common in five aspects including management concept, hardware features, corporate image, education and training and service characteristics. Among them, the technical ability of medical professionals ranks first, secondly customer satisfaction and then organizational commitment and coordination of team work. Marketing channel, market segmentation and geographical location are less regarded. In addition, corporate image and education and training achieve more success factors than others. It indicates that managers of obstetrics and gynecology hospitals rely more on corporate image and education and training than the other tree aspects in managing their business. In this study, the follow suggestions are proposed: 1. On drawing up management strategies in the future, the superiority and inferiority of a hospital, management strategy type and business performance should be taken seriously into consideration. 2. It is suggested that business managers should enhance market segmentation and market channel to build their differentiation so as to upgrade business competition to reach their targets. 3. Suggestions for future study, Quantitative Research Methods can be adopted in the future study. With more samples to exam or access the key factors for success mentioned in this study, carry out overall examination to search objective results. 4. In the case of a successful hospital, comments from staffs and customers is also very important. Thus, it is suggested that the scope of study can be extended to the segments of staffs and customers, from different points of view to explore key factors of success to manage a hospital.