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  • 學位論文

區域教學醫院經營成長策略研究─以大里仁愛醫院為例

A Study on the Growth Strategy of Regional Teaching Hospital –take Jen-Ai Hospital as an Example

指導教授 : 葛維鈞
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摘要


企業成長理論在知識日益重要的今日,已成為醫療機構爭相研究的企管理論,尤其在發展多角化方面,更是各院所奉為圭臬競相引用的重要依據。經營成長策略有許多的執行方式,但在績效衡量上甚不容易,短期的報酬率亦並非是判斷其策略成功與否的關鍵指標。因為企業在進行成長或多角化策略時,很容易忽略該企業原本的核心資源是否會被弱化,或是公司內部資源是否因執行多角化或經營 成長策略力量被分散。 本研究嘗試從區域教學醫院的角度,探討個案醫院在執行成長策略、產品差異化策略、多角化策略等因素,以該醫院暨有的醫療技術基礎透過「Ansoff 矩陣」的競爭格局進行優勢選擇,進一步擬定經營成長策略。 本研究訪談個案醫院經營策略推動者,運用半結構方式,運用財務報表以質性研究方法,解開其成長策略規劃內容與著力點,並透過與地方醫療主管機關評價個案醫院在決定進行經營策略的成果、相關經營策略或多角化策略型態上的選擇、外部產業特性、公司內部資源以及高階主管特質。藉以探討區域教學醫院在面臨健保政策和醫療環境變化的壓力下,增加收入和降低成本的因應策略。 因此本文研究目的以了解個案醫院發展「全人照護」制度對提升經營層次是否具有標竿作用;以「病人至上」做為經營之核心價值是否可支持五大醫療中心的推動,並改善全民健保總額支付制度對醫院經營收入管制所產生的影響;推動專家團結合作獲得區域內民眾的信賴,是否是財團法人私立區域教學醫院成功的重要關鍵。 透過研究觀察,個案醫院執行經營成長策略系以發展急、重症病患醫療照護為主,建立相關性服務產品差異化的五大醫療中心為核心。其中,台灣脊椎中心的建構過程符合多角化併購模式,其他四個中心符合策略聯盟的綜效,尤其鼓勵優秀醫護人員內部創業,有效達成人才選、育、留並獨當一面的目標。 再者,個案醫院獲利的主要來源發生在與健保給付內容有關的「原廠與台廠藥物並存」、「重要檢查管控-降低非藥費單價」的下降與「非健保醫務收入」的上升三個部分。若將此三項以98 年與94 年相比較,其合力多貢獻出12%的實質盈餘,在其他費用與收入保持不變下,淨值容易突顯。這與健保未能給付的內容,具有相當大的關聯性,顯示我國健保的給付基礎並未能滿足急、重症病患或罕見病患者得需求。

並列摘要


The Growth Strategy results measures tops very and not and easily, the guerdon of the short date''s leading doesn’t judge as well multi-field success or not of can believe index sign, because carry on multi-field easily neglect whether the company original core resource will be weakened, if multi-field management opportune moment still immaturity, then easily cause the dispersion of company strength. This research tries from the angle of district teaching hospital, study the management strategy adopted, with and the medical technique foundation for having through the competition structure and form of "Ansoffmatrix" carry on an advantage choice and draft the Growth Strategy further. This research interviews an individual case hospital multi-field promotion, make use of a half structure method, make use of financial report with the quality study method, untie its multi-field program content and put forth effort a point, and with place medical supervisor the organization evaluate the individual case hospital is just deciding to carry on the choice, external industry characteristic and company internal resource and top executive characteristic of the result, the Growth Strategy and multi-field strategy type of multi-field strategy. By increasing income and reducing the strategy of cost by teaching hospital in the study district while facing the pressure that health insurance policy and medical environment change. Therefore this text research purpose takes the management strategy of individual case hospital as to set out to understand that the individual case hospital develops "whole person care" system to have a standard function towards promoting management layer whether; The core that take "patient highest" as management value whether can support 5 greatly central promotions, and improve total amount control the influence for producing is toward management in the hospital; Push an expert to solidify a cooperation to acquire the people''s trust inside the district, whether is the important key that the private corporate body district teaching hospital succeeds. Through the research observation, it is the Growth Strategy in the 5 greatest cores, the construction process of spinal cord center matches multi-field merger mode, other 4 inside center effect according to strategic alliance, particularly encourage that the internal and excellent medical personnel inner part starts a business and makes available teachers to choose, teach, stay the target that the disease takes charge as chief. Furthermore the individual case hospital makes a profit of main source occurrence at have something to do with health insurance paying a content of "original factory and set factory medicine.

參考文獻


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