長照機構之商業模式分析：以某護理之家為例

過去的文獻在衡量長照機構績效時，多半由經營策略、關鍵成功因素、服務品質、以及平衡計分卡等觀點來進行。近年來，開始有學者從商業模式(Business Model, BM)的角度來探討長照機構的經營管理。相較於其他組織經營管理分析方法，商業模式分析提供整體性，系統性的架構協助經營者來探討企業的運作現況，並從中提出新的改善建議。本研究主要目的是應用商業模式來分析長照機構的經營管理，採用4V商業模式（價值主張（value proposition）, 價值組態（value configuration）, 價值結構（value architecture）, 價值財務（value finance））作為長照機構商業模式分析的基本架構，以台灣南部某護理之家為個案研究對象，探討該護理之家經營現況。透過與機構經營者的訪談，從四個價值面向整理出十四個重要改善議題。針對這些議題，本研究從經營策略創新與服務流程創新兩個方向，提出五個護理之家未來經營的改善建議。經營策略創新包含“擴增潛在目標客群”與“降低機構營運成本”兩項。服務流程創新創新包含“智慧型照顧管理”，“主動式照顧人員訓練”，以及“悅趣化自立輔助訓練”三項。研究顯示4V商業模式分析可以應用於護理之家的經營管理，而本研究結果不僅可提供護理之家經營者作為未來改善的依據，同時也可以提供長照實務工作者進行長照機構訓練與診斷的參考。

關鍵字

商業模式；經營策略創新；服務流程創新；長照機構；護理之家

並列摘要

In previous research, while discussing the operation and management of long-term care facilities, researchers usually conduct evaluation of facilities from the perspectives of business strategy, key success factors, quality of service, and balanced scorecard. Researchers have recently paid attention to the business model perspective to explore the operation and management of long-term care facilities. A business model provides a comprehensive and systematic framework to analyze the current status of business operation and determine new strategies for improvement. This study aims to apply a business model to analyze operation management of long-term care facilities and adopts a 4V business model (value proposition, value configuration, value architecture, value finance) to develop an analysis framework of long-term care facilities. A nursing home in southern Taiwan served as a research case to examine the feasibility of the framework. This study analyzed the current status of the nursing home based on the 4V business model framework. Through depth interviews with leaders of the nursing home, 14 important operation and management issues were extracted. Finally, this research proposed five improvement suggestions from the perspectives of business strategy innovation and service process innovation. Two alternatives were identified for business strategy innovation: ‘expansion of potential customers’ and ‘reduction of the operation cost of facilities’. Three were identified for service process innovation: ‘intelligent care management’, ‘proactive caregiver training’ and ‘gamified learning of self-supporting’. This study demonstrates that analysis of a business model can be applied in the operation and management of nursing homes. Our results will provide a reference for top management of nursing homes and can also be used as a good example for nursing home practitioners in training and diagnosis of a business model.