公立醫院公務人員與作業基金聘用之行政人員的工作滿意度與組織承諾之比較分析

Comparisons of Job Satisfaction and Organizational Commitment between Civil Servants and Administrative Staffers Employed by the Operating Fund of Public Hospitals

葉碧雲(Pi-Yun Yeh)

指導教授 ： 黃國哲

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2011年)

https://doi.org/10.6831/TMU.2011.00077

摘要

緒論：醫院經營者以往通常以名醫及高科技醫療設備等誘因來吸引顧客，然而近年來面臨社會經濟環境的變遷、國民健康意識的抬頭及國家衛生政策的變化，醫院管理者不得不積極改變做法，而採取企業化的經營管理策略。人才是組織發展的重要關鍵，且人事成本占醫院總成本的比重最高，導致現行醫院管理者更重視人力資源管理，希望降低人事成本，加強人力資源彈性運用，提升人力素質，提高競爭力，以達永續經營之目的。政府因應公立醫院人力資源運用的需求，於2001年進行人事法令鬆綁，同意公立醫院以營運收入之作業基金自行進用不具公務人員資格之醫務人員，但公務人員與作業基金聘用人員適用不同的法令制度，如薪資、福利、休假及退休制度等均有差異，但公務人員與作業基金聘用人員其工作內容實際上並無太大差異，是否因而有同工不同酬之心態失衡，進而影響員工工作滿意度與組織承諾。
研究方法：本研究以北部某公立醫學中心於2011年3月時現職行政人員為研究對象，包括公務人員318人及作業基金聘用之行政人員395人。研究進行的第一階段選定特定對象進行深度訪談，藉以深入了解不同僱用別人員（即公務人員及作業基金聘用之行政人員）的任職動機，以及對薪資、福利、陞遷、工作環境及管理制度之看法。第二階段則進行問卷調查，以比較分析不同僱用別員工其工作滿意度與組織承諾。
結果：整體而言，本研究的重要發現如下：
1.公務人員與作業基金聘用之行政人員其工作滿意度有顯著性的差異。
2.公務人員與作業基金聘用之行政人員其組織承諾有顯著性的差異。
3.不同個人屬性的員工對工作滿意度有顯著性的差異。
4.不同個人屬性的員工對組織承諾有顯著性的差異。
討論：依據上述研究結果，本研究對公立醫院管理階層建議應加強作業基金聘用之行政人員之職務發展及運用策略，以達到彈性用人提升營運管理績效之目的。最後，本研究的研究限制為所收集的資料是某公立醫院的單一資料，若以其他公立醫院為研究對象可能會有不同的結果，因此若要將研究結果類推至其他醫院時應十分謹慎。

關鍵字

公務人員 ； 作業基金聘用之行政人員 ； 工作滿意度 ； 組織承諾 ； 人力資源彈性運用

並列摘要

Introduction：In the past, the incentives for hospital administrators to attract customers are the well-known physicians and high-tech medical equipments. In recent years, in facing of the changes for both social and economic environments, as well as the health-recognition and changes of the national health policy, the hospital administrators should change their ways and follow the policy of industrial management strategy.The talented person is the key for the development of an organization. The cost of human affairs accounts for the highest ratio of total hospital expenditure. It makes the current hospital administrators to consider that the human resources management is very important. They hoped to reduce human affairs costs, strengthen the elasticity for human resources utilization, to promote manpower quality, to enhance the competitive power in order to achieve the goal of management continuity forever.
In 2001, in response to the demand of human resources utilization for the public hospitals, the government deregulated the Human Affairs Act and agreed that the public hospitals, Operating-Fund provided by hospital incomes may be voluntarily used for hiring some medical professional to be paid as a staff employed by the Operating-Fund . Two different management systems of Act are applied to the civil servants, and staff employed by the Operating-Fund separately based on two various Act systems. Although the job description almost similar among these employers, they are separately managed and paid under significantly different salary, welfare, vocation-leave, and payments for retirement. Due to the staffs under two different management system of Act and under the situation of same labor with different rewards, the imbalance of personnel feeling is inciting.The objective is to study the influence on employee’s job satisfaction and organizational commitment responses to their employer- hospitals.
Methods： In March 2011, there were 318 active civil-servant-staffs and 395 administrative staffs employed by the Operating-Fund in a northern public medical center.In the first phase, we visited each of selected specific staffs and make interviews in depth as to understand the job of different staff, their visions and views on the motivation, salary, welfare, promotion, work environment and management system. In the second phase, we conducted a questionnaire survey, to understand and analyze the employees under different management system ( civil servants and administrative staffs employed by the Operating-Fund ) about the factors affecting their job satisfaction and organizational commitment.
Results：Results of this study were the following :
1. The job satisfaction between civil servants and administrative staffs employed by the Operating-Fund is significantly different.
2. The organizational-commitment for either civil servants or the administrative staffs employed by the Operating-Fund is significantly different.
3. There are significant differences on job satisfaction of employees among the staffs with various personal-characteristics.
4. There are significant differences on organizational-commitment among the staffs with various personal-characteristics.
Discussion：Based on the above findings, we recommend the public hospitals to strengthen the job- development and utilization-strategy for the administrative staffs employed by Operating-Fung as to improve operational-management-performance and to achieve the purposes of utilization-flexibility for employment. There is a limitation in this study. The surveyed information is collected in a single public hospital only. If we study in more other public hospitals, different results may be gotten. It should be very cautious to apply the results of this study to other hospitals.

並列關鍵字

civil servants ； staffers employed by the Operating-Fund ； job satisfaction ； organizational commitment ； flexibility of human resource

參考文獻

史習安、陳佐任(2008)。正向主管獎賞行爲如何影響員工的工作表現？目標接受與組織承諾的中介角色。組織與管理，1(2)，89-121。

蔡雅芳、吳世望、張肅婷(2008)。教學醫院內部行銷與組織承諾關係之探討。醫務管理期刊，9(3)，188-204。

廖述賢、胡大謙、鐘慧瑩(2008)。國際觀光旅館主管與部屬關係、工作滿足與組織承諾關聯性之研究。人力資源管理學報，8(1)，1-23。

葉桂珍、汪美香(2003)。資訊管理專業人員之專案團隊認同與其工作壓力及工作滿足之關係。臺大管理論叢，14(1），79-118。

楊建昌、彭依雯、賴靜莉、陳世欣、楊紅玉、趙婉青(2004)。工作滿足對組織承諾與病人滿意度之相關性探討—以台北某區域教學醫院之護理人員為例。醫務管理期刊，5(2)，152-170。