醫療機構納入勞基法規範之後,醫院必須額外支付各項人事成本,而婦女輪值晚夜班的限制,更給醫院在人力調度上帶來困難。為了達到有效的成本控制,許多醫院就開始考慮內製或外購(make-or-buy)的決策,業務外包成為醫院管理的首要策略之一。 本研究選擇高雄一家醫學中心為研究樣本,觀察該醫學中心之外包管理業務內容並討論相關的管理意涵。研究結果顯示該樣本醫院:1.外包項目分屬6個單位,合計33種合約並有繼續增加趨勢;2.外包管理模式傾向:在監督構面,洗衣工廠、工務室、營養室傾向過程監督,其餘為傾向監督結果;洗衣工廠及工務室在控制構面較能提供誘因,其餘多傾向處罰;洗衣工廠及工務室在信任關係建立上傾向合作,其餘則依價格競標傾向競爭;在資訊處理方面,洗衣工廠及工務室傾向理性分享,其餘是傾向投機;合約績效採主管人員主觀評價外包管理模式,以透過監督過程、建立夥伴關係、理性收集資料,而又強調罰責的控制有較高滿意度。研究結果除建立外包管理業務之屬性與歸類外,將可作為後續追蹤評價的基礎。
When medical institutes take the basic law of labor into account, hospital have to pay extra expenses caused by changes related to human resources. For example restrictions on night shifts for female employees create difficulty for staff arrangement. In order to effectively control the associated costs, many hospitals employ the decision making strategy of make-or-buy. One of the primary strategies is outsourcing management. This investigation used one of the medical centers located in Kaoshiung as a case study. The results of the study: In this case, they had thirty-three contracts in six departments; The outsourcing management model consists of contact fulfillment or result monitoring, incentive giving or punitive measure, cooperative or competitive relationships, and rational or opportunistic information collections. With a firm handle of progress and quality control on contractor, the risk of serious damage can be reduced. The study results not only provide valuable insights of hospital outsourcing management but also lay the foundation for further researches on outsourcing management performance.