泛談美國多體制醫療機構(MUS)及其對我國醫院之示範作用

The Multiple-Unit System in the U.S. and Its Impact on the Hospital System in Taiwan

吳肖琪(Shiao-Chi Wu)

《中華民國公共衛生學會雜誌》 7卷1期 (1987/05) Pp. 8-14

https://doi.org/10.6288/JNPHARC1987-07-01-02

摘要

MUS多體制醫療機構(Multiple-unit systems)是美國漸流行的一種趨勢，它指的是一群醫院組成一個系統，由單一管理制度來管理。這種聯合方式能滿足醫院及社區之需求，達到強有力的中央控制。
政府的介入醫療，民眾要求高品質低收費之醫療服務，保險公司的參與，醫院問的強烈競爭，醫院已不再單純是一種服務事業，而必須在爭取醫事人員、病人及財力支援上高度競爭。
可提供醫院包括經濟上，避免重覆投資、聯合採購、降低成本、分擔風險等，醫療品質的提升，民眾的可近性與留住人才、提高管理效率等利益。目前MUS採用的策略，可分爲聯合分擔服務、合約服務、合併、聯盟、合約管理等。
近十幾年，台灣地區醫院不斷的擴建與新建，醫院間缺乏協調，預料醫院病床數將面臨過剩，且在地理上有分布不均，資源分布不均及重覆浪費之現象，爲了醫院之生存以及民眾之需求，台灣未來的趨勢，將會更廣泛地運用MUS之策略。

並列摘要

Multiple-unit Systems means that a variety of hospital systems operated by a single integrated management structure. All signs point to expansion and growth of hospital systems capable of balancing a need for strong central control with the needs and desires of local communities.
The U.S. health care delivery system is part of a huge political arena. Congress, federal and state governments are demanding do more with less. Patients are saying they want more services at lower cost with quality and compassionate care. Hospitals today are not only service institutions, but also highly competitive organizations for physicians, patients and financial support.
MUS offer contain advantages over autonomous hospitals. These primary advantages are (1) economy, (2) quality, (3) accessibility and (4) power. Hospital systems also offer specific advantages in terms of community accountability, responsiveness to consumers and comprehensive care programs. There are a variety of approaches being taken to regionalize and intergrate hospitals into systems. These new strategies are shared services, contract services, mergers, affiliations and contract management.
In recent ten years, Autonomous hospital was built or expanded in Taiwan. The main problems, including hospital beds surplus, hospital beds maldistribute and a lack of coordination between providers, leading to overcapacity in some areas and duplication in others.
As a result, hospitals in Taiwan will force for being systems in order to meet community needs and their survive. Now we can find some kind of hospital systems strategies in Taiwan. And we believe that the systems number will increase in a future.