中國醫療體制轉型時期醫院之委外策略研究

中國經濟改革帶動醫療體制改革，經濟改革期間大陸採行低價世界代工廠策略成效卓著，在經濟快速成長後，人民對醫療的需求快速增加，不僅要求就醫可近性，同時也提高對醫療品質的要求，醫療體制改革過程中，衛生政策與醫療機構如何運用外部資源，以加速醫療體制轉型，成爲中國醫改的一大重要議題。本研究採取成本觀點、資源觀點以及組織變革觀點來探討醫院採行委外方案來調適轉型之驅動因素，並行體制觀點與代理人觀點來解釋委外之干擾因素，以中國五種六家不同規模類別醫院爲研究對象，來探索中國醫院委外之策略運用以及影響委外之因素。

關鍵字

戰術性委外；策略性委外；轉型性委外

並列摘要

The economic reforms and the widespread implementation of market socialism in Chinese society, as the economic reforms have unfolded and they have been accompanied by significant changes in the health care system. In general, the people demanded for improving in health status and greater access to health care. It is an important issue that hospitals adopt external resource to improve health care delivery in the reform era. The primary purpose of the paper is to contribute to a concept of the framework that address the driving factors of outsourcing from the cost, resource-based, and organizational change perspectives of the health care organizations. Meanwhile, this paper illustrates that institutional factors and agency factors have caused outsourcing obstacles and problems in the outsourcing strategy. A case study approach was adopted with primary data collected through in-deep interview with six hospitals in China and secondary data aggregated from hospital documents and website. This paper presents a systematic exploration of the drivers and obstacles of outsourcing in China, and provides a framework that may guide health care organizations to develop strategic outsourcing plans, and to achieve outsourcing objectives.