醫院策略與環境外部配適對績效影響之實證研究

A Study of Strategic Fit and Performance-External Fit between Strategy and Environment of Hospitals

彭彥瑋(Yen-Wei Peng) ； 陳柏元(Bo-Yuan Chen) ； 彭朱如(Tzu-Ju Peng) ； 林金賢(Chin-Shien Lin) ； 黃銘章(Ming-Chang Huang)

《醫務管理期刊》 6卷4期 (2005/12) Pp. 399-428

https://doi.org/10.6174/JHM2005.6(4).399

摘要

本研究之主要目的在探討醫院在不同的環境不確定下，採用不同的競爭與合作策略對醫院績效之影響，亦即環境與策略之外部配適對績效之影響。以醫院為分析單位，針對全國醫院進行調查，共收集100份有效樣本。實證結果顯示，當醫院面臨市場及醫療技術設備的快速變化時，就競爭策略而言差異化策略比低成本策略較能創造高績效。就合作策略而言，採用經濟式合作策略較能因應環境變化而創造較高的績效，反而強調與政府或公會學會之機構式合作策略績效較差。而當醫院面臨衛生主管機關對於相關法令制定或增修非常頻繁且難以預測時，就競爭策略而言低成本策略反而能創造較高的績效。另外當醫院的經營風險越高或營運壓力越大時，差異化策略將顯著的為醫院帶來正面效益。本研究除了在學術上提供一環境與策略配適對績效影響的實證案例外，實證結果亦能提供醫院管理者在制定策略時一參考的依據。

關鍵字

競爭策略 ； 合作策略 ； 策略外部配適 ； 醫療產業

並列摘要

Conducting by empirical study, this article aims at exploring the competitive strategies as well as cooperative strategies in Taiwan healthcare industry. Drawing from the theoretical perspective of strategic external fit, the alignments among strategy and external environments was proposed and tested. As the unit of analysis at hospital level, quantitative survey was used to collect primary data. 100 valid samples were gathered including medical centers, regional hospitals, and district hospitals. The results of regression model demonstrated that: (1) In terms of competitive strategy, when the perceived market change and technology change is high, differentiation strategy generates better performance than cost-leadership strategy does. In addition, when the regulatory environmental change is fast and unpredictable, cost-leadership strategy generates better performance than differentiation strategy does. (2) In terms of cooperative strategy, when the perceived market change and technology change is high, economic cooperative strategy generates better performance than institutional cooperative strategy does. Hopefully, the empirical results may provide the evidence for theoretical perspectives. As well, this article is expected to have practical implications for hospital executives in strategy formulation and implementation.

並列關鍵字

Strategic External Fit ； Competitive Strategy ； Cooperative Strategy ； Healthcare Industry

參考文獻

王俊文、葉德豐、陳紫郎(1999)。健保新時代醫療產業之生態與因應。醫院。32(2)，17-31。

白佳昇、張錦文(1994)。面對全民健保，醫院經營管理之因應策略。醫務管理期刊。27(2)，25-31。

李妮真、楊銘欽(1995)。醫院因應全民健康保險之可能策略調查。醫務管理期刊。28(5)，9-19。

李怡慶、何碧宜、張勝立、吳世望、蔡雅芳、黃銑扶(2002)。醫療機構策略性經營分析體系建構之初步探討。醫務管理期刊。35(4)，1-14。

李芳菁(2003)。醫學中心及區域醫院在健保制度變革下之競合策略研究(碩士論文)。國立陽明大學衛生福利研究所。