從「零和競爭」到「價值取向競爭」——臺灣血液透析市場分析與破壞式策略建議

藉由深度的S-C-P分析，本研究分析了臺灣血液透析市場的現況，並進一步發現政府政策是形成臺灣血液透析市場的市場結構、市場行為及市場績效的關鍵因素。此外，本研究更發現，目前臺灣的血液透析市場陷入了零合競爭的情況，在零合競爭下，產業內一方的收益來自於犧牲另一方的利益，換句話說，臺灣透析產業陷入了成本轉嫁的惡性循環，透析服務者、透析患者及政府皆藉由轉嫁成本至他方來提高自身利益。為了改善目前的現狀，本研究提供了兩個策略概念：（1）退出策略——退出目前由全民健保局所控制的產業環境，並創立一個不受健保局規範的新競爭環境；（2）競爭重心轉移策略——將競爭重心由原本的「成本轉嫁」轉換成「價值提升」。本研究基於前述的兩個策略概念提出一個具體策略——引進居家夜間血液透析（home nocturnal hemodialysis），居家夜間血液透析對透析服務者、透析患者及社會整體的優點在研究中進一步的分析，本研究也將探討目前實施居家夜間血液透析所受到的限制。

關鍵字

臺灣血液透析市場；零合競爭；價值取向競爭；產業分析

並列摘要

Through a thorough S-C-P analysis of dialysis industry in Taiwan, this research provides an in-depth picture of the industry. It further identifies that government policy is the key determinant of the overall industry structure, market conduct as well as market performance. Unfortunately, this research also reveals that the current industry is in zero-sum competition where one industry player’s gain is at the other’s expense. All industry players, including dialysis service providers, dialysis patients and government are trapped in the cost-shifting vicious circle with little hope to step out. To the very situation, this research proposes two strategic concepts to improve the current phenomenon: (1) the option out strategy—withdrawing from game under NHI’s control and start a new game field free from NHI regulation and planned economies; and (2) competition focus switching strategy—switching the focus of competition from cost reduction to patient’s value creation. One concrete strategic recommendation has been made in the later part of the thesis—home nocturnal hemodialysis serving both for the purpose of optioning out and competition focus switching. The advantages of HNHD, to dialysis service providers, to the patients and to the overall society as well, are analyzed in details. The current restrictions to execute HNHD in Taiwan are also discussed in the research.

並列關鍵字

industry analysis ； zero-sum competition ； value-based competition ； Taiwan dialysis industry

參考文獻

林佳燕，〈血液透析與腹膜透析病患之長期醫療成本分析〉，國立臺灣大學醫療機構管理硏究所碩士論文，2009年。

吳佳穎，〈透析總額制度對腎臟專科醫師執業行為的影響〉，國立臺灣大學碩士論文，2008年。

許績天（Ji-Tian Sheu），連賢明（Hsien-Ming Lien），〈賺得愈少，洗的愈多？——臺灣血液透析治療的誘發性需求探討〉（”Physician Induced Demand and Hemodialysis Treatment in Taiwan”），經濟論文叢刊Taiwan Economic Review，35:7，國立臺灣大學經濟學系，2007

蔡文正（Wen-Chen Tsai），龔佩珍（Pei-Tseng Kung），徐約翰（Yueh-Han Hsu），廖凱平（Kai-Ping Liao），〈不同經營特性洗腎機構之洗腎服務滿意度〉(“Patient Satisfactions of Hemodialysis Care in Different Operation-Type Health Care Organizations)，《醫務管理期刊》，Vol.5 No.1 (2004/03):101-119

行政院衛生署，全民健康保險醫療費用協定委員會，第166次委員會報告案投影片〈門診透析服務支付標準之合理性探討及醫療院所管理情形〉，2010年。http://www.doh.gov.tw/CHT2006/DM/DM2_p01.aspx?class_no=109&now_fod_list_no=11208&level_no=3&doc_no=78402

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從「零和競爭」到「價值取向競爭」——臺灣血液透析市場分析與破壞式策略建議

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