專科醫院營運模式及經營管理

The Operation and Management of Specialized Hospital

林鼎淯(Dian-Yu Lin)

指導教授 ： 林嬋娟

共同指導教授 ： 郭瑞祥

國立臺灣大學/管理學院/會計與管理決策組/碩士(2015年)

https://doi.org/10.6342/NTU.2015.01699

摘要

本研究目的在於闡述說醫療服務的提供者－醫療體系，其運作模式是承襲自百年以前以解決疫病、戰爭醫療後援等基礎架構，然而面對人口老化的大趨勢、醫療技術日新月異、人們對於醫療及健康生活的品質要求升高等挑戰如何因應？問題的答案有諸多解決的面向，而核心議題之一即如何提出有效率的治療模式？即最重要的疾病治療、解決病人問題的有效性，並兼具營運服務的成本及時間效率。
此研究方法在策略層面，不同於醫療原本以體系本身的改變作為著眼點，Porter提出VBC (Value-Based Competition)原則，認為理想與正確的醫療競爭應在於「為病患創造價值」，此「價值」之定義為醫療競爭之參與者每一元的醫療成本所能達成的醫療結果。(Michael Porter, 2006)；在營運層面，Christensen等提出將「破壞型創新」應用於醫療產業，從「節流」著手，改變供給面的成本，讓健保在維持品質的前提下能更便宜，讓更多人能負擔的起、使用的起(Christensen, 2009)。本研究以VBC原則及「破壞型創新」營運模式為探討醫療體系解決方案的基礎，並提出「專科醫院」的效率醫療模式做為正向例子作深入探討，兼具比較一般大型綜合醫院醫療模式的效率，並討論「專科醫院」在醫療服務的限制性。
結果及結論：「專科醫院」的效率醫療模式的確可能在疾病治療、醫療品質、病人安全、對病人的服務流程、醫療成本及整體社會的醫療資源支出等方面有效改善及提升。

關鍵字

醫療體系 ； 專科醫院 ； 價值競爭原則 ； 「破壞型創新」

並列摘要

Object: The whole medical system has been facing to update challenges from modern society, such as aging population, continually newly derived medical technology, and demand for high quality of medical service. However, the operation structure of medical system has been based on an ancient system from hundreds years ago, which was operated majorly for the purposes for public health (ex. Infection disease control) and for rear service for war. Herein, the major issue of medical system operation comes to find out the “Efficient model”, which consists of disease treatment, cure efficacy, with cost and time benefit.
Methods: The great challenges urge medical system to stab into vessels of solution. Instead of institutional evolution, Porter proposed a patient-oriented value system for revolution……Value-Based Competition (VBC). Strategy of VBC focuses on the creation of value and benefit for patients. The value could be measured by the health outcomes achieved per dollar of cost compared to peers(Porter, 2006) Inthe evolution of management and operation, the “Disruptive Innovation”, proposed by Christensen, could be applied on medical system as well. (Christensen et al. 2009) VBC and Disruptive Innovation are both theories to be utilized for the current study. Material evidence from “Specialized Hospital” was presented in the study, especially to compare the current general hospitals. The business model of “Specialized Hospital” was discussed in aspects of competitive analysis, strategy, medical efficiency, institutional operation, cost and finance, marketing modality and the limitation of development.
Results and conclusion: Business model of “Specialized Hospital” based on VBC and “Disruptive Innovation” provides improvement in disease cure efficacy, medical quality, patient safety, patient-oriented process value, medical cost and even overall consumption of medical resource. The current model is possible an efficient model for medical system revolution.

並列關鍵字

medical system ； Value-Based Competition (VBC) ； Disruptive Innovation ； Specialized Hospital

參考文獻

1. Bohmer, Richard, “The Rise of In-Store Clinics-Threat or Opportunity?” New England Journal of Medicine, vol.356, no.8, pp.765-68, 2007.

2. Charles B., Stabell and OysteinD.Fjeldstad, “Configuring value for competitive advantage: On chains, shops, and networks”. Strategic Management Journal, vol. 19, pp. 413–437, 1998.

3. Clayton M. Christensen, Jerome H.,Grossman and Jason Hwang,“The Innovator’s Prescription: A Disruptive Solution for Health Care”, McGraw Hill,2009.

4. Henry J., Kaiser Family Foundation, 2009.

8. Michael Porter and Elizabeth Teisberg, “Redefining Health Care: Creating Value- Based Competition, Client Distribution Services”, Client Distribution Service, 2006.