醫療體系的擴張與其企業社會責任-以中國醫藥大學附設醫院在1995-2017年的策略發展為個案研究

The expansion of the health care system and its corporate social responsibility-A Case study of the China Medical University Hospital (1995-2017)

劉大任(Ta-Jen Liu)

指導教授 ： 邱瓊萱

臺北醫學大學/管理學院/醫務管理學系碩士在職專班/碩士(2018年)

摘要

本研究旨在探討全民健康保險於1995年實施後，個案醫院(中國醫藥大學醫療體系) 如何藉由強化急重症醫療能力，運用管理技術(例：降低管銷成本、改變就醫動線、加強服務管理、制定標準作業流程、持續投資設備人才、創造優質就醫環境等)，以使命及團隊領導力進而提升營運效率來克服財務危機，更以企業社會責任(例：協助臺灣921 大地震醫療照護並捐款賑災、承接南投縣信義鄉整合性醫療服務計畫照顧偏遠地區民眾、捐助桃芝颱風災民醫療與健保費用、帶領中部地區安全渡過SARS病毒肆虐危機)，來恪盡醫學中心職責發揮教學、研究、服務三 大使命，並且勇於承擔急症、重症、難症、罕見疾病之社會照護責任，在十年之間，積極協助營運狀況不佳的地區醫院轉型為中國醫藥大學體系醫院，逐步發展偏鄉醫療，建構起中國醫藥大學醫療體系網，適當的補足了醫療資源不足區域的醫療服務能量，發揮出有別於財團法人醫院、公立醫院的社會責任及角色，本研究著重在中國醫藥大學如何透過推動一連串的組織變革，以實踐以病人為中心的醫療使命，使醫院能夠自主經營，不造成社會負擔，並且將經營利潤共享於社會，藉此來印證學者的觀點及理論。本研究結果，中國醫藥大學附設醫院在1995-2017年的策略發展:1.成為臺灣中醫藥之領航者，加速中醫藥現代化及國際化、2.平衡區域醫療資源，建立中部先進醫療重鎮，鞏固大臺中最後的醫療防線、3.擴展醫療體系，校院永續成長、.建立服務精神、體現利他價值，綜觀臺灣現有醫院之歸類，可將醫院依經營型態、權屬類別區分為：公立醫院、公立醫學院校附設醫院、軍醫院、榮民醫院、機關附設醫院、財團法人醫院、宗教財團法人附設醫院、醫學院校附設醫院、其他法人附設醫院、私立醫院等型態，但不論何種組織架構、治理方式，醫院在臺灣均屬非營利組織，扣除公立醫院，多數均以董事會作為非營利組織內最高之決策單位，非營利組織董事會功能是否能發揮，由於私立醫學大學附屬醫院的治理權責少有研究探討，本個案為私立醫學大學同時設置附屬醫院之非營利組織，目前對於校、院一體之董事會治理研究甚少，希望透過本研究來彌補相關文獻之缺口。

關鍵字

醫療體系的擴張 ； 中國醫藥大學附設醫院 ； 企業社會責任

並列摘要

Title of thesis: The expansion of the health care system and its corporate social responsibility-A Case study of the China Medical University Hospital (1995-2017)
Author: Ta-Jen, Liu
Thesis advised by: Chiung-Hsuan, Chiu PhD
The purpose of this study is to explore how the case hospital (China Medical University Medical System) can strengthen the management of acute care medical services by using management techniques (such as reducing the cost of the production , changing the Line of medical treatment to strengthen the medical service and management, to develop the standard operating procedures, continue to invest in equipment , create a quality medical environment, etc.), to improve the operational efficiency, hope through to the mission and team leadership, could overcome the financial crisis and take the corporate social responsibility (for example, assisting 921 Taiwanese Earthquake medical care and take integrated health care services in Xinyi Town, Nantou County to take care of people in remote areas, donate medical and health insurance costs of typhoon victims in Taoyuan and lead the SARS virus crisis care plan) to fulfill the medical center Responsibilities To achieve the three missions of teaching, research and service, and take the social care responsibility of acute, severe, difficult disease and rare diseases. In 10 years, the case hospitals actively assisting the poor operation conditions will be transformed into hospitals of China Medical University system, Gradual development of rural medical care, build "China Medical University This system focuses on how "China Medical University" promotes a series of activities such as the promotion of a series of organizations through the promotion of health care services, Change, in order to practice the "patient-centered" medical mission, enabling hospitals to operate independently without social burden, and will be the operating profit, social sharing, this series of changes in order to prove the scholar's point of view and theory .
Looking at the classification of existing hospitals in Taiwan, the following types of hospitals can be distinguished according to the type of operation and the type of ownership: Public hospitals, hospitals affiliated to public medical colleges, military hospitals, Veterans General Hospital, hospitals attached to hospitals, hospitals of consortia, religious consortia Hospitals attached to medical institutions, hospitals attached to medical colleges, hospitals attached to other legal persons, and private hospitals. However, no matter what kind of organizational structure and management mode, hospitals are non-profit organizations. Results of this study are concluded as follows: firstly, to be the leader of traditional Chinese medicine in Taiwan, China Medical University took the leading roles to speed up the modernization and internationalization of Chinese medicine. Secondly, to balance regional medical resources, CMU established an advanced medical center in central China, and consolidate medical resources in Taichung. Thirdly, CMU expanded their vertical and horizontal integration,,sustained university’s growth, established of good quality of medical service, and finally reflected the value of altruism.
In Taiwan, with the exception of public hospitals, most of which are governed by the board of directors As the highest decision-making unit in the "non-profit organization", whether the functions of the board of non-profit organizations can play a role in influencing the development of organizations is very small. Due to the lack of research on the management rights and responsibilities of the affiliated hospitals of private medical universities, Affiliated Hospital of non-profit organizations, the current school, hospital board governance research very little hope that through this study to make up for the lack of relevant literature.

並列關鍵字

The expansion of the health care system ； China Medical University Hospital、corporate social responsibility

參考文獻

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