急重症病患整合醫療照護服務提供之探討： 醫療價值鏈觀點

A Study on the Integrated Medical Care Services for Critical Patients: A Medical Value Chain Perspective

羅晴雯(Ching-Wen Lo)

指導教授 ： 嚴奇峰

中原大學/商學院/企業管理研究所/碩士(2017年)

https://doi.org/10.6840/cycu201700297

摘要

醫療照護的需求的改變，影響現今醫療體系中健康體系的發展策略，決定健康照護的價值「以病人為中心」概念是全球醫療照護的新典範。本研究聚焦在「醫療照護價值」中之「醫療體系內部科別彈性化」，亦即打破各科別專業主義，打造整合科別的醫療管理制度，在組織的運作階段偕同專業與分工兩功能，產出階段更符合供需期待。本研究經由文獻探討以 Michael Porter 提出的醫療價值鏈為主要理論基礎，找出醫療照護整合過程中與組織雙元俱存能力的關聯，發展出研究架構。以質性個案研究法探討個案醫院瞭解實行情況，經由資料收集與訪談分析，進而提出研究發現，推導出命題與子命題。

本研究以「跨科團隊運作」、「雙元俱存能力」與「績效衡量」三者作為主研究架構。跨科團隊所採用的編制、指揮、控制，影響組織的雙元俱存能力側重整合彈性或側重功能效率，對應彰顯在績效衡量面的病患滿意或醫療收入之上。 研究發現個案在急重症病患整合醫療照護服務提供「整合彈性」與「專科效率」兩者間調適下的發展現況，與個案醫院分別選擇「策略影響結構」「結構影響策略」的策略觀點。最後敘明本研究之相關限制並對未來研究提出建議。本論文屬於探索性研究，主要依據個案深入探討的結果進行論述，建議後續可針對相關主題進一步去驗證研究命題。

關鍵字

醫療價值鏈 ； 以病人為中心 ； 雙元俱存能力 ； 個案研究

並列摘要

Changes in the demand for medical care, influencing the development strategy of health systems in today's health care systems, and determining the value of health care. The patient-centered concept is a new paradigm for world medical care. This study focuses on the internalization of the medical system in the medical care value, that is, breaking the professionalism of various disciplines, creating a medical management system for integrating the subjects, and working with the division of labor in the operation stage of the organization. The output phase meets expectations of supply and demand. This study explores the medical value chain proposed by Michael Porter as the main theoretical basis, to identify the relationship between the integration of medical care and ambidexterity. Develop a research framework. Survey the case to understand the progress status, through data collection and in-depth interview, and then put forward proposition and subproject
This study is based on the "cross-team operation", "ambidexterity" and "performance measurement" as the main research framework. The ability of the team to develop, direct, control, affect the organization's ability to focus on flexibility or focus on efficiency, corresponding to patient satisfaction or medical income, which is manifested in performance measurement.
Finally, describe the relevant limitations of this study and make recommendations for future research. The paper is an exploratory study, mainly based on the results of in-depth discussion of the case, the proposed follow-up can be further related to the subject to verify the research proposition.

並列關鍵字

Value Chain ； Patient-Centered ； Ambidexterity ； Case Study

參考文獻

許士軍，1996。 定性研究在管理研究上的重要性 ，中原學報，第二十四卷第一期，頁 1-3。

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