跨組織合作影響因素之研究─以代理理論探討台灣醫院為例

Agency Theory and the Determinants of Interorganizational Cooperation – The Case of Taiwanese Hospitals.

李佳蓁(Chia-Chen Lee)

指導教授 ： 黃佑安

國立暨南國際大學/管理學院/經營管理碩士學位學程在職專班/碩士(2012年)

摘要

台灣醫療產業，在環境上面臨到全民健保的產生和給付制度的改變，使醫院經營者面臨到許多競爭和挑戰，因此當考慮是否將醫院內醫療科別採取自行發展或跨組織合作，已成為目前的重要課題。本研究利用代理理論的目標不一致、資訊不對稱、風險認知差距和監督成本，作為醫院內醫療科別採取自行發展或跨組織合作的探討因素。並希望對於未來有意研究醫療組織合作相關議題者或是能給醫院決策者，提供一套初步的評估工具，方便對於醫院內醫療科別自行發展或跨組織合作時作為決策參考依據。因此，本研究之目的如下：
一、跨組織合作中，進行跨組織合作的科別，有何種特性？
二、代理關係對醫院內醫療科別跨組織合作的傾向何影響？
研究結果顯示：無論資訊不對稱程度高低和風險認知差距大小皆會採取跨組織合作，是由於醫療產業和一般企業有所不同，醫院和跨組織合作單位的人員，都必須在醫院體制下工作，並不是由跨組織合作單位所擁有，醫院內各醫療科別都必須遵守醫院的規範，而受到高度的控制，所以即便是資訊不對稱高和風險認知差距大，也會採取跨組織合作。目標不一致和監督成本與過去的研究發現並無明顯差異，若目標不一致和監督成本之影響程度低，則可採取跨組織合作。

關鍵字

跨組織合作 ； 代理理論 ； 目標不一致 ； 資訊不對稱 ； 風險認知差距 ； 監督成本

並列摘要

In modern medical industries of Taiwan, hospitals must face lots of different competitiveness and challenges with the poignant changes of benefit policies in National Health Insurance and it becomes a matter of utmost importance to decide whether to collaborate with each other in different medical organizations or to insource more efficiently. Therefore, we propose Agency Theory (an objective-conflict, asymmetrical information, risk perception discrepancy and supervision cost) in this study to discuss and analyze the differences between inter-organizational cooperation and insourcing in hospitals. It has a high probability that the policymakers of the hospitals or researchers would adopt these results as an initial evaluation to make a decision of whether to choose inter-organizational cooperation or insourcing as their main tactic. The main objectives of this research are:
1. The characteristics of medical departments in inter-organizational cooperation
2. Any likelihood of applying Agency Theory to the inter-organizational cooperation in the hospitals
The aftermath of the study revealed that hospitals would adopt the strategy of inter-organizational cooperation, disregarding the extent of the asymmetrical information and risk perception discrepancies. This demonstrated that general enterprises are too different from medical industries because all the staff in the respective hospitals must work according to the policies in there and are highly restrained by the regulations issued by hospitals. Hospitals would still introduce the strategy of inter-organizational cooperation even with larger differences in asymmetrical information and risk perception discrepancies. Results showed that it had no significant differences in objective-conflicts, risk perception discrepancies and supervision costs in comparison to those in the past. If business achievements of the hospitals have poor relationship with objective-conflicts and supervision costs, it is highly suggested of adopting strategy of inter-organizational operation.

並列關鍵字

Inter-Organization ； Agency Theory ； Objective-Conflict ； Asymmetric Information ； Risk Perception Discrepancy ； Supervision Cost

參考文獻

一、中文部份

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