ISO 9000系列全院驗證對地區醫院經營策略之影響-以陽明醫院為例

Impact of ISO 9000 Series Hospital-wide Authentication to Business Strategy of Regional Hospitals Take Yangming Hospital as an Example

沈嵩程(Shen Sung Cheng)

指導教授 ： 許嘉文

國立中正大學/管理學院/企業管理學系/碩士(2013年)

摘要

台灣先進的醫療水準和親善的醫療服務，早已獲得世界肯定，英國《經濟學人》雜誌曾列出世界健康排名，台灣高居世界第2；瑞士洛桑學院的醫療保健基礎建設排名，台灣在55個國家中排名第13名；連諾貝爾經濟學獎得主克魯曼也曾盛讚台灣健保，甚至被譽為世界最好的制度之一。但光鮮亮麗的外表下，台灣的健保制度也讓國內的醫療生態產生急遽變化，根據行政院衛生署中央健康保險局民國102年公布的資料顯示，地區醫院由民國77年高峰期的837家銳減到現今的374家，幾年來已減了150家。
雖說國內現今的健保環境對於地區醫院相當不利，但目前仍有倖存者，盼這些尚存之地區醫院能永續經營，故本論文希望能歸納出地區醫院因醫院特性或環境因素不同下，藉建立有效管理制度、檢視改善機構體質之可行的經營策略，期盼能對於地區醫院的經營管理有所助益。
國際標準組織（ISO）為建立世界共通的品質標準，於1987年3月公佈ISO 9000系列國際品質管理與品質保證標準，引起世界各國的重視。我國製造業與營造業率先導入ISO後，改善公司體質與制度、降低成本增加生產力、提昇品質與市場競爭力及增加客戶滿意度等均有良好的成效。而當今健保制度，迫使醫療產業步入激烈競爭的時代，醫院唯有以滿足顧客的優勢為競爭前題，提供高品質醫療服務為生存對策。
本研究主要在探討個案醫院建立國際化ISO 9000系列品保制度的經驗，對於地區醫院現今的處境、ISO 9000和國內醫院評鑑的相關性、推行ISO 9000後的效益，經由文獻探討作詳盡的介紹，然後以個案醫院成功推行的心路歷程，藉由實際訪談彙整後，互相印證提供可行的經驗想法，相信將引領上進的醫療院所有所依循且為之受惠。

關鍵字

醫療品質 ； 人力資源 ； 地區醫院 ； 全院驗證 ； ISO 9000系列 ； 經營管理

並列摘要

The advancement of the quality of medical care and the friendliness of medical service in Taiwan have acquired recognition worldwide long ago. "The Economist” of U.K. listed Taiwan as the 2nd healthiest country in the world. In addition, IMD, Switzerland ranked Taiwan’s medical insurance infrastructure 13th out of 55 countries. Even the Nobel Economics Prize winner Mr. Paul Robin Krugman praised Taiwan’s medical insurance system as one of the best in the world. However, under the sugar coating, Taiwan’s medical insurance system has caused dramatic changed to its medical environment. According to the 2013 statistics from the Bureau of National Health Insurance, Depart of Health, Executive Yuan, the number of regional hospitals have decreased from a peak of 837 in 1988 to 374 as of today. Specifically, about 150 regional hospitals ceased to exist in the past few years.
It is fair to say that the present medical insurance system in Taiwan is hostile to its regional hospitals. Still, there are surviving ones trying to figure out ways to achieve perpetuity. This thesis hopes to systematically summarize the characteristics of and the environmental factors affecting regional hospital operations, so as to provide an operational strategy, of establishing effective management mechanism and operable infrastructure review guideline, beneficial to regional hospitals.
The International Standardization for Organization (ISO) announced in March, 1987, the ISO 9000 series of international quality management and quality assurance standard to establish a worldwide norm, and it has successfully attracted attentions from countries around the globe. Taiwan’s manufacturing and construction industries first introduced the ISO 9000 series and have acquired spectacular results in improving company infrastructure and regulations, lowering costs, increasing productivity and customer satisfaction, and raising overall quality and competing power. Taiwan's present medical insurance system has forced the medical industry to enter a highly competitive era. In order to survive, hospitals are required to satisfy customer needs by providing high quality medical service.
This research aims to examine the experience of establishing ISO 9000 series quality assurance system of individual regional hospitals. A thorough introduction to the status quo of regional hospitals, the relativity between ISO 9000 and the present hospital evaluation mechanism, and the benefit of introducing the ISO 9000 is also provided through literature study and analysis. Then, field interviews of hospitals that successfully introduced ISO 9000 are summarized and used for cross-examination, so as to provide operable guidelines for visionary hospitals to reference and benefit.

並列關鍵字

Human resources ； Regional hospitals ； The hospital authentication ； ISO 9000 series ； Quality of care ； Management

參考文獻

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