醫院非核心業務外包之評估—以中部某醫學中心救護車業務為例

The Evaluation of Outsourcing Hospital’s non-core Business：A Case Study of Ambulance Business of A Medical Center in Central Taiwan

陳耀賓(Yao- Pin Chen)

指導教授 ： 劉子琦

亞洲大學/管理學院/經營管理學系碩士班/碩士(2004年)

摘要

本研究主要是針對醫院非核心業務，救護車業務外包或自營為主題，目的在於進行醫院救護車採行委外或自營方案的比較，以為管理階層決策的參考。
本研究採個案研究方式，嘗試以中部某醫學中心醫院救護車業務為例，利用深度訪談法搜集救護車產業資料，輔以醫院內部救護車業務數據、外包商成本資料等，運用五力分析、SWOT分析、成本效益分析等方法，進行探討醫院救護車業務自營與外包的優、劣勢、利弊得失的評估，所得的研究結果如下：
一、救護車成本效益分析方面：
從淨營運現金流量可以看出，救護車業務自營的各年現金流量明顯大於業務外包的現金流量。再納入資金成本率(機會成本)因素後，從淨現値(NPV)的角度看救護車外包或自營成本效益分析，救護車業務自營亦優於外包。
二、救護車產業五力分析的結果：
民間救護車機構之設立門檻並不高，同業彼此之間競爭激烈，替代品的威脅度不大，購買者的議價力低，供應商具有高度的議價能力。
三、個案醫院救護車業務自營與外包的SWOT分析：
外包雖可達到組織精簡、減輕管理上負擔之目的，但是外包人員素質服務品質不易掌控、廠商配合度問題、須與外包廠商負連帶責任、重建內部作業代價花費將更高等將是醫院在採取外包作業可能面臨的隱憂。而自營則有專業醫護人員、設備的優勢，服務品質能獲得一定程度的保障，並可落實對民眾「提供卓越及全人醫療服務」的承諾，但是恐怕會引發救護車公司的聯合抵制、排斥。
四、醫療機構的價值鏈分析：
從醫療機構的價值鏈分析中發現，救護車業務雖然對醫院的盈餘助益不大，但是可從提高救護車業務服務品質，再藉由運送的機會，作為醫院免費的流動廣告，以達醫院的宣傳效果。

關鍵字

外包 ； 成本效益分析 ； 五力分析 ； SWOT分析 ； 價值鏈分析

並列摘要

This research is mainly to the non-core business of the hospital, ambulance affairs of outsourcing or self-operation, and it is on purpose to compare ambulance of original equipment with self-operation to provide references for management decision.
This research adopts case study way, trying to take some medical ambulance business of capital center in the middle part as an example, by using depth interview to collect ambulance industry information, adding with the data of ambulance affairs inside the hospital, and outsourcing factory cost information, making use of five-strength analysis, SWOP analysis, cost-benefit analysis and so on to discuss the superiorities, inferiorities, and the evaluation of advantages and disadvantages. The results are as followings:
1. The ambulance cost-benefit analysis.
From cash flow of net profit, the cash flow of self-operation ambulance affairs is obviously more than the cash flow of outsourcing. Adding with the factor of capital-cost rate opportunity cost, the cost-benefit analysis of outsourcing or self-operation in terms of NPV, the self-operation is superior to outsourcing, too.
2. The five-strength analysis’ result of ambulance industry:
Though the threshold of the establishment of private ambulance industry is not hard, high competition, low threat of substitute, low bargaining power for purchaser, supplier is still equipped with high bargaining ability.
3. The SWOP analysis of self-operation and outsourcing of the hospital in this individual case.
Although outsourcing can simplify the organization, and alleviate the burden of management; however, it is hard to control the quality of outsourcing staff and the service, the co-operation of factory owners, the related responsibility with outsourcing factory, and it will be a forthcoming disaster to rebuild inside operation if this hospital adopts outsourcing operation. On the contrary, self-operation has the superiority of professional medical staff, equipment, and the service quality can be ensured to certain extent which can keep the promise to people of “ providing excellent and human medical service.” Nevertheless, it may induce the united boycott, and repellence of ambulance companies.
4. The value chain analysis of medical organization:
From the value- chain analysis of medical organization, though ambulance affairs cannot create a great deal of profits for a hospital, it can be the free mobile advertising to promote the hospital by virtue of raising the service quality of ambulance affairs and transportation.

並列關鍵字

outsourcing ； cost-benefit analysis ； five-strength analysis ； SWOT analysis ； Value chain analysis

參考文獻

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