鑑於近年來醫療界所面臨的競爭及環境產生急劇的變化,在這瞬息萬變的環境中,使得原本各自為政的醫院紛紛尋求跨組織合作關係,期望提高對外在環境的可預測性及穩定性。本文主要探討醫院組織為因應環境變化所投入的跨組織合作關係,分別從理論及實務兩方面著手,期能從理論觀點中得出在實務上的涵意,以作為實務運作的理論基礎。在理論方面,以文獻探討方式回顧有關跨組織合作關係的定義、理論背景、動機及決定因素、類型、動態發展過程、及其優缺點等議題;在實務方面,則依據理論的涵意提出醫院之間可行的跨組織合作策略包括加入協會、聯合分擔服務、及聯合經營,其中聯合分擔服務又包括醫療及照護合作、人力資源及訓練合作、行政管理及其他服務方面的合作;聯合經營則包括租賃、多醫院系統、多機構系統及連鎖經營等。
The increasing competition and dramatic changes of surroundings have forced many hospitals which originally operated independently to cooperate with others in order to enhance their predictability and stability to cope with the external environment. The present paper aimed to investigate the interorganizational cooperative strategies adopted by most hospitals to tackle the changing society from both theoretical and practical perspectives. As for the theoretical aspect, literature of the interorganizational relationships was reviewed, including definitions, concept, background, determinants, types, dynamic developmental process, advantages and limitations. With regards to the practical applications derived from theoretical implication, three types of cooperative strategies were introduced, including association participation, service sharing and joint operation. The service sharing can be further divided into medical care service, human resources and training, administrative services etc. The joint operations include leases, multi-hospital systems, multi-institution systems and franchise hospitals.