目標:本研究之目的在瞭解市立綜合醫院員工(不同層級與職別)對不同民營化型式之看法及未來意向,做為在推動既有醫院民營化時,爭取現有員工之認同與支持,並減少員工抗拒之參考。方法:本研究以台北市所有市立綜合醫院之員工(分為主管與非主管,非主管再區分為醫師、護理人員、其他醫事技術人員及行政人員等子群)採比例分層抽樣共計1,054人,以問卷方式進行調查。調查時間為86年9月,回收771份,回收率73.1%。本研究所調查公立醫院民營化可行模式,共有五種型式:首長經營制、半開放制度、部份出租或委託經營、整體出租或委託經營及成立公設財團法人。結果:調查結果顯示,對於市立醫院民營化之態度,員工普遍認同半開放模式及較不認同整體出租或委託模式與公設法人模式,而對於部份出租或委託以及首長經營模式,醫師/主管與其他職別員工/非主管兩方持不一致的態度。此亦可由其留下繼續服務之意願獲得佐證。結論:從市立醫院各層級或職別員工之角度而言,有利於市立醫院未來績效之民營化模式,卻可能因其對工作環境之變革較大,使得員工一致不認同,如整體出租或委託模式,而另有模式不僅利於未來績效,也亦受員工一致支持,如半開放模式。因此,對既有公立醫院之民營化,如何兼顧民營化之優點與現有員工之認同與支持、創造民眾、 員工及政府三贏之結果,實需審慎規劃。
Objective: This study intends to understand the opinion and attitude of municipal general hospital employees toward different privatization models. This information will provide a reference for gaining consensus and support and lessen the potential for resistance among the employees during the privatization implementation phase. Methodology: This study surveyed the opinions of Taipei City General Hospital employees (management vs. non-management, non-management is further divided into physicians, nursing staff, medical technicians, and administration staff) using proportional stratified sampling, involving 1,054 people. The survey was conducted in September 1997 and 770 responses were received with response rate of 73.1 %. This study investigated five privatization models: deregulation, semi-open, partial leasing/contracting-out, that leasing/contracting-out, or non-profit foundation. Results: According to the survey responses, most employees favor semi-open model and least favor total leasing/contracting-out model or non-profit foundation model. As for partial leasing/contracting-out or deregulation, the opinions' diverge between physicians vs. all others as well as management vs. non-management. This result could be supported by the desires of employee to stay on after privatization. Conclusion: Privatization models such as total leasing/contracting-out that are more advantageous to the hospitals in terms of performance are not favored by the employees, perhaps because these models also bring the most disruption to the work place. On the other hand, models such as semi-open that will bring improved performance are also favored by the employees. Therefore, in order to obtain the advantages of privatization and support among current employees, as well as to ensure the public, hospital employees and the municipality all winners, careful deliberation on privatization is a necessity.
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