不同等級醫院其資源優勢、策略優勢與績效之關係

The Relationship between Resource Advantage, Strategic Advantage, and Performance under the Department of Health

蘇勳璧(Chin-Bih Su) ； 彭朱如(Tzu-Gu Peng) ； 鄧振華(Jen-Hwa Teng)

《醫務管理期刊》 2卷1期 (2001/03) Pp. 93-109

https://doi.org/10.6174/JHM2001.2(1).93

摘要

台灣當前的醫療產業正面臨前所未有的困境，經濟快速成長，醫療科技不斷進步，民眾教育水準提昇，醫療人力已達飽和，健保和自費項目開發有限，健保給付與衛生法規束縛重重，使著台灣醫療產業的變革正方興未艾，傳統醫療生態一一被瓦解，為應付此衝擊，醫療界正重新思考尋找新的策略和新的內部資源，而公立醫院在此波變革中有何風貌呈現呢？本文乃以衛署醫院為例研究公立醫院為因應此衝擊而勵精圖治的成效。本研究系以衛署醫院在資源優勢、策略優勢與績效間的關係中加以研究，期能針對資源優勢和策略優勢與績效關係，提出對衛署醫院績效競爭的建言。研究結果得出衛署醫院的績效，以區域醫院表現最優，準醫學中心次之，地區醫院最差。而不同等級醫院會採取不同的資源優勢和策略優勢，準醫學中心係採取服務專業型，區域醫院採取組織組合型和服務專業型，但以服務專業型醫院整體績效較優於組織組合型，地區醫院採取組織組合型、內部功能型、全面行銷型和服務專業型，其中以全面行銷型醫院的整體績效最優，而內部功能型醫院的整體績效最差。在採取相同資源優勢和策略優勢的醫院等級中，以區域醫院的整體績效最優，準醫學中心次之，地區醫院最差。所以衛署24家醫院的總體績效衡量結果，以區域醫院經營績效最優，故建議可將地區醫院升級為區域醫院，以創造衛署醫院整體經營績效的提昇，而區域醫院中，以採取服務專業型醫院績效最優，地區醫院宜採取全面行銷型會有較好的績效表現。

關鍵字

資源優勢 ； 策略優勢 ； 經營績效

並列摘要

This study took as its sample 24 hospitals under the Department of Health. The instrument for determining resource advantage and strategic advantage was designed on the basis of questionnaires presented in domestic and foreign research literature. Data was obtained by conducting a questionnaire survey of hospital managers. As for determine operating performance, the chief source was grading data provided by the central Taiwan office of the Department of Health. The content of this data included the eight items of pre-tax operating surplus, net contribution per person, net contribution per physician, patient satisfaction, average year-round bed occupancy rate, average daily inpatient person-days, and average daily emergency patient number. Factor analysis, cluster analysis, Chi-square test, correlation analysis, and single-factor multivariate analysis were used to organize the data. The following conclusions were derived.
If the eight performance indicators are used to assess the performance of 24 hospitals of different grades under the Department of Health, the results show that regional hospitals displayed the best business performance, followed by perspective medical centers, while local hospitals did the worst. Local should therefore be upgraded to regional hospitals in order raise the overall level of performance of hospitals under the Department of Health. Moreover, the performance of regional hospitals that had adopted a service specialization type approach was best, while regional hospitals that had adopted. a full marketing type approach also enjoyed relatively good performance.

並列關鍵字

resource advantage ； strategic advantage ； business performance