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中小型醫院經營策略與營運績效之探討-以平衡記分卡觀點分析

Strategic Management and Hospital Performances in Small Medium Hospitals-From the Viewpoint of Balanced Scorecard

摘要


The new era of National Health Insurance has impacted the management of the small medium hospitals significantly. For the purpose of survival and maintaining good performance, the small medium hospitals need to adopt a suitable strategic management. The published literatures in the hospital performance are numerous but with more focus in the field of public and larger hospitals, very few of them discussed about the smaller hospitals. Previously, the measurement of hospital performance has been mainly based on the financial guideline. In this work, we investigated the relationship between strategic management and hospital performance in the different scaled small medium hospitals using the viewpoint of Balanced Scorecard(BSC). This project was a cross-sectional and non-experimental study with a hospital as the unit of analysis. We used an eleven-items questionnaire (Conant, 1990) to classify hospitals into four different strategic types: prospector, defender, analyzer and reactor. (Miles & Snow, 1978). We also used Kaplan & Norton's Balanced Scorecard to measure the hospital performance, which including 18-item questions for internal business process, innovation and learning, customer as well as financial perspectives. Two hundred and fifty questionnaires were mailed to the hospital CEOs with 103 were returned, representing a response rate of 41.2%. Factor analysis, Chi-Square test, ANOVA and Scheffe's test were used for the statistical analysis. The results of this study showed that 35.2% of the hospitals were analyzer, followed by defender (24.2%), reactor(24.2%), and prospector(16.5%), respectively. Regarding the influence of the hospital size on hospital strategies, we found that the larger the hospital is, the more the prospectors are (p<0.01). Hospitals using prospector strategies showed better internal business performances while comparing with reactors (p<0.01) On the other hand, defender hospitals had better financial performance comparing with analyzers (p<0.05). There were no significant findings in either innovation or customer perspectives. Our conclusion suggests that most of the studied hospitals are still analyzers due to the size of the hospitals. Prospector usually are larger hospitals and have better internal business performance, while other performance indicators remain unknown.

並列摘要


The new era of National Health Insurance has impacted the management of the small medium hospitals significantly. For the purpose of survival and maintaining good performance, the small medium hospitals need to adopt a suitable strategic management. The published literatures in the hospital performance are numerous but with more focus in the field of public and larger hospitals, very few of them discussed about the smaller hospitals. Previously, the measurement of hospital performance has been mainly based on the financial guideline. In this work, we investigated the relationship between strategic management and hospital performance in the different scaled small medium hospitals using the viewpoint of Balanced Scorecard(BSC). This project was a cross-sectional and non-experimental study with a hospital as the unit of analysis. We used an eleven-items questionnaire (Conant, 1990) to classify hospitals into four different strategic types: prospector, defender, analyzer and reactor. (Miles & Snow, 1978). We also used Kaplan & Norton's Balanced Scorecard to measure the hospital performance, which including 18-item questions for internal business process, innovation and learning, customer as well as financial perspectives. Two hundred and fifty questionnaires were mailed to the hospital CEOs with 103 were returned, representing a response rate of 41.2%. Factor analysis, Chi-Square test, ANOVA and Scheffe's test were used for the statistical analysis. The results of this study showed that 35.2% of the hospitals were analyzer, followed by defender (24.2%), reactor(24.2%), and prospector(16.5%), respectively. Regarding the influence of the hospital size on hospital strategies, we found that the larger the hospital is, the more the prospectors are (p<0.01). Hospitals using prospector strategies showed better internal business performances while comparing with reactors (p<0.01) On the other hand, defender hospitals had better financial performance comparing with analyzers (p<0.05). There were no significant findings in either innovation or customer perspectives. Our conclusion suggests that most of the studied hospitals are still analyzers due to the size of the hospitals. Prospector usually are larger hospitals and have better internal business performance, while other performance indicators remain unknown.

被引用紀錄


林靖傑(2013)。醫院評鑑制度的實施與檢討-以臺大醫院為例〔碩士論文,淡江大學〕。華藝線上圖書館。https://doi.org/10.6846%2fTKU.2013.00682
凃富籌(2014)。如何促進兒童發展聯合評估流程順暢-以新竹某醫院為例〔碩士論文,國立交通大學〕。華藝線上圖書館。https://doi.org/10.6842%2fNCTU.2014.00327
夏祥泰(2004)。商業智慧應用於醫院管理之研究—以區域級醫院為例—〔碩士論文,中原大學〕。華藝線上圖書館。https://doi.org/10.6840%2fcycu200400684
許 苗(2007)。公立醫院組織變革之研究—以臺北市立聯合醫院為例〔碩士論文,元智大學〕。華藝線上圖書館。https://doi.org/10.6838%2fYZU.2007.00118
徐正宜(2014)。醫院員工對組織文化、組織承諾及工作滿意度之分析--榮民醫療體系垂直整合模式下兩家分院為例〔碩士論文,長榮大學〕。華藝線上圖書館。https://doi.org/10.6833%2fCJCU.2014.00117

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