公立醫院商店街整體外包過程與效益之個案探討

本案勘屬國內公立醫院商店街整體外包做法之首例，期間經過構想形成、採購作業創新與持續管理工作之歷練，遂成為國軍外包案例之典範，並於民國九十年榮獲國家醫療生技品質委員會入圍獎項。醫院設立商店衛，在國內各大醫院素有所聞，惟因醫院的規模、地理位置及外包方式之不同，造就出不同的經營模式商店街。规模較小醫院可能僅只於成立便利商店或雜貨捕，大醫院則需要較大规模的商店街以符合住院病患的各種生活需求；地理位置近市中心、週邊生活機能發達者，可以結合週邊資源，院方較不需要設置商店衛，民眾也因為選擇性較多，亦未必會使用院內設置之商場。商店街外包模式為分包出租及統包（含管理統包及整體設計統包二種），分包出租模式為醫院對所有商店均做好隔間裝修，各店家依需求狀況分別向醫院辦理承租，此種情形醫院需耗費不少人力管理；而商家自行佈置門面，商場整體性亦較難維持。統包模式之商店街，為國內較少見之作法，尤其在醫院的發展更是如此。管理統包的商場為商場內之隔間及設計均已由醫院完成，再委由一家廠商承包所有商場的承租管理；而整體統包的商場是委由一家包商完成商店衛整體之設計（含美化）、招商、承租及管理等工作，醫院僅需辦理選商作業及督導商店街成立聯合管理中心，並要求及監督管理中心之管理狀況，這種外包模式，應屬較能符合國內公立醫院之做法；其原因包含，能精簡採購作業流程、減少醫院管理人力投入、節省國家預算投資、分攤公務維持預算等，均為此統包策略之重要效益與成果。

關鍵字

商店街；整體外包

並列摘要

This is the first case of total outsourcing of the market center in a public medical center in Taiwan, It is a fine paradigm as it combines generating new ideas, new purchasing procedures and administrative style. It has also received the award of excellence from the National Biotech and Health Care Development Committee in 2001. Market center within hospitals is very common in Taiwan, nevertheless, it is different from outsourcing methods due to hospital capacity, location and operating strategies. A convenient store or general stole is sufficient to provide convenience in small hospitals, however, a more functional market center is necessary for patients in larger hospitals. Hospitals in downtown areas are easy to access local facilities; hence, a more functional market center within the hospitals may not be required for serving patients. Market center has three types of outsourcing methods including separated outsourcing and total outsourcing (including overall design and simple management total outsourcing) in Taiwan. The hospital market centers usually use price-oriented competition when outsourcing, as well as providing finished renovations for all rental spaces. All vendors can apply for rental space depending on individual business requirements. In this separated outsourcing model, hospitals must spend more manpower to manage rental matters, and it becomes difficult to maintain consistency across all stores in the market centers as each vendor may change the internal designs of the rental spaces. There are less total outsourcing cases found in Taiwan than separated outsourcing. It involves renting all stores' space in market center to one vender, as well as providing finished renovations for all rental spaces in simple total outsourcing. For overall design total outsourcing, it involves renting of all stores in the market center to one vendor who handles all aspects of management including store design, rental, and overall management. The role of the hospital is merely to establish a management consultant team to monitor the performance of market administration, Total outsourcing is a suitable method for public hospitals in Taiwan as it minimizes manpower, decreases government expenditure, as well as hospital administration cost.