社會網絡影響公私協力運作成效之研究：以台灣中醫與牙醫健康保險總額支付委員會為例

A Study on the Impact of SocialNetworks on Operational Performance of Public- Private Partnership: Evidence from the Chinese Medical and Dental Global Budget PaymentCommittees in Taiwan

王光旭(Guang-Xu Wang)

《行政暨政策學報》 53期 (2011/12) Pp. 65-113

https://doi.org/10.29865/PAP.201112.0003

摘要

公私協力的運作機制反映了集體行動的特質，然對於運作良窳的評估，行動者間關係所造成的影響往往在分析中被忽視。健保總額支付委員會是站在執行總額預算制度第一線的公私協力單位，也是執行總額政策環節中，健保局、醫事團體與其他相關代表最重要的溝通平台，對於其運作效能的評估，自然有其管理上的重要意涵。本文利用陳敦源（2008）健保局委託研究案的資料，對於牙醫與中醫總額支付委員會協力機制運作良窳觀感的影響因素進行分析。在該報告中，陳敦源（2008）已經透過四個總額支委會的資料，驗證了制度環境的條件如果愈完善，對於支付委員會此一協力機制運作績效的觀感也會愈正面。作者依據本文研究目的，先透過因素分析進行變數上合理的調整，繼之控制上述制度變項，並加入社會網絡變項及決策行為、決策影響力等變項進行分析，再一次檢視是否會改變原有的預測，並進一步檢視社會網絡的變項，是否會影響委員對於支付委員會運作良窳的觀感。分析結果顯示，社會網絡的變項對公私協力機制的成效均產生顯著的影響，其反映透過對委員彼此間關係的管理，會有助於改善中醫與牙醫總額支付委員會的運作成效。

關鍵字

公私協力 ； 社會網絡 ； 健保總額支付委員會 ； 社會鑲嵌性 ； 集體決策

並列摘要

Public private partnership (PPP) is a collective action rather than an individual option. In literature, PPP can be symbolised as a collaborative network which is formed between the public bodies and private sectors, based on a shared commitment to achieve a desired public policy outcome. For understanding the operational performance of PPP it is important to understand as to how people work together and the factors to influence the collective action. Studies demonstrate that decisions are not made in isolation but they are the products of influence and confluence of social correlates. Social network studies of decision making focus the research analysis on the dynamic social interactions between actors embedded in collective action scenarios. This study attempts to apply social network analysis to study the impact factors associated with the operation performance of the Chinese Medicine and Dental Global Budget Payment Committees. In regard to research methods, social network questionnaire survey has been used to collect data. In conclusion, despite the factors of institutional environment, the analysis shows that social networks of these committee members are matter for the operational performance of the committees.

並列關鍵字

public private partnership (PPP) ； social network ； Global Budget Payment Committee ； social embeddedness ； collective decision-making

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