台灣醫療產業的組織合作：不對等合作關係運作機制之探討

陳端容

《台灣社會學》 3期 (2002/06) Pp. 119-162

https://doi.org/10.6676/TS.2002.3.119

摘要

在一個組織位階結構制度化的醫療產業中，權力與地位不平等的組織進行合作如何可能？本論文分析地位不對等的醫療組織對合作關係正面評價的影響因素。以自行設計之結構式問卷進行資料蒐集，輔以深入訪談，以地區教學醫院層級以上之128家醫院為研究對象，回收89家醫院問卷，回收率69.5%，深入訪談49家醫院主管，成功率55.1%。89家醫院共提出345對實質互動的合作關係。分析結果指出，擁有合作決策主導權，以及透過間接第三者推薦，都增加優勢組織對合作關係的認可，顯示權力支配原則是優勢組織管理不對等合作關係的重要基礎。不對等合作關係中的兩方對合作正面評價的影響因素不同，反映合作雙方在產業結構中強、弱不同的權力位階關係。研究結果支持了制度論者所提出組織行動是鑲嵌在制度環境中的權力關係與價值架構的論點，也對「社會鑲嵌」論述中有關第三者的策略性位置提供了部分證據。

關鍵字

醫療產業組織 ； 不對等組織合作 ； 醫院間合作關係

並列摘要

The central question of this paper concerns the possibility of cooperation between and among health service organizations that operate within the confines of extreme institutional stratification. To determine the grounds for partnership success, and to identify the benefits and barriers associated with these partnerships, we examined human resource transfers (n=345) at 89 hospitals. Data collected via questionnaires and interviews indicate that a) dominant organizations feel it is important to gain leadership positions in order to express positive evaluations of asymmetric cooperation, and b) successful instances of cooperation are generally established through social relationships-i.e., third-party recommendations. The concept of fairness in such exchanges has different meanings for the asymmetric partners, with symbolic gains often considered more important than financial gains. We suggest that future research in this area requires a strong focus on hospital stratification.

並列關鍵字

health service organization ； asymmetric cooperation ； inter-hospital cooperation

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