行政院衛生署桃園醫院多角化策略經營之研究

On the Management of Diversification Strategy of Tao-Yuan General Hospital, Department of Health

王偉傑(Wei-Jie Wang)

指導教授 ： 蘇喜

國立臺灣大學/公共衛生學院/醫療機構管理研究所/碩士(2009年)

https://doi.org/10.6342/NTU.2009.00007

摘要

多角化的績效衡量上甚不容易，短期的報酬率也並非判斷多角化成功與否的可信指標，因為進行多角化容易忽略公司原本的核心資源是否會被弱化，若多角化經營時機尚未成熟，則容易造成公司力量的分散。根據個案醫院多角化經營的時間觀察，15項多角化業務的發展時間在83年至97年期間，但多角化業務的開發執行績效受到管理者與主管機關的政策影響越大者，其績效滿意度受到第一線從業人員的認可越高。
區域級以上醫院多角化經營最主要之核心問題在於需靠自身的力量改善財務務結構，正本清源下，醫院的多角化經營應由全體人員產生共識，推動醫院內持續改善的服務品質以及自動自發學習新技能，如此才能使多角化新事業的推動得以持續進行，朝向健康與正面互動方向開拓，使醫病關係建立在預防醫學的領域上，如此以本業為出發的多角化經營才能夠真正有所成效與建樹。
再者，醫院的多角化經營層與醫院的本業經營層需分離，目前醫院高階管理者均為醫療專業人員，對於商業性醫務管理無法專注，對於醫療產業商業化的管理效果以健保總額效果出發，也缺乏適當的績效評估模式，無法有效評估及管理多角化事業。若能讓現任的管理者在醫療專業之外，擁有適當的醫務商業管理知識，了解當地的醫療環境及市場需求，以推動適當的多角化事業，可肩負署立醫院管理的重任是當務之急。
再者，目前各署立醫院在財務報表上可以上繳國庫的金額幾乎為零，但以財務報表來觀察，各家區域級以上的醫院其盈餘公績金總額在上億者十分普遍，以個案醫院總資產約48億的規模觀察，公積金餘額有2億多元，以營利公司的觀點來看，署立醫院無股東盈餘分配的情形下，公營事業設有股東盈餘的科目依法無據，主管機關應推動醫院財報公開資訊制度，莫讓公營追求社會福利醫院的財務狀況一直處在虧錢不賺錢的現象之中。主管單位對於公營餘款亦應強制繳回，以照顧更多弱勢病患，或在多角化業務的開拓上進行補助，以推展重大醫療政策所用。

關鍵字

多角化介面 ； 總額預算 ； 相關多角化 ； 非相關多角化 ； 署立醫院

並列摘要

Diversification strategies are used to expand hospitals' operations by adding markets, products, services, or stages of production to the existing business. The purpose of diversification is to allow the company to enter lines of business that are different from current operations. Formally the Bureau of Health Insurance introduced the “Global Budget System” as of 2004, all hospitals are
responsible for earning and debt for theirself. An updated look at the TaoYuan General Hospital 15 kind diversification performances the term of 1994-2008，
The thesis is able to validate the findings of policy depentment of global budget system about diversification as follows:
1.When the diversification is strategically related to the existing lines of business,it is links with policy,manager and the time.Diversification occurs when there is a good performances of strategic relationship between the medical
manager and medical profession have the business of consistency.
2. Diversification strategies are effected which diversification performances come from cognizeing difference and exist the effect of difference medical profession and medical manager diffical conflicting, let business conducts beter and beter.
3. Under relevant diversification of the global budget system, medical profession and medical manager have the same result,they have the same conducts.Under non-relevant diversification of the global budget system,medical profession and medical manager have the differical diversification result,because medical profession and medical manager have the problem of the agent system.

並列關鍵字

Porter’s diversification strategy ； global budget system ； relevant diversification ； non-relevant diversification ； hospital department of health

參考文獻

5.Drucker, P. F. (1995), Managing in a Time of Great Change, Truman Tally.Pittes.

8.Kamien, Michael E.(1975).”Competitive Advange, Creating and Sustaining Superior Performace”, New York, The Free Press.

9.Porter, Michael E., ‘Competitive strategy: Techniques for analyzing industries and competitors’, New York: Free Press, 1980.

10.Porter, Michael E., ‘The competitive advantage of nations”, N. Y.: Free Press, 1990.

11.Reed, R. & Luffman G.A ，1982，Diversification in British Industry in 1970’s，Strategic Management Jourmal，Vol.3，P303-314