醫療單位外包經營模式及其影響因素之探討

THE ROLES AND ASSOCIATED FACTORS OF OUTSOUCING MODEL IN MEDICAL INDUSTRY

陸梅珍(Mei-Chen Lu)

指導教授 ： 李 弘 暉

元智大學/管理學院/管理研究所/碩士(2006年)

摘要

由於全民健保總額預算的實施，醫療環境更加的動盪不安，以及醫院之間的競爭愈來愈激烈，醫院為求長期的生存與發展，必須更加重視經營型態及模式，醫療機構為了取得互補資源、降低成本、降低營運風險、達到經濟規模、強化現有資源，紛紛採取不同的策略以提高醫療服務品質，與加強競爭力。外包是單純及成效快速顯現的方法。鑑於臨床醫療單位的獨特性，醫療單位外包的策略，應有別於一般事務性，行政單位外包的目的，僅在於有效的控制成本，而更重要的目的是應建構在風險分攤-資金風險、業務風險、專業分工、專科經營、醫療品質等方面的提升，進而達到彈性運用能力、強化佔有率、差異化技術等無形的競爭優勢。
本研究以個案研究的方式討論醫院採行核心業務外包的策略、外包模式、外包業務、績效評估、服務品質、外包單位在執行過程與醫院及其它單位之溝通配合情形。在探討醫院採取外包策略的動機、服務品質、外包單位與醫院內其它單位之溝通配合情形這幾方面的主題時，採用與醫院高階主管面及承包單位主管深入訪談的方式，而在績效評估方面則以相關資料分析比較的方法探討外包前後的效益。
研究發現醫療單位外包的策略，不同於一般事業外包的目的，大多著重於成本領導策略，個案醫院經營者訂出組織不同的策略方針，依據醫療單位的單位特性，將醫療單位定位為事業單位組織，運用不同類型及層級作策略性的外包經營。打破核心事業不外包的迷思。另外研究發現外包商的角色及合約內容的設計是直接影響醫療單位外包經營績效的重要因素。

關鍵字

外包 ； 醫療單位 ； 經營策略

並列摘要

Medical environment is in an uproar over the new global budget policy of National Health Insurance. Moreover, due to the fiercer and fiercer competition between the hospitals, in order to ask long-term survival-ship and development, the hospitals must pay more attention to their operation and business model. The medical organizations, for obtaining complementary resources , lowering costs , reducing the operation risk , reaching economic scale , strengthening existing resources, adopt different tactics to improve medical care quality , and strengthen the competitiveness one after another . Outsourcing is one simple way that can immediately reach the business goals. In view of the uniqueness of the clinical medical operation unit, the tactics of outsourcing the business of medical operation unit should be different from those of outsourcing the general affairs in administrative units. They not only lie in effective controls of cost, but their more important purpose is to build, and to construct a mechanism to share in the risk - the risk of funding and business, to promote the improvement in professional division of labor, division of management among specialized departments, medical quality, etc.. So as to achieve intangible competition advantages of operation power, market share expansion, and differential technologies.
This research discusses by way of case study on a hospital that adopts the tactics of outsourcing its key business- the outsource model, the outsourced business, the performance and assessments, the service quality, and the workflow of the service provider, the communication and the cooperation between the hospital and the contractor. In probe into the motive of a hospital adopting outsourcing strategy, the quality of outsourcing service, the cooperation of outsourcing contractor and other units in the hospital, we interviewed the hospital’s and the contractor’s executives exhaustively. And we compare with relevant analysis in the performance to assess the outcome before and after the outsourcing.
The research shows that the strategy of outsourcing a medical business, unlike that of most outsourcings, mostly focuses on low-cost oriented tactics. The executives of the hospital under study draw up and organize different policies and different tactics according to the characteristic of each medical operation unit, orientate the medical unit as a business unit where different types and levels of outsourcings are applied.
It breaks the myth that the core business is not beyond the scope of outsourcings. Other findings of this research are that the role of the contractor and the contents of the contracts are the key factors that affect the performance and effects of the outsourced business.

並列關鍵字

Outsourcing ； Medical Industry ； Business Strategy

參考文獻

10. 范麗娟，深度訪談之簡介，戶外遊憩研究，Vol.7, No.2，頁25-35，1994。

6. Badri, M.A., Davis, D., Davis, D., “Operation Strategy,Environmental

28.盧瑞芬、謝啟瑞，2003年，「臺灣醫院產業的市場結構與發展趨勢分析」，經濟論文叢刊，31(1):107-153 (TSSCI) (第三屆王金茂醫管論文獎得獎作品)

2. Ahmed P. K., Hardaker G. and Carpenter M., “Integrated Flexibility-Key to Competition in a Turbulent Environment” Long Range Planning, 29, 4,pp.477-571, 1996.

5. Autrey, P. and Dennis T., “Competitive Strategy in the Hospital Industry”,Health Care Management Review, 11, 1, pp.7-14, 1986.