公立醫院組織變革之研究—以臺北市立聯合醫院為例

A Study on the Organizational Reform of Public Hospitals – A Case Study on Taipei City Hospital

許 苗(Miao Hsu)

指導教授 ： 賴慧文

共同指導教授 ： 李弘暉

元智大學/管理學院/管理研究所/碩士(2007年)

https://doi.org/10.6838/YZU.2007.00118

摘要

近年來醫療環境在變化，外在中央健保局實施總額預算支付制度、新興大型醫院崛起與企業化經營競爭，內部面臨政府財政困難，公務預算緊縮，每年補助款大幅縮減；在這種市場競爭衝擊之下，公立醫院無不都在汲汲思考如何減少營運衰退走向自給自足，及減少對政府補助款依賴，走向企業永續經營管理模式。
臺北市立醫院位置分散在各行政區域，大小規模、性質及各院專攻之重點不同，協調處理不一致，爲了增加經濟規模、減少重覆醫療浪費，共享技術、設備、行政管理、教育等以提升效率，增進傳染病防治能力，使市民健康、福利獲得充分保障。因此九十四年一月一日將十家市立醫院合併成一家，整合規模是國內外衛生醫療界從未有之經驗，組織再造工程（reengineering）引起社會矚目，醫院合併迄今二年，話題仍經常為各界所議論。
本研究針對臺北市醫在組織重整後，高低階層員工之認知、顧客服務、醫療品質與營運上，藉由文獻、收集實務資料、訪談，探討其變革前後經營效率及正負面之影響。期望提供醫療機構爾後做決策等之參考。

關鍵字

公立醫院，組織再造，變革

並列摘要

The medical environment is changing in the recent years. Externally, the Bureau of National Health Insurance has deployed the policy of “global budgets or expenditure limits,” and new, large hospital enterprises have emerged. Internally, government funding and budgets shrinking, and annual subsidies are drastically reduced. Under such fierce competition and market impact, no public hospitals are exempt from researching methods to reduce loss, become self-sufficient, reduce the need for governmental support, and achieve the management of business continuity.
There are several districts of Taipei City Hospitals scattered in places, which are different in terms of scale, nature, and discreet, and lack proper coordination. Expanding market financially, saving medical resources, such as technologies, facilities, and education those activities allow better efficiency, increase the capacity for disease control, and ensure public well-being, the ten separate city hospitals were unified into one single entity on January 1, 2005. Such merge was a first case medical field throughout the world, “Re-engineering” process would attracted world wide attention. After two years since the merger,
discussions of event still take place.
Our study focuses on Taipei City Hospital’s post-reform phase. We wish to discuss how high-level and low-level faculties think about the merger, and literature analysis, information collection, and deep interviewing to discuss the changes and impacts after the reformation on customer service, medical quality, and operation. It is hoped that the findings would serve as reference for decision makers in
medical organizations.

並列關鍵字

public hospitals, organizational reform, transformation

參考文獻

47.臺北市政府衛生局(民93a)，《臺北市政府衛生局編制修正案彙編》。

44.臺北市立聯合醫院基金年報（民96）。

20.徐享達(民90)，「公立（營）機構績效不振因素分析兼論署立醫院突破困境因應之道」，《醫務管理期刊》，第2卷，第3期，頁.47-59。

8.成之約（民94），「政府部門組織改造與民營化政策對勞動與社會影響之探討」，國政研究報告，財團法人國家政策研究基金會，臺北。

18.Michael, H. ,＆ Stanton, S.(1995). The Reengineering Revolution,New York N.Y.：Harper Collins.