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  • 學位論文

探討醫院服務創新:醫學倫理與顧客價值整合性觀點

A Study on Service Innovation in Hospitals:Integrated Viewpoint on Medical Ethics and Customer Value

指導教授 : 邱文宏
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摘要


近年有關醫院管理相關研究文獻,多專注於醫療服務與管理、健保制度、醫療糾紛、醫療保健、醫療歷史等議題,較少探討醫院之服務創新。故本研究目的為以醫學倫理與顧客價值整合性五大觀點,探討醫院之服務創新內涵、類型與歷程發展,其中經由文獻歸納整理此五大觀點為倫理價值、功能性價值、快樂性價值、關係性價值與情境性價值。本文採單一產業個案導向之質性研究方法,針對各醫院醫療門住診服務點數申報點數前150大醫院中,醫學中心20家皆挑選,區域醫院與地區醫院主要各選前20大,共篩選60家為研究個案,透過次級資料蒐集與深度訪談,共蒐集536件創新事件據以發展個案資料庫,並以每一創新事件為分析單元,依類型比對、解釋建構、時間序列分析、以及程序邏輯模式進行資料分析。研究發現為:一、在整合性五大觀點下進一步歸納獲得18項創新類型(含45項創新細類);二、服務創新以「功能性價值」為核心價值,「情境價值」與「關係性價值」為輔之經營發展,而創新類型以醫療服務比例最高、友善醫療環境營造次之、國際關係佔第三位、e化科技服務佔第四位與研發服務佔第五位;三、醫院層級規模越大較注重功能價值之持續發展,醫院層級規模越小則較注重發展關係價值,而創新服務因區域不同各自發展特有模式;四、醫療業連結外界關係(政府、異業、產學)發展e化科技服務趨勢;五、政府政策與體制力量影響我國醫療業服務創新的發展歷程。

並列摘要


In researches literatures related to hospital management in recent years, most mainly focus on the issues of medical service and management, healthcare systems, medical disputes, medical care and medical history, with few investigating the service innovation in hospitals. Therefore, with the five integrated viewpoints on medical ethics and customer value, this study aims to investigate the connotation, types and development course of the service innovation in hospitals. After summarizing and analyzing the literatures, it obtained the five viewpoints: ethical value, functional value, happy value, relationship value and situational value. Based on the largest 150 hospitals in the number of outpatient and inpatient services points and registered points, this study adopted the single-industry case-oriented qualitative research method to select a total of 60 hospitals as cases study from all 20 medical centers, and 20 largest regional hospitals and 20 local hospitals. Through secondary data collection and in-depth interviews, this study totally collected 536 innovation events to form the case database, and conducted data analysis according to type comparison, interpretation construction, time series analysis and program logic model based on using each innovation event as an analysis unit. The study findings obtained are as below: (1) 18 innovation types (which including 48 sub-types) are obtained from further analysis based on the five integrated viewpoints; (2) In terms of the hospitals’ operation and development, their service innovation takes “functional value” as core value, supplemented by “situational value” and “relationship value”. In innovation types, the medical service takes the highest proportion, followed by friendly medical environment creation, international relation, E- technology service and R& D services in sequence; (3) The hospital with larger hierarchy scale pays more attention to the sustainable development of functional value, and the hospital with smaller hierarchy pays more attention to the development of relationship value, and the innovation services respectively develop their own unique pattern due to the different regions; (4) There is an E-technology trend in the development of medical industry connects with outside relations (such as governments, cross-industries and Industry-academia, etc.); (5) The government policies and systems affect the development course of our country’s medical service innovation.

參考文獻


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