臺灣博碩士論文加值系統

根據健保局全民健康保險統計(2011)指出，由於近年來受到國內人口日趨老化、醫療新科技的引進和對重症病患加強照護等因素影響，健保醫療費用大幅成長，保費收入長期不足以支應醫療費用支出，健保財務已面臨嚴重的考驗。
研究以量性研究之觀點，以醫院資源、競爭優勢、外包管理三大構面來驗證不同的醫療機構外包後對醫院之績效。本研究採用問卷調查法，以台灣地區醫院教學評鑑制度列為地區醫院以上層級之醫院為研究對象，視其醫院實際狀況來做問卷的填答；問卷發放509份，回收問卷數219份，扣除填答不完全、無效作答以及非高階管理者所填答的問卷數量27份，共計有192份有效問卷數，有效回收率為37.7%。
本研究結果發現不同的醫療院所在不同的醫院資源和競爭優勢下，對外包管理呈現正向關係；在不同的外包管理監控下，對外包績效也有正向關係。

According to the National Health Insurance Bureau of National Health Insurance (NHI) statistics (2011) pointed out that in recent years by the domestic population is aging, the introduction of new medical technology was to enhance care of ill patients, health insurance costs grew rapidly, and long enough to cope premium income medical expenses, health insurance has been facing serious financial challenges.
This study used quantitative perspective, including hospital resources competitive advantage, outsourcing management, three dimensions of the different medical institutions to verify the hospital's performance after outsourcing. The study also used questionnaires to evaluate teaching hospital in Taiwan as a regional hospital for the study, depending on the actual situation of the hospital to do the questionnaire; 509 questionnaires were released, got the 219 questionnaires, 27 questionnaires invalid, got a total of 192 valid questionnaires, the effective rate was 37.7%.
The study found that different hospitals have different hospital resources and competitive advantage under outsourcing management have the positive relationship, outsourcing management control and monitor well , are positively related to outsourcing performance.

目次
中文摘要 Ⅰ
英文摘要 Ⅱ
誌謝 Ⅲ
目次 Ⅳ
表次 Ⅵ
圖次 IX
第一章 緒論....................................... 1
第一節 研究背景.................................... 1
第二節 研究動機.................................... 3
第三節 研究目的.................................... 5
第四節 研究問題.................................... 5
第五節 研究限制.................................... 6
第六節 研究流程.................................... 7
第二章 文獻探討........................................... 9
第一節 外包相關研究................................ 9
第二節 影響外包管理之因素......................... 23
第三節 外包績效................................... 30
第三章 研究方法.......................................... 32
第一節 研究架構................................... 32
第二節 研究方法................................... 33
第三節 研究母群及樣本建立......................... 34
第四節 研究工具建立............................... 36
第五節 資料處理................................... 54
第四章 資料統計與分析................................. 59
第一節 描述性統計分析............................. 59
第二節 各變數構面間之相關分析..................... 73
第三節 迴歸分析................................... 76
第五章 結論與建議...................................... 102
第一節 研究結果與貢獻............................ 102
第二節 研究建議.................................. 107
參考文獻................................................ 110
壹、中文部分..................................... 110
貳、英文部分..................................... 112
附錄................................................... 118
附錄3-1 專家審查問卷............................ 118
附錄3-2 專家意見表.............................. 128
附錄3-3 正式問卷................................ 134

表 次
表2-1 國內外學者對外包定義之彙整表..................... 11
表2-2 國內外學者對外包的目的彙整表..................... 20
表2-3 醫院資源構面..................................... 26
表2-4 競爭優勢構面..................................... 28
表2-5 外包管理構面..................................... 30
表2-6 外包績效構面..................................... 31
表3-1 醫事服務機構統計表............................... 35
表3-2 問卷初稿題目表–醫院資源評估部分................. 36
表3-3 問卷初稿題目表–競爭優勢評估部分................. 37
表3-4 問卷初稿題目表–外包管理評估部分................. 38
表3-5 問卷初稿題目表–外包績效評估部分................. 39
表3-6 專家名單......................................... 41
表3-7 醫院資源分析結果................................. 45
表3-8 競爭優勢構面分析結果............................. 46
表3-9 外包管理構面分析結果............................. 47
表3-10 外包績效構面分析結果............................. 49
表3-11 醫院資源構面之預試信度檢定分析................... 50
表3-12 醫院競爭優勢構面之預試信度檢定分析............... 51
表3-13 外包管理構面之預試信度檢定分析................... 51
表3-14 外包績效構面之預試信度檢定分析................... 52
表3-15 預試量表信度..................................... 52
表3-16 正式問卷發放與回收統計表......................... 56
表3-17 有效樣本之期望值機率表........................... 56
表3-18 有效樣本之卡方檢定適合度分析檢定表............... 57
表3-19 正式問卷各變項之信度Cronbach’s αLPHa值檢定分析. 57
表4-1 有效研究樣本統計醫療機構特徵分佈表............... 60
表4-2 有效研究樣本填答者基本資料統計表................. 62
表4-3 各研究變項之均差值............................... 63
表4-4 醫院人力外包項目................................. 65
表4-5 醫院儀器/設備外包項目............................ 66
表4-6 人力外包項目資料統計分析-臨床醫療作業部分........ 66
表4-7 人力外包項目資料統計分析-輔助醫療作業部分........ 68
表4-8 人力外包項目資料統計分析-醫務行政與行政庶務作業部分 68
表4-9 儀器設備外包項目資料統計分析-臨床醫療作業部分……… 70
表4-10 儀器設備外包項目資料統計分析-輔助醫療作業部分………72
表4-11 儀器設備外包項目資料統計分析-醫務行政與行政庶務作業部分...72
表4-12 各研究構面相關係數表............................. 75
表4-13 儀器設備構面對外包管理構面之迴歸分析............. 77
表4-14 儀器設備構面對外包效益構面之迴歸分析............. 78
表4-15 病床數量構面對外包管理構面之迴歸分析............. 79
表4-16 人力構面對外包管理構面之迴歸分析................. 80
表4-17 整體醫院資源構面對外包效益構面之迴歸分析......... 81
表4-18 創新能力構面對外包管理構面之迴歸分析............. 82
表4-19 資訊整合構面對外包管理構面之迴歸分析............. 83
表4-20 醫療專業構面對外包管理構面之迴歸分析............. 84
表4-21 學習能力構面對外包管理構面之迴歸分析............. 85
表4-22 整體競爭優勢構面對外包管理構面之迴歸分析......... 86
表4-23 控制構面對外包績效構面之迴歸分析................. 87
表4-24 監督構面對外包績效構面之迴歸分析................. 88
表4-25 整體外包管理構面對外包績效構面之迴歸分析......... 89
表4-26 簡單迴歸分析之假設結果........................... 89
表4-27 複迴歸分析之假設結果............................. 94
表4-28 醫院資源與競爭優勢對整體外包管理之複迴歸分析 95
表4-29 醫院資源與競爭優勢對控制之複迴歸分析............. 96
表4-30 醫院資源與競爭優勢對監督之複迴歸分析............. 97
表4-31 外包管理對整體外包績效之複迴歸分析............... 98
表4-32 外包管理對顧客滿意度之複迴歸分析................. 99
表4-33 外包管理對成本之複迴歸分析...................... 100
表4-34 外包管理對品質之複迴歸分析...................... 101
表5-1 迴歸分析之假設結果.............................. 102


圖　次
圖1-1 本研究流程圖................................ 8
圖2-1 外包專案管理項目矩陣....................... 23
圖2-2 醫院管理理論與實務架構..................... 25
圖3-1 研究架構圖................................. 33

壹、中文部分
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