臺灣博碩士論文加值系統

由於全民健保等多項醫療政策的實施，造成醫療院所面臨前所未有的競爭。醫療環境的急遽的變化，使中小型醫療院所不堪虧損而紛紛關閉。醫療院所為求生存，不得不尋求解決之道。現今院方除了多角化之外，便是機構彼此間的策略聯盟，期能透過機構間的不同型態的策略聯盟而獲得效益，降低經營成本，以解決醫療機構日益減少的財務收益。
本研究主要將針對存在於醫療服務業中不同型態的策略聯盟模式，依據平衡記分卡模式(balanced scorecard model)，以問卷調查方式，針對參與策略聯盟的七家醫療機構之員工進行調查，試探討策略聯盟機構員工對策略聯盟關係及施行後績效改變之認知，及個人特性與醫療院所特性的影響。問卷樣本數為1200份，有效回收率為49.25%。
本研究之重要結果如下：
聯盟關係部分，院內員工對於醫院參與聯盟多採正面態度，但對於聯盟關係內容認知上則多半不清楚。員工個人因素之服務年資、職級別及部門別影響聯盟關係認知，而醫院參與聯盟之型態亦影響聯盟關係認知。至於對醫院參與聯盟後績效改變部分，員工對於內部流程面及顧客面改善認知較強，財務面及學習成長面改善認知不明顯。個人因素多半不影響員工對績效的認知，而醫院參與之聯盟型態為影響績效改變認知的主要因素。

Due to the enforcement of many health policies, such as National Health Insurance (NHI), hospitals are now facing unprecedented competitions. The rapid change of the environment makes many small hospitals close, and those striving to survive cannot but seek solutions for all these. In addition to the diversification of medical services, hospitals have started to make new agreements with other organizations. They expect that by forming various types of strategic alliances, hospitals can lower their costs and thus improve the getting-worse financial situation.
The major of this study is to inquire key factors that influence the hospital workers’ recognition of alliances relationship and hospital performance, based on the balanced scorecard model (BSC). 1,200 questionnaires were distributed to workers in 7 strategic alliance member hospitals, and 591 samples were retrieved. The effective response rate is 49.25%.
Major findings of this study are as follows:
Most hospital workers have positive attitudes toward hospitals’ joining the strategic alliances, but they don’t really have a clear view on the content of it. Individual factors such as past service years, ranking and department all have significant influences on their recognition of the alliance relationship. As for the evaluation of hospital performance, most workers believe that there is apparent improvement in customer perspective and internal business process. On the other hand, somehow they don’t think that joining alliances obviously affect the organizational growth, learning, innovation and the financial situation. To conclude, alliances’ structure is the key factor to affect the recognition of performance change.

第一章緒論…………………………………………………………….1
第一節 研究背景與動機…………………………….……………………1
第二節 研究問題………………………………………….………………3
第三節 研究目的……………………………………………….…………3
第二章文獻探討……………………………………………………….4
第一節 策略聯盟定義………………………….…………………………..4
第二節 策略聯盟動機理論………………………….……………………..6
第三節 醫療服務業策略聯盟動機…………………….………………..…9
第四節 策略聯盟型態…………………………………….………………10
第五節 策略聯盟之績效評估……………………………………….……17
第六節 影響策略聯盟成功的相關因素…………………….……………29
第七節 醫療服務業策略聯盟之相關實證研究…………….……………33
第三章研究設計….…………………………………………………..38
第一節 研究流程…………………………….……………………………38
第二節 研究假說…………………………….……………………………38
第三節 資料來源…………………………….……………………………39
第四節 信度與效度………………………….……………………………43
第五節 分析方法…………………….……………………………………47
第四章 研究結果………………………………………………………48
第一節描述性分析………………………………………………………48
第二節策略聯盟關係及參與聯盟後績效變動之差異分析……………54
第三節策略聯盟關係認知及參與聯盟後績效變動之複迴歸分析……57
第五章 研究討論………………………………………………………81
第一節 對策略聯盟關係認知部分………….……………………………81
第二節 對參與聯盟後醫院績效變動之認知部分…………….…………82
第六章 結論與建議…………………………………………………....86
第一節 結論………….…………………………………………………....86
第二節 研究建議………….………………………………………………87
第七章 研究限制………………………………………………………90
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附錄

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二 中文部分:
方麗鈞，省市立醫院"醫院醫療業務支援合作"模式建立之研究，中國醫藥學院醫務管理研究所碩士論文，民87年
王復蘇，醫院組織及最新發展策略，台灣博格文化事業有限公司，民86年
司徒達賢，「中小企業之策略聯盟」，經濟情勢暨評論，第二卷第三期，頁1-7，民85
司徒達賢，中小企業之策略聯盟，經濟情勢暨評論季刊,，第5卷，第3期，民85年
朱道凱譯，Robert S. Kaplan & David P. Norton著，平衡計分卡-資訊時代的策略管理工具
江敦雄，國內航空業發展策略聯盟成功關鍵因素，長榮管理學院經營管理研究所碩士論文，民87
江義平，台灣中小企業策略聯盟決策模式建構與分析之研究，中興大學企業管理研究所博士論文，民87
竹田志郎，國際策略聯盟，同文館，民81
吳安妮，績效評估新趨勢，會計研究月刊第133期，p11-16，民85
吳青松，「台灣資訊電子產業成功關鍵因素，公司能力與聯盟策略之實證研究」，民81產業科技研究發展管理研討會論文集，頁1-13，民81
吳青松，「台灣資訊電子業成功關鍵因素能力與聯盟策略之實證研究」，(一)塑造產業科技遠景，產業科技研究發展管理研討會論文集，民81，1-13
吳青松，「本國產業策略聯盟結構與績效之評估」，民80產業科技研究發展管理研討會論文集，民80
吳青松，「策略聯盟之國際發展趨勢」，經濟情勢暨評論，第二卷第3期，頁8-13，民85
吳思華，「交易成本理論在企業經營策略與組織管理上涵義」，管理新思潮，台北：中華民國管理科學學會，民79
李文芳，台灣南部地區中小型醫院策略聯盟之實證研究，成功大學工業管理研究所碩士論文，民86
李文芳，台灣南部地區中小型醫院策略聯盟之實證研究，國立成功大學工業管理研究所碩士論文，民86
李書行，”務實創新的策略性績效評估”，會計研究月刊第113期，p15-23，民84
沈意如，省立醫院經營策略之調適與定位，中國醫藥學院醫務管理研究所碩士論文，民87
林政道，台灣中小企業以策略聯盟創新知識技術之研究，東華大學企業管理研究所碩士論文，民87
邱柏松，國際策略聯盟在國內的現況與績效，經濟情勢暨評論季刊，第五卷第三期，民85
苗豐強，雙贏策略-苗豐強策略聯盟的故事，天下文化，民86
張威國，我國私立醫院連所經營之可行性分析-分析層級程序法之應用，中國醫藥學院醫務管理研究所碩士論文，民81
郭崑謨、張五岳，台商與大陸鄉鎮企業關係之發展--策略聯盟之需求與意向探討，行政院大陸委員會委託研究，民84
郭崑謨、黃營杉，中小企業特質、現代化策略與經營績效(Ⅱ)，行政院國家科學委員會研究報告，民85
彭朱如、王維元、張錦文，醫院對外合作策略與績效評估，醫院，31卷第2期，p32-44
彭康麟，半導體策略群組與其策略聯盟動機之研究，國立中興大學企業管理研究所，民87
曾鈺琦，購併企業之人力資源管理措施滿意度與組織氣候關係，中興大學企業管理研究所碩士論文，民87
黃同圳、黃瓊玉，「中小企業策略聯盟下組織管理策略之探討」，第二屆中小企業管理研討會論文集，頁1-11，民84
葉乃銘，醫院組織成員之工作滿足組織承諾及合作態度關係之研究-以成大、省南及奇美醫院為例，成功大學企業管理研究所碩士論文，民86
葉匡時、蔡敦浩、周德光，「策略聯盟的發展策略--交易成本觀點」，管理評論，第十二期，頁99-117，民81
廖國超、顏裕庭、牟聯瑞、黃明和、許素貞，全面醫療品質管理，偉華書局有限公司，民87
齊思賢譯，Benjamin Gomes-Casseres著，策略聯盟新紀元，先覺，民89
蔡正揚、許正郎，「運用策略聯盟促進技術引進之研究」，中華民國科技管理研討會論文集，pp.209-218，民81
謝國松，美國NAA公報議介-企業績效之衡量，會計研究月刊第113期，p28-34，民85
嚴建藏，省市立醫院連所經營之研究，中國醫藥學院醫務管理研究所碩士論文，民77