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研究生:羅任珮
研究生(外文):Jen-Pei Lo
論文名稱:地區醫院垂直整合護理之家:以資源相依之觀點
論文名稱(外文):Community Hospitals'' Vertical Integration into Nursing Facilities: A Resource Dependence Perspective
指導教授:葉淑娟葉淑娟引用關係
指導教授(外文):Shu-Chuan Jennifer Yeh
學位類別:碩士
校院名稱:國立中山大學
系所名稱:醫務管理研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:英文
論文頁數:63
中文關鍵詞:資源相依理論護理之家垂直整合
外文關鍵詞:resource dependence theoryvertical integrationnursing facility
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研究目的
本研究目的在於透過資源相依理論,探討地區醫院垂直整合護理之家的相關環境與組織因素。
資料來源
本研究使用的資料來源有三:中華民國醫院協會所製作的九十一年度台灣地區醫院年鑑、中華民國長期照護專業協會編印的2002年版的台閩地區長期照護資源名冊、以及各縣市政府主計室所公佈的九十一年度人口結構統計資料。
研究設計
本研究採橫斷式設計,研究時間為九十一年。分析單位為地區醫院,樣本數總計達248家。由於依變項為二分法,所以採用羅吉斯迴歸利用SPSS 10.0統計軟體來進行分析。
主要發現
本研究結果發現有提供洗腎和居家護理服務且位於老年人口比例較高和競爭程度較高區域的地區醫院進行垂直整合護理之家的可能性也較高。而佔床率、復健科服務、呼吸治療科服務、高科技設備、醫師病床比率、與護士專科護理師病床比率對於地區醫院是否垂直整合護理之家並沒有顯著的影響。
結論
並非所有的地區醫院都適合垂直整合護理之家。就環境因素而言,位於老年人口比例較高和競爭程度較高區域的地區醫院比較可能進行垂直整合護理之家。而從組織層面來說,有提供洗腎和居家護理服務的地區醫院對於垂直整合護理之家有顯著的影響。
Research Objective
The purpose of this study is to profile market factors and organizational characteristics associated with community hospitals’ vertical integration into a nursing facility through the lens of resource dependence.
Data Sources
Data for this study were drawn from three sources: the 2002 secondary data collected by Taiwan Community Hospital Association (TCHA) on a regular yearly basis; the 2001 secondary data compiled by Taiwan Association of Long-Term Care Professionals (TALTCP); and the 2002 area-based population data gathered by Department of Budget, Accounting, and Statistics (DOBAS) in local governments respectively.
Study Design
This study is a one-year cross-sectional design with community hospitals as the unit of analysis. A sample of 248 community hospitals was the focus of this study. Since the dependent variable is dichotomous, the logistic procedure was used to fit the regression. The analysis was performed using the statistics software, SPSS 10.0.
Findings
A higher ratio of the elderly, a high degree of competition, and the provision of dialysis and home care services spur community hospitals on to vertical integration into a nursing facility. Occupancy rate, the rehabilitative service, respiratory care service, high technology, the ratio of MDs to staffed beds, as well as the ratio of RNs and LPNs to staffed beds bear no reference to community hospitals’ vertically integrating a nursing facility.

Conclusion
Not all community hospitals are equally good candidates for stepping into the avenue to nursing facility. Given the environmental factors, community hospitals situated in highly competitive district areas with a higher ratio of the elderly are more likely to vertically integrate a nursing facility. In terms of organizational factors, the provisions of dialysis service and home care service have a significant relationship with the likelihood of vertical integration.
Acknowledgement i
Abstract iii
Chinese Abstract v
Table of Contents vi
List of Tables vii
List of Figures vii
Chapter 1 Introduction 1
Introduction 1
Purpose of the Study 4
Chapter 2 Literature Review 5
The Definition of Hospital-based Nursing Facilities 6
Integration in US Health Care Industry 7
Chapter 3 Theoretical Framework 12
Resource Dependence Theory 12
Conceptual Framework 17
Hypotheses 19
Chapter 4 Methodology 26
Study Design 26
Unit of Analysis 26
Sample 27
Measurement 27
Data sources 33
Data analysis 34
Chapter 5 Results 37
Descriptive Statistics 37
Univariate Statistics 40
Logistic Regression Analysis 42
Chapter 6 Discussion & Conclusion 48
Major Findings and Discussion 48
Study Limitations 53
Implications 54
List of References 56
List of Tables

Table 4-1 Variables, Operational Definitions, and Data sources 31
Table 5-1 Descriptive Statistics for the Variables of Interest (n=248) 39
Table 5-2 Univariate Statistics for Vertical Integration (n=248) 42
Table 5-3 Results of Logistic Regression Analysis for Community Hospitals’Vertical Integration into a Nursing Facility 43
Table 5-4 Summary of the Hypotheses and Results 47

List of Figures

Figure 3-1 Conceptual Framework 19
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