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研究生:詹文正
研究生(外文):Weng-Cheng Chan
論文名稱:醫療業務委外因素對醫院委外合作模式影響之研究
論文名稱(外文):The Impact of Outsourcing Factors of the Medical Activities on the Clinic Service Cooperative Model
指導教授:黃銘章黃銘章引用關係
指導教授(外文):Ming-Chang Huang
學位類別:碩士
校院名稱:靜宜大學
系所名稱:企業管理研究所
學門:商業及管理學門
學類:企業管理學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
論文頁數:104
中文關鍵詞:快速進入市場範疇經濟規模經濟閒置資源組織學習股權涉入醫療產業策略聯盟委外合作
外文關鍵詞:outsourcing cooperationeconomy of scaleeconomy of scopefirst-mover advantageorganizational learningequity participationHealthcare IndustryStrategic Alliance
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由於國內健保制度的影響,醫院面臨外在環境的改變,加以同業間的競爭,導致國內醫療市場走向「高度競爭,低獲利率」的時代,醫療產業跨組織合作的經營模式或策略聯盟已經是一項不可忽視的趨勢,且合作的範圍由以往非核心業務擴大到醫療核心業務的合作,而委外合作策略就是其中的一種方式。有鑑於此,本研究欲探討醫療業務委外因素對醫院委外合作模式之影響。
研究方法分為兩個步驟,首先以個案訪談來分析構面之間的關係,以四家醫院為訪談的對象;接著以定量研究法中之SPSS分析模型的統計結果,導出模式之配適度為何,進一步推導出構念間結果。樣本以中華民國九十二年十月中央健康保險局在約中之地區醫院級以上之醫院名單資料為研究對象,包含了醫學中心23家,區域醫院80家與地區醫院434家,有效問卷為63份。
研究結果顯示,政府政策因素對於醫院委外合作時其股權涉入程度之影響不顯著。規模經濟因素對於醫院委外合作時其股權涉入程度之影響不顯著;範疇經濟因素對於醫院委外合作時其股權涉入程度存在正向影響;醫療儀器設備之更替性因素對於醫院委外合作時其股權涉入程度之影響不顯著。在快速進入新市場因素方面對於醫院委外合作時其股權涉入程度存在顯著影響。而閒置資源、組織學習與過去委外經驗等因素對醫院委外合作時其股權涉入程度之影響均不顯著。
For the public health and insurance policies, most of the hospitals in Taiwan were face the institutional environment and becoming high competition, low profit margin to survive. Under the circumstances, the interorganizational collaboration strategy has become a tendency for decision makers of hospitals to cope with its firms. The range of collaboration extends from non-core services, such as safety-guard, cleanliness, restaurant etc., to core activities and business issues. However, outsourcing is one of the strategies of collaboration. Thus, in this research we examined the relationships between the outsourcing factors of the medical activities and the Clinic Service Cooperative Model.

This study contends two stages of research methods: qualitative method and quantitative method. Firstly, case study aims to revise the conceptual framework and proposed relevant hypotheses observed from this study. We interviewed four directors who are in charge of the hospital. Secondary, the models were proposed to clarify the relationships among the constructs. Mailing questionnaire that is developed and completed will collect pilot study quantitative data. According to the hospital accreditations administered by the central government in Taiwan, conceptual all of the 547 hospitals composed our sample and the effective respondents were 63 sets. Regression analysis and SPSS were conducted for the variable in each model.

The empirical results demonstrate several findings from the hospital-based as follow: the higher the intent of first-mover advantages, the lower equity participated. The higher the extent of economy of scope, the higher the equity participated. But there exists no significant correlation among the government medical policy, economy of scale, organizational slack and the organizational learning.
目 錄

中文摘要……………………………………………………………………..I
英文摘要……………………………………………………………………. II
目錄………………………………………………………………………….IV
表目錄……………………………………………………………………….VI
圖目錄……………………………………………………………………….VII

第一章 緒論………………………………………………………………….1
第一節 研究動機………………………………………………………….2
第二節 研究問題與研究目的.....................................................................3
第三節 研究流程與論文結構…………………………………………….5

第二章 文獻探討…………………………………………………………….6
第一節 委外與醫療委外………………………………………………….6
 第二節 醫療業務委外合作的動機……………………………………...12
第三節 委外合作的模式………………………………………………...27
第四節 研究架構…...……………………………………………………31

第三章 研究方法…………………………………………………………...34
第一節 研究假說………………………………………………………...34
第二節 操作性定義與變數衡量………………………………………...41
第三節 資料收集………………………………………………………...45
第四節 資料分析方法…………………………………………………...48
第五節 信度與效度檢定………………………………………………...49

第四章 研究結果與討論…………………………………………………...53
第一節 敘述性統計分析………………………………………………...53
第二節 醫院醫療業務委外科別與股權涉入模式之敘述性統計分析...55
第三節 醫療業務委外因素與股權涉入模式之實證分析……………...63

第五章 結論與建議………………………………………………………...68
第一節 研究結論………………………………………………………...68
第二節 管理意涵………………………………………………………...77
第三節 後續研究建議…………………………………………………...80
第四節 研究限制………………………………………………………...84

參考書目……………………………………………………………………...86
附錄一:問卷………………………………………………………….……..96
附錄二:醫療事業項目委外調查表………………………………………..100
附錄三:醫療業務委外合作訪談紀錄……………………………………..101
表目錄

表2-1-1 委外與外購之差異............................................................................7
表2-1-2 策略聯盟定義彙總表........................................................................9
表2-1-3 醫院外包前十名項目調查表..........................................................11
表2-2-1 進入市場順序之分類......................................................................20
表2-3-1 聯盟類營定義彙總表......................................................................29
表3-3-1 各變項之操作性定義......................................................................43
表3-4-1 本研究問卷構面與題項彙整表......................................................46
表3-6-1 卷量表內部一致性檢定與信度表..................................................50
表3-6-2 構面驗證性因素分析......................................................................51
表4-1-1 本資料之敘述性統計結果..............................................................54
表4-2-1 各院醫療業務委外科別、股權涉入模式之敘述性統計結果......55
表4-3-1 業務委外因素各變項間相關係數分析表......................................63
表4-3-2 醫療業務委外因素與委外股權涉入模式關係之分析..................65
表5-1-1 本研究假說檢定結果彙整表..........................................................70
圖目錄

圖2-1-1 價值活動自製外包關係圖…………………………………………7
圖2-1-2 競爭優勢-策略易受傷害矩陣圖…………………………..……..8
圖2-1-3 自製與外包關係……………………………………………..……..9
圖2-2-1 企業成長策略動態邏輯….………………..……………………...17
圖2-3-1 資源與交易條件互動的假設示意圖……………………………..30
圖2-4-1 本研究架構......................................................................................33
壹、中文部分
1.方世榮、尹文婷與許書銘(2003),「關係策略群組織探討」,,第一屆新世紀優質企業理念與價值創造研討會論文集;輔仁大學管理研究所,頁111-128。

2.王俊文、葉德豐與陳紫郎(1999),「健保新時代醫療產業之生態與因應」,醫院雜誌,32(2),頁17-31。

3.王惠美 (2001),「國際代工夥伴關係下之資產專屬性與能力建構-供應商觀點分析」,國立台灣大學國際企業研究所博士論文。

4.王棋 (2000),「醫院外包管理構築模式之研究:整合性觀點」,國立中山大學人力資源研究所未出版論文。

5.古永嘉,企業研究方法,民85,華泰書局。

6.司徒達賢 (1996),「中小企業之策略聯盟」,經濟情勢暨評論,第2卷第3期,頁1-7。

7.余建志 (2003),「組織內外部因素、進入模式及競爭策略與海外市場經營績效之關聯性研究」,國立成功大學企業管理研究所碩士論文。

8. 吳典龍 (1997),「台灣醫療業策略聯盟之研究」,中原大學工業工程研究所碩士論文。

9. 吳欣席、鄭博文(2003),「地區基層醫療策略聯盟模式與可行性之探討-以雲林地區之基層醫療聯盟為例」,第三屆提升競爭力與經營管理研討會論文集,頁15-35。

10.吳思華 (1990),管理新思潮,台北:中華民國管理科學學會出版,頁 109-139。

11.吳思華 (1993),「迎接由競爭邁向合作的時代」,世界經理文摘, 83期, 頁40-51。

12.吳思華 (2000),策略九說,臉譜出版社:台北,三版。

13.吳美凰 (2004),「回任協助方案對回任人員離職傾向影響之研究」,靜宜大學企業管理研究所碩士論文。

14.吳國基 (1993),「醫院外包之研究」,中國醫藥學院醫務管理研究所碩士論文。

15.李文瑞 (2000),「廠商特性對台商海外投資之股權結構的影響」,管理學報,第十七卷,第二期,頁321-342。

16.邱雅萍 (2002),「多國企業在台子公司知識來源型態影響因素之研究」,國立政治大學企業管理學系博士論文。

17.金傳蓬 (2003),「知識特性與社會特性對於人力資源活動外製程度之影響」,國立政治大學企業管理學系博士論文。

18.張正二 (1994),「醫院行銷與公共關係」,醫院,19(3),頁34-35。

19.張音、楊澤泉與張瓊文 (2002),「醫院採行合作經營方案之研究」,台大管理論叢12(2),頁 211-239。

20.張笠雲與朱永昌 (1994),「組織場域的浮現:台灣醫療產業的研究」,中央研究院民族學研究所集刊,第77期,頁157-192。

21.張善湧 (2003),「人力資源活動外包之委外關係與委外績效相關性之研究」,國立中央大學人力資源管理研究所碩士論文。

22.張錦文、譚開元、黃佳經 (1986),醫院管理,水牛出版社。

23.許瞻桂 (2001),「國際企業海外投資進入模式適用情境之分析-交易成本觀點」,國立屏東商業技術學院學報,第三期,頁179-196。
24.連雅慧 (民91),「學習型組織構面與組織績效—以台灣一科技公司為例」,商管科技季刊,第三卷,第四期。

25.都中秋 (2003),「進入策略與市場導向配適對市場績效影響之研究-以國中、小學教科書市場為研究對象」,中原大學企業管理學系碩士論文。

26.陳文哲 (1986),「外包作業,好處多多」,現代管理月刊,第1期。

27.陳玲媛 (2002),「台商量販百貨店赴大陸投資所有權進入模式之研究」,大葉大學國際企業碩士論文。

28.陳慧芳與楊美雪 (1998),「台灣地區醫院外包支出費用及績管理分析研究」,嘉南學報,24 期,頁64-74。

29.陳馨文(1991),「醫院合作之相關研究」,國立陽明醫學院醫務管理研究所碩士論文。

30.湯明哲與李吉仁 (1999),「外包與專業製造商雙贏的策略」,遠見雜誌,162期,頁172-175。

31.黃明和 (1998),「健保對區域醫院帶來的衝擊即因應之道」,教學醫院現況與展望國際研討會,頁10-13。

32.黃銘章 (2002),「影響代工供應商與顧客間夥伴關係因素之研究-以台灣電子資訊產業為例」,國立政治大學企業管理學系博士論文。

33.黃銘章與楊淑珍 (2003),「策略聯盟之資源構成與競爭優勢關係之研究」,中華管理學報,第四卷,第二期,頁59-75。

34.黃俊英(民80),多變量分析,台北:中國經濟企業研究設。

35.蔡志宏 (2001),「巨變時代下中型醫院策略聯盟之研究」,中國醫藥學院醫務管理學研究所碩士論文。

36.羅芳怡 (2002),「競爭優勢來源、網絡中心性及績效之研究—以參與醫療聯盟群之醫院為例」,靜宜大學企業管理研究所碩士論文。

37.羅淑君 (2003),「股權參與對策略聯盟價值的影響」,國立成功大學國際企業研究所碩士論文。
貳、 英文部分
1.Ahuja, G. (2000), “The duality of collaboration:inducements and opportunities in the formation of interfirm linkages,” Strategic Management Journal, Vol.21, pp.317-343.

2.Allen, J.W. and G.M., Phillips (2000), “Corporate Equity Ownership, Strategic Alliances, and Product Market Relationships,” The Journal of Finance, 6, 2791-2814.

3.Amit R. and P. J. H. Schoemaker (1993), “Strategic Assets and Organizational Rent, Strategic Management Journal, Vol.14, pp.33-46.

4.Anderson, E. and H. Gatignon (1986), “Modes of Foreign Entry: A Transaction Cost Analysis and Propositions,” Journal of International Business Studies, 17, pp. 1-26.

5.Argyris and Donald Schon (1978), “Organizational Learning: A Theory of Action Perspective,”MA: Addison-Wesley Publications.

6.Barney J. (1991), “Firm Resources and Sustained Competitive Advantage,” Journal of Management, Vol. 12, pp. 49-68.

7.Bidault, F., C. Despres and C. Butler (1998), “The drivers of cooperation between buyers and suppliers for product innovation,” Research Policy, Vol.26, pp.719-732.

8.Chi, T. (1994), “Trading in Strategic Resources:Necessary Conditions, Transaction Cost Problems, and Choice of Exchange Structure,” Strategic Management Journal, Vol.15, pp. 271-291.

9.Chung S., H. Singh, K. Lee (2000), “Complementarity, status similarity and social capital as drivers of alliance formation,” Strategic Management Journal, Vol.21, pp.1-22.

10.Combs, G.J., and D.J. Ketchen, Jr. (1999), “Explaining interfirm cooperation and performance:Toward a reconciliation of predications from the resource-based view and organizational economics,” Strategic Management Journal, Vol.20, pp.867-888.

11.Contractor and Lorange (1988) , “Why Should Firm Cooperate? The Strategy and Economics Basis for Cooperative Venture,” Cooperative Strategic in International Business, Lexingion
Books.

12.Contractor FJ. (1984), “Choosing Between Direct Investment and Licensing: Theoretical Considerations and empirical tests,” Journal of International Business Studies, 11(3): 9-12.

13.Das, K.T. and B-S Teng (1998), “Resource and risk management in the strategic alliance making process,” Journal of Management, Vol.24, No.1, pp.21-42.

14.Das, T.K. and B-S Teng (2000), “A resource-based theory of strategic alliances,” Journal of Management, Vol.26, No.1, pp.31-61.

15.Day S. George and Robin Wensley (1988), “Assessing advantage: A framework for diagnosing competitive superiority,” Journal of marketing, Vol. 52, pp.1-20.

16.DiBella, Anthony J; Nevis, Edwin C; Gould, Janet M (1996), “Understanding organizational learning capability,” The Journal of Management Studies, 33( 3), pp.361-379.

17.Dodgeson, M. (1993), “Organizational Learning: A Review of Some Literature,” Organization Studies, 14(3), pp.375-394.

18.Duncan, R. and Weiss, A. (1979), “Organizational Learning: Implications for Organizational Design,” Research in Organizational Behavior, Vol. 1, pp.75-123.

19.Dunning, J.H. (1980), “Toward and Eclectic Theory International Production: Some Empirical Test,” Journal of International Business Studies, Vol. 11, pp. 9-31.

20.Dyer, J.H. (1997), “Effective Inter-firm Collaboration: How Firms Minimize Transaction Value,” Strategic Management Journal, Vol.18, pp.553-556.

21.Dyer, H.J. and H. Singh (1998), “The relational view:Cooperative strategy and sources of interorganizational competitive advantage,” Academy of Management Review, Vol.23, No.4, pp.660-679.

22.Eisenhardt, M.K. and C.B. Schoonhoven (1996), “Resource-based view of strategic alliance formation:Strategic and social effects in entrepreneurial firms,” Organization Science, Vol.7, No.2, pp.136-150.

23.Elias Mazzawi (2002), “Transformational outsourcing,” Business
Strategy Review, Volume 13 Issue 3, pp 39-43.

24.Erramilli, M.K. and C.P. Rao (1993), “Service Firms’ Choice: A modified Transaction-Cost Analysis Approach,” Journal of Marketing, Vol. 57, pp. 19-38.

25.Farr, C.M. and Fischer, W.A. (1992), “Managing International High Technology Cooperative Projects,” R&D Management, Vol. 22, No. 1, 1992, pp. 55-67.

26.Fottler, M.D., Schermerhorn, J.R., Jr., Wong J. and Money, W.H., (1982) “Multi-institutional arrangements in health care: Review, analysis, and a proposal for future research,” Academy of Management Review, Vol.7, pp.67-79.

27.Foxman, N. (1994), “Succeeding in Outsourcing Cultivate the Outsourcing Relationship,” Information System Management, Winter, pp. 77-80.

28.Ginn, G.O. and Young, G. J. (1992), “Organizational and environmental determinants of hospital strategy,” Hospital and Health Services Administration, 37(3): 29-37.

29.Glaister, W.K. and P.J. Buckley (1996), “Strategic Motives for International Alliance Formation,” Journal of Management Studies, 33:3, pp.301-332.

30.Golder and Tellis (1993), “Pioneer Advantage: Marketing Logic or Marketing Legend?” Journal of Marketing Research, 30, 2, pp.158–171.

31.Gulati, R. (1995), “Does Familiarity Breed Trust? The Implications of Repeated Ties for Contractual Choice in Alliance,” Academy of management Journal, 38, No 1, 85-112.

32.Gulati and Singh (1998), “The Architecture of Cooperation:Managing Coordination Costs and Appropriation Concerns in Strategic Alliances,” Administrative Science Quarterly, pp.781-814.

33.Haeckel, S. H.and R. L. Nolan (1993), “Managing by Wire,” Harvard Business Review, 71(5), pp.122-132.

34.Hamel, G. (1991), “Competition for Competence and Interpartner Learning Within International Strategic Alliances,” Strategic Management Journal, Vol. 12, pp. 83-103.

35.Hamel, G., Y.L. Doz and C.K. Prahald (1989), “Collaborate with your competitors and win,” Harvard Business Review, Vol.67, No.1, pp.137-139.

36.Harrigan, K.R. (1988), “Joint Venture and Competitive Strategy”, Strategic Management Journal, Vol. 9, pp. 141-158.

37.J. M. Pennings, Harry Barkema and Sytse Douma (1994), “Organizational Learning and Diversification,” Academy of Management Journal, Vol. 37, No.3.

38.Kerin Roger A., P. Rajan Varadarajan (1992), “First-Mover Advantage: A Systhesis, Conceptual Framework, and Research Propositions,” Journal of Marketing, Vol. 56, pp. 33-52.

39.Kim, W.C. and P. Hwang (1992), “Global Strategy and Multinationals Entry Mode Choice,” Journal of International Business Studies, pp. 29-53.

40.Knoke, D. and Janowiec-Kurle, L. (1999), “Make or buy: The externalization of company job training,” Research in the Sociology of Organizations, Vol.16, pp.85-106.

41.Kogut, B. and H. Singh (1988), “The Effect of National Culture on the Choice of Entry Mode,” Journal of International Business Studies, Fall, pp. 411-432.

42.Kogut, B. (1988), “Joint venture: Theoretical and empirical perspectives,” Strategic Management Journal, Vol. 9, No. 4, pp.319-332.

43.Kumar, V. and V. Subramaniam (1997), “A Contingency Framework for the Mode Entry Decision,” Journal of World Business, 32(1), pp. 53-72.

44.Labbs, Jennifer J. (1993), “Successful Outsourcing Depends on Critical Factors,” Personnel Journal, pp. 51-60.

45.Leiblein, J. Michael and Douglas J. Miller (2003), “An empirical examination of transaction- and firm-level influences on the vertical boundaries of the firm,” Strategic Management Journal, Vol.24, No.9, pp.839-859.

46.Lieberman, M.B. and D.B. Montgomery (1988), “First-Mover Advantage,” Strategic Management Journal, 9, Summer, pp. 41-58.

47.Lieberman (1987), “Excess Capacity as a Barrier to Entry: An Empirical Appraisal,” Journal of Industrial Economics, 35, 607–627.

48.Makadok R. (1998), “Can First-Mover Advantages Be Sustained in an Industry with Low Barriers to Entry/Limitation,” Strategic Management Journal, Vol. 19, pp. 683-696.

49.McFarlan, E. W. and R. L. Nolan (1995), “How to Manage an IT Outsourcing Alliance,” Sloan Management Review, Winter, pp.9-23.

50.McGill, Michael E., John W. Slocum, Jr., and David Lei (1992), “Management Practices in Learning Organizations,” Organizational Dynamics, 21(1), Summer, pp.5-17.

51.Meyers, P. W. (1990), “Non-linear Learning in Technological Firms,” Research Policy, 19 (2), pp.97-115.

52.Morgan, G. and Ramirez, R. (1983), “Action Learning: A Holographic Metaphor for Guiding Change,” Human Relations, 37(1), pp.1-28.

53.Oliver E. Williamson (1981), “The Modern Corporation: Origins, Evolution, Attributes,” Journal of Economic Literature, Vol XIX, pp. 1537-1568.

54.Penrose, Edith T. (1959), The Theory of the Growth of the Firm, John Wile, New York.

55.Pisano, G.P. (1989), “Using Equity Participation to Support Exchange: Evidence from the Biotechnology Industry,” Journal of Law, Economics and Organization, 5, No 1, pp.109-126.

56.Porter, M.E. and M.B. Fuller (1986), “Coalitions and Global Strategy, Competition in Global Industries,” Edited by Michael E. Porter, Harvard Business School Press, Boston, Massachusett, 1986s, pp.315-343.

57.Quinn, J.B. and F.G. Hilmer (1994), “Strategic Outsourcing,” Sloan Management Review, Summer, pp.43-55.

58.Quinn, B.R(1999), “Strategic outsourcing:Leveraging knowledge capabilities,” Sloan Management Review, Summer, pp.9-21.

59.Rakich, J. S., Longest, B. B. and Kurt Darr, J.D. (1992), Managing Health Services Organizations.

60.Robert, P.W. and Greenwood, R. (1997), “Integrating Transaction Cost and Institutional Theories: Toward a Constrained-Efficiency Framework Understanding Organizational Design Adoption,” Academy of Management Review, Vol. 22, No. 2, pp. 346-373.

61.Senge, Peter M. (1990), The Fifth Discipline, New York: Doubleday.

62.Shane (1996), “Hybrid organizational arrangements and their implications for firm growth and survival: A study of new franchisors,” Academy of Management Journal, Vol.39, pp.216-234.

63.Sharpe, M. (1997), “Outsourcing, Organizational Competitiveness and Work,” Journal of Labor Research, Vol.18, Fall, pp.535-549.

64.Stata, R. (1989), “Organizational Learning: The Key to Management Innovation,” Sloan Management Review, 30(1), pp. 63-74.

65.Teece, D.J. (1992), “Competition, Cooperation and Innovation Organization Arrangements for Regimes of Rapid Technological Progress,” Journal of Economic Behavior and Organization, Vol. 18, pp.1-25.

66.Urban L. Glen, Thereas Carter, and Steven Gaskin (1986), “Market Share Rewards to Pioneering Brands: An Empirical Analysis and Strategic Implication,” Management Science, Vol. 32, pp. 645-659.

67.Wernerfelt B. (1984), “A Resource-Based View of the Firm,” Strategic Management Journal, 5, pp.171-180.
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