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研究生:蔡龍輝
研究生(外文):Long-fei Chai
論文名稱:制度壓力與合作形式之關係-以眼科基層醫療機構為例
論文名稱(外文):The Relationships between Institutional Pressure and Cooperative Types: The Case Study of Ophthalmologic Primary Medical Agencies
指導教授:曾紀幸曾紀幸引用關係
指導教授(外文):Chi-Hsing Tseng
學位類別:碩士
校院名稱:國立屏東商業技術學院
系所名稱:行銷與流通管理系
學門:商業及管理學門
學類:行銷與流通學類
論文種類:學術論文
論文出版年:2006
畢業學年度:94
語文別:中文
論文頁數:133
中文關鍵詞:新制度理論合作形式管理者社會網絡
外文關鍵詞:administrative social networkcooperative typesNeo Institutional Theory
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醫療產業面臨制度環境的變化與衝擊,如全民健保等諸多重要政策及法令的施行,對醫療產業產生多方面的影響,也改變了醫療產業的生存環境。醫療機構面對環境的改變所帶來的挑戰,無不發展各式各樣的合作關係,以確保醫院的生存及成長。本研究研究目的乃藉由醫療機構制度壓力的現況,來了解基層醫療機構合作關係的形成及形式,及其制度壓力大小對醫療機構間合作關係所產生的影響,而管理者社會網絡關係又如何影響醫療機構間合作關係。針對相同科別的眼科基層醫療機構為研究對象,透過多重個案研究方式來探討管制壓力及規範壓力如何影響醫療機構間的合作,及管理者的社會網絡又如何影響合作關係。期盼藉此給予學界、業界在研究及策略施行的參考。研究結果顯示當制度壓力越大,醫療機構為增加其競爭性,所產生的組織間醫療性及行政管理的合作也越多。醫療機構成員授權公會或協會等組織或模仿成功合作模式的規範壓力越強,醫療機構間合作也越多。醫療機構尋求合作對象時,管理者社會網絡的強連結關係,有助於合作的情形的增多。而自費市場的開發,也間接促使醫療機構間醫療性及行政管理的合作關係會更多元化。
The medical industry has confronted with change and impact under the environment of institutionalization, such as the implementation of NHI (National Health Insurance) and many other major policies and regulations. Together they had brought different types of influences to the medical industry and also changed the surviving environment. The medical agencies are facing the challenges which brought by the change of environment. Various types of partnership are developed to secure the survival and growth of the hospitals. Through the observations of present situation of medical agencies under the institutional pressure, this studies aim at understanding the formation and convention of partnership between primary medical agencies, the influence caused by different degree of institutional pressure on cooperative types , and also how administrative social networks affects the cooperative types. Primary ophthalmic medical agencies of the same department were chosen as the subjects of this study. By means of multiple case studies, restraint and regulation of institutional pressure and strength of administrative social networks were investigated to realize how they affected the cooperative types of medical agencies. Thus the present study may provide both academic and medical fields a reference in future research and implementation of strategies. The findings indicate that when pressure increased under institutionalization, so as to raise the competitiveness of medical agencies, more medical and administrative cooperation were shaped accordingly. When more regulating pressure came from authorization of medical institutional members to the association or imitations of successful cooperative patterns, more cooperation was developed between medical agencies. When seeking for cooperative partners among medical agencies, the potent bonding of administrative social networks is advantageous to the expansion of cooperation. The development of private medicine indirectly urges the multiplicity of medical and administrative cooperative types between medical agencies.
目次
摘要 Ⅰ
英文摘要 Ⅱ
謝誌 Ⅲ
目次 Ⅳ
表次 Ⅵ
圖次 Ⅷ
第一章 緒論 1
第一節 研究動機 1
第二節 研究目的 4
第三節 研究問題 5
第四節 研究貢獻 6
第二章 文獻探討 7
第一節 制度理論 7
第二節 組織間合作關係 24
第三節 社會網絡關係 35
第四節 各構面間的相關性 38
第三章 醫療產業的制度環境 42
第一節 眼科現況 42
第二節 醫療產業的管制 43
第三節 醫療產業間的規範 51
第四章 研究方法 53
第一節 研究架構 53
第二節 研究變數 54
第三節 個案研究法 57
第四節 資料收集與分析 58
第五節 信度與效度 61
第六節 研究限制 63
第五章個案分析與描 64
第一節 個案描述 64
第二節 綜合分析 81
第六章 研究命題 89
第七章結論與建議 94
第一節 研究結論 94
第二節 管理意涵 98
第三節 後續研究建 99
參考文獻 100
中文部分 100
英文部分 101
附錄A 107
附錄B 110
附錄C 113
附錄D 117
附錄E 122
附錄F 123
附錄G
圖次
圖2-1-1不同層級及制度支柱的說明學派 19
圖2-2-1 組織失靈架構圖 30
圖4-1-1 研究架構圖 53
圖5-1 甲個案健保前合作關係網絡圖 67
圖5-2 甲個案健保後合作關係網絡圖 67
圖5-3 乙個案健保前合作關係網絡圖 71
圖5-4 乙個案健保後合作關係網絡圖 71
圖5-5 丙個案健保前合作關係網絡圖 75
圖5-6 丙個案健保後合作關係網絡圖 76
圖5-7 丁個案健保前合作關係網絡圖 80
圖5-8 丁個案健保後合作關係網絡圖 80
圖5-9 管制壓力對醫療機構間合作的影響 84
圖5-10 規範壓力對醫療機構間合作的影響 84
圖5-11 本研究修正後架構 88
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