臺灣博碩士論文加值系統

隨著醫療型態的改變，醫病關係互動不再只是單向溝通，注重在醫師和病患間的互動，而過去的醫療管理注重醫療品質，無法實際去了解到病患所想要的品質和服務；過去對於價值共創的研究，屬於比較宏觀的研究，但近期關注在比較微觀的研究，比較著重在非人、物件、機器，研究出的結果也更細微，這也顯示出行動參與者在價值共創中的重要性。然而，醫療品質卻來至於價值共創，近年來確實有看到跟醫療相關的共創研究，也代表這問題值得去注意和探討。在科技發展的時代，應有各式各樣的行動者納入，參與者間互相的配合，才能創造出優良的醫療服務，形成良好的醫療生態體系，共創出更多的價值。為了解病患在醫療服務過程中與各個行動參與者間互動的過程及價值共創，並以服務主導邏輯理論的觀點，將本研究問題定為：「探討在ㄧ個醫療服務生態系統裡，各個行動參與者間，如何共同創造價值？」從醫療情境中，各個行動參與者間，跨科別間子系統間的互動溝通中，如何解決病人的問題？從病患的參與中去發現病患的服務體驗感受；而在服務者導邏輯的概念下，將各個行動參與者皆視為行動者，本研究將從各個行動者參與者間的互動為個案出發，探究「奇美醫學中心」服務生態系統下的四個子系統所生成之過程。根據研究結果發現，各個行動參與者加入互動，透過資源整合和互動後共同創造出價值，也會與醫院願景相呼應，並為其他行動參與者帶來正向影響。換句話說，各個行動參與者的互動及共創的價值，都將更加強化此服務生態系統。也期望本研究未來在實務上，能有助於醫療服務生態系統之研究提供參考。

With the change of medical pattern, the interaction between Medical-patient relationship interaction is no longer just one-way communication, focus on interaction between doctors and patients, while the past medical management pays attention to the quality of medical care, cannot actually understand the quality and service that patients want; The results, which were more focused on non-humans, objects, and machines, were more subtle, which also showed the importance of action participants in value creation. However, the quality of medical care has come to the value of co-creation, in recent years has indeed seen with the medical-related co-creation research, but also on behalf of this issue worthy of attention and discussion. In the era of scientific and technological development, there should be a variety of actors included, the cooperation between participants, in order to create excellent medical services, the formation of a good medical ecosystem, create more value. To understand the process and value of patient interaction with individual action participants in the course of medical services, and to take the view of service-dominant logic theory, this study is defined as: Explore how the various action participants in the health care ecosystem can create value co-creation ?. How to solve the patient's problem in the interaction between the various action participants and the inter-branch subsystems from the medical situation? The patient's service experience experience is discovered from the patient's participation, and under the concept of the service provider's guidance logic, the participants of each action are considered actors, and this study explores the process generated by the four subsystems under the service ecosystem of the Chimei Medical Center, starting with the interaction between the participants of each actor on a case-by-case basis. Based on the results of the study, the interaction of individual action participants, creating value through resource integration and interaction, also echoes the hospital vision and has a positive impact on other action participants. In other words, the interaction and created value of individual actors will strengthen this service ecosystem.

摘要 I
誌謝 V
目錄 VI
表目錄 VIII
圖目錄 IX
第一章 緒論 1
第一節 研究背景 1
第二節 研究動機與目的 3
第三節 研究流程 5
第二章 文獻探討 6
第一節 醫療品質管理相關研究 6
第二節 價值共創 9
第三節 服務主導邏輯 13
第三章 研究方法 17
第一節 質性研究方法 17
第二節 個案研究法 19
第三節 資料蒐集 21
第四節 資料分析 27
第四章 個案發現 28
第一節 奇美醫院生態系統介紹 28
第二節 科內醫師與病患間的價值共創 29
第三節 各科別醫師與病患間的價值共創 31
第四節 以急診為平台之醫師與病患間的價值共創 33
第五節 操作達文西手術之醫師與病患間的價值共創 35
第六節 小結 38
第五章 結論與建議 39
第一節 討論 39
第二節 意涵 41
第三節 結論 44
第四節 研究限制 44
參考文獻 45
附錄一 47
表2-1共創價值四大基石 11
表3-1訪談人員記錄表 25
圖1-1 研究流程 5
圖2-1 服務生態系統的關鍵要素 15
圖2-2服務主導邏輯的價值共創流程 16
圖3-1奇美醫院歷史沿革 21
圖3-2奇美醫療財團法人奇美醫院Logo 23
圖3-3研究步驟 26
圖4-1 奇美醫院生態體系下的各科部介紹 28

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