目標：依據群聚經濟的觀點，組織群聚（Agglomeration）可以透過組織間資源與知識的流動等因素而促進當地產業組織的成長與績效提升。然而，組織群聚亦可能因環境的擁擠、市場的激烈競爭、昂貴的土地成本等因素，造成群聚不經濟的現象而導致生產力下滑的情況。因此，基於群聚經濟的矛盾現象，本研究欲觀察醫療產業區位層級的兩種群聚經濟是否存在，並且檢視跨區群聚效應對醫院生產力的影響，以瞭解距離在群聚外部效益的角色。方法：本研究以臺灣醫療產業為實證研究對象，利用民國87年至98年間全臺縣市（五都變更前）的行政院衛生署之衛生統計系列及內政部各縣市人口統計資料庫作為縱貫性次級資料，透過多元迴歸模式來檢測臺灣醫療產業之群聚效應對於醫院生產力的影響。結果：研究顯示群聚經濟效應對醫院生產力有正向的影響，但又因群聚型態與跨區域影響而有所不同。群聚型態：當更多相似產業群聚，意即更多醫院群聚，區域化群聚效應程度就會越高，顯著增加對醫院生產力的正向影響。跨區域群聚效應：當都市周邊人口愈多，都市外部群聚效應的程度越高，顯著增加對當地醫院生產力的正向影響；但相較當地的都市群聚效應，來自相鄰縣市的都市外群聚效應對當地醫院生產力的影響反而較高。區域外部群聚效應的程度越高，並無顯著增加當地醫院生產力；但相較於當地的區域群聚效應，來自相鄰縣市的區域外群聚效應對當地醫院生產力的影響確實較低。結論：本研究主要貢獻為確認台灣醫療產業存在區域化群聚經濟效應，及跨區域群聚效應比較當地群聚效應對醫院生產力之影響。 Objective: According to the theory of Agglomeration Economies, Agglomeration can promote the growth and performance improvement of the local industry organizations through the resources, knowledge and other factors of inter-organizational. However, cluster may lead to the diseconomies of agglomeration and decline in productivity due to crowded environment, competition in the market, high costs of land and other factors. Therefore, based on economic paradox, this study will find out the existence of Agglomeration Economies and explore the correlations between Agglomeration Economies and hospital productivity in Taiwan medical industry.Methods: In this study, we focus on the medical industry in Taiwan. Use Statistics Series of Department of Health and Interior demographic database of Ministry of the Interior from counties and cities in the Republic of China during the period from 1998 to 2009 to be longitudinal secondary data and examine the agglomeration effect of hospital productivity by Multiple Regression Analysis in Taiwan's medical industry.Results: Localization economies have a significant impact on productivity in Taiwan’s hospitals. External urbanization economies have considerable effect on productivity in hospitals. Compared with the urbanization economies, external urbanization economies have a higher effect on the local hospital productivity; while external localization economies relatively have lower impact on the productivity compared with the localization economies.Conclusion: The main contribution of this study is to prove the existence of localization economies medical industry in Taiwan, and to compare cross-regional effect with local cluster effect on hospital productivity.
