| 摘要: | 研究背景與目的： 地區醫院屬於社區第一線照顧病患的重要角色，而醫療大環境牽制，與步步艱難的競爭市場下，為求永續生存和提升營運績效，獲得外部機構的合作關係資源是最快的方式，不管策略聯盟或併購轉型後成功，若地區醫院能永續經營，則能負起為社區民眾健康守門的角色。過去不僅甚少有地區醫院同時歷經策略聯盟與併購之經驗，更少有研究針對這樣的個案醫院深入評估其採用策略聯盟與併購後之成效，因此本研究乃欲深入探討這兩者合作策略對醫院的經營績效之影響。研究方法： 本研究以台灣南部某地區教學醫院為研究對象，採用個案研究法來進行質性與量性分析，量性分析的部分，乃收集個案醫院次級資料進行績效分析，績效資料期間：策略聯盟以2009年9月至2011年8月為期；併購以2011年9月至2013年8月為期，前後共4年的經營績效數據。而本研究之績效乃分為投入績效及產出績效，產出績效再分為財務績效指標與非財務績效指標，後續再透過這些績效指標進一步比較策略聯盟與併購之成效。研究結果： 個案醫院所發展的策略聯盟與被併購的動機與目的，包含取得夥伴資源增加醫師護理人力、提升競爭優勢及醫院知名度、改善業務績效增加市場佔有率及達經濟規模和內部經濟因素：經營者的自身利益與資金需求。而個案醫院跨組織合作類型因不同模式實質合作內容而有所差異，於策略聯盟期間主要合作對象是國立醫學中心，為契約式書面合約關係，合作期間個案的所有權與經營權並無變動，個案醫院的自主性與控制權高；而被併購後合作對象是財團法人醫學中心，被併購後成為醫療財團法人體系內醫院，法律形式屬新設醫院，併購後個案醫院的所有權與經營權變動，所以個案醫院的自主性與控制權低。最後，績效差異分析的部分，研究結果顯示權益基礎之併購期間的投入績效、財務績效、非財務績效優於非權益基礎之策略聯盟。結論： 本研究發現個案醫院跨組織的合作涉入程度與關係緊密及鬆散程度和所有權與控制權變動皆影響醫院的經營與策略管理，此外本研究亦證實個案醫院在非權益基礎策略聯與權益基礎併購期間經營績效有顯著差異，故相較於非權益基礎策略聯盟，併購有利於經營績效提升。
Background and Purpose: Local Hospitals are important roles for community patient health care as first gate keepers. However, under current health care system and severe competition circumstances, in order to seek for long-term survival and operational performance improvement, find access to outdoor agency partnership for resources is the most efficient way. Either by executing strategic alliances or successful transition after acquisition act, if local hospitals could sustain service, they can serve as key factors to be responsible for community health care. There were rare experiences of alliances and acquisitions among local hospitals before, and also rare studies focusing on the outcome and effect of such cases. Hence, this study would probe into these two kinds of cooperation strategy and also explore these effects of cooperation strategy on the business performance of local hospitals.Methods: In this study, the research object was a local teaching hospital in southern Taiwan. I used case study method to carry out qualitative and quantitative analysis and also, in the portion of quantitative analysis, we collected secondary data for performance analysis. Duration of the data selected: strategic alliances from September 2009 to August 2011 as one period; acquisitions from September 2011 to August 2013 as one period. We tried to analyze total four years of business performance data. The definition of performance from this research was divided into input and output performance whereas output performance was further divided into financial and non-financial performance indicators. After collecting business performance indicators, we further compared the outcome of strategic alliances with that of acquisitions.Results: The motivation and purpose of strategic alliances and the acquisition act of the case hospital included obtaining human resources from partners to increase amount of physician and nurses, enhancing competitiveness and raising hospital popularity, improving business performance to increase market share hence achieve economy scale and internal economy factors (interests and funding needs of business operators). The interorganizational cooperation patterns of case hospital varied due to different content of cooperation. During strategic alliance period, the main partner was National Medical Center. It was one kind of contract-based alliance relationship. There were no changes in ownership and management right during this period. In addition, the case hospital still had high autonomy and control power. After being acquired by Foundation's Medical Center, the case hospital became one part of the medical Foundation system. It became a new hospital. The ownership and management right had been changed after the acquisition and the case hospital had low autonomy and control power. The result of performance analysis showed that the case hospital had superior input performance, financial performance, and non-financial performance during the period of acquisition than the period of non-equity strategic alliance.Conclusion: The study found the involvement and relationship strengthen of interorganizational cooperation, and the change of ownership and control power will all affect the business and strategic management of the case hospital. In addition, this study also found significant differences in business performance between the period of non-equity strategic alliance and the period of equity strategic alliance. Therefore, comparing with non-equity strategic alliances equity-based acquisition will be more beneficial to hospital performance improvement. |
