| 摘要: | 台灣醫療產業在人口老化、資通訊科技發展、醫療使用習慣轉變與健康保險總額給付制度實施環境脈絡的影響下，近來醫療機構的經營發展傾向於體系化、聯盟化的策略思維熱潮。然而體系化或聯盟化的策略發展思維的成形對醫療機構經營的意義為何則目前仍顯有討論。本研究旨乃以個案研究探討當前一家醫療體系體系化發展中的商業模式思維。
本研究以南部某醫療體系作為研究場域，從其中的醫學中心做為起點，採用質性研究方法中的個案研究探索體系化發展的歷程。以Osterwalder and Pigneur（2010）提出之商業模式觀點作為理論指導，發展深度訪談與分析規劃，訪談對象以滾雪球方式蒐集並採半結構式訪談共計9位受訪者。
結果顯示個案醫療體系在體系化發展中，將目標客群採用抽象化的定義，著重於教學、研究、服務為基礎，進而建構出符合需求的醫療網絡，體系的發展的過程必須將內部的資源籌備更加完善，包括利用人力資源以支應體系的拓展或利用資通設備達到資訊的整合性與即時性，不過受到權屬別的限制，相關的法令與政策所帶來的影響使得在發展上因此受限，綜觀而言，體系在發展上更注重於長期的發展效益，並推展出五個命題；命題一：體系發展將目標客群的定位以抽象化概念作為發展基礎；命題二：人力資源配置為醫療體系拓展的重要策略思維；命題三：資通訊科技是醫療體系發展重要的催化劑；命題四：政策法令的規範下是醫療體系發展主要的阻力，卻也是主要的助力；命題五：體系發展除了關注有形成本與收入外，更重視它的長期效益。
事前的規劃與投資以及持續投入的執行過程，都對體系發展的成功與否，有顯著的影響；但是研究中也發現採用商業模式所帶來層面上的迂迴效果和定位認知上的問題。為使體系發展更具體化，本研究將依據結果與命題提出研究建議，以作為未來體系在發展上的參考依據。
Under the multi-stream of social context, the aging population, the moving forwarding ICTs, the transforming patients’ healthcare utilization, and the reinforcing monitoring of NIH global budget system, it forces a upsurge of strategic perspective on the strategic institutionalization and strategic alliances. However, it still lacks of its reflexion on the understanding of the meaning of healthcare strategic alliance and strategic institutionalization. This research aims to do a reflexion case research based on the perspective of business model research.
The case study started its understanding of the development of medical strategic institutionalization from the medical care system in the southern Taiwan. With the theoretical guidance of the model from Osterwalder and Pigneur(2010), we developed in-depth interviews and the participating observation. With the snowball sampling, we finished the interviews by 9 participants in this case system.
The results showed that strategic institutionalization of the case system started by its conceptualization of the target customer into the symbolic meanings of educational focused, scientific focused, and service oriented. Under the development of the strategies, the system must complete the preparation of internal resources, mostly on human resources, information and communications technology (ICT), etc. However, the development is limited by the influence of the laws and regulations. By and large, the development of strategic institutionalization of this case concerned more about the imagination with a long range view on the timeframe. During the research, the author also found that the problem of roundabout effect and positioning cognitive arise from the application of business models.
Finally, this research proposed research recommendations based on the understanding of the case as a reference for the development of the future system. |
