健保制度下地區醫院經營管理策略之研究-以某地區醫院為例

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Title:	健保制度下地區醫院經營管理策略之研究-以某地區醫院為例
Other Titles:	A Case Study of Strategic Management for District Hospitals Under Nation Health Insurance Policy
Authors:	謝明憲 Hsieh, Ming-Hsien
Contributors:	黃欽印;蔡禎騰 Huang, Chin-Yin;Tsai, Jen-Teng 東海大學工業工程與經營資訊學系
Keywords:	健保制度;經營策略;地區醫院 Health insurance policy;Strategic management;District hospital
Date:	2009
Issue Date:	2011-02-25T01:55:33Z (UTC)
Abstract:	全民健康保險自民國八十四年三月一日開辦，十多年來對國內醫療環境造成很大的衝擊，各層級醫院除面臨醫療競爭、民眾消費意識改變及各種經營條件的急遽改變，且由於整個醫療環境對地區醫院的衝擊最大，地區醫院經營者為突破困境，均依據醫院條件調整經營策略來因應健保制度，以求能夠生存與發展。本研究嘗試從地區醫院的角度，去探討地區醫院經營管理策略在健保制度衝擊下改變的原因，以分析地區醫院在面臨醫療環境變化時，所採取的經營策略、管理策略和因應健保制度所採取的經營策略。本研究主要的目的是以地區醫院經營策略之觀點探討：1.地區醫院因應健保策略之需求取向及策略的抉擇，如復健、呼吸治療病房、洗腎中心、合作經營業務、急診等。2.地區醫院採行因應健保策略對地區醫院經營績效的影響。3.希望藉由本研究瞭解地區醫院因應健保策略所遭遇相關困難，提出可行的解決方案。本研究針對某家地區醫院在全民健康保險實施前後之經營管理策略做研究，並運用質性研究方法，探討該地區醫院之經營策略，獲得下列結論：1.該地區醫院在面臨健保政策和醫療環境變化的壓力，執行正確的增加收入和降低成本的發展和因應策略。2.該地區醫院選擇能幫助醫院增加業務量和收入的因應健保策略，以復健、呼吸治療病房和洗腎病床為因應健保制度的優先選擇。3.該地區醫院因應健保制度之經營策略，在組織和人力以精減人力和人員共用或相互支援為主；業務和行銷部份則以新醫療服務為病人來源的基礎，再積極拓展社區服務和長照機構和醫院轉診客源做為行銷主軸；在醫療服務管理部份，必須加強慢性病和相關疾病的醫療品質的提昇；在財務管控部份，採取合作經營策略有更靈活的運用空間。我們可以從論文的分析中看到，地區醫院因應健保制度採取之策略，確實對於地區醫院經營有很大的幫助，如醫療業務量、財務收入、人員的互動和社區關係等，國內的地區醫院可參考本研究結果，以提升醫院存活的機會。 Since the national health insurance program has been implemented in March 1995, it has posed great impacts on the healthcare related industries. The impact is especially large on the local community hospitals. District hospitals have to dynamically change themselves according to the ever changing health insurance policies to survive in the highly competitive environment.This research intends to investigate the feasible hospital strategy management for the following subjects when health insurance policies are changing:(1) Developing strategic business units on physical therapy, respiratory therapy, dialysis services, emergency rooms, etc;(2) Changes of Performance based on the changes of health insurance policy;(3) Reviewing the successful and failure stories to develop feasible strategic solutions.By deeply interviewing the managers of a District hospital, the following suggestions have been made:(1) District hospitals should monitor their incomes and costs continuously, so proper strategy can be developed and implemented accordingly.(2) To increase sales and incomes, strategic business units on physical therapy, respiratory therapy, and dialysis services should be developed first.(3) From the perspective of human resources, employment downsizing and developing multi-skillful employees is the first priority. From the marketing perspective, developing new healthcare services is the first priority, so the patients may be retained. Additionally, community service, long term care service, and patient referral service will benefit the hospital in marketing. From the healthcare perspective, chronic disease service is the first priority. From the perspective of financial management, to join venture with some large hospital may received some financial benefits. The case study concludes that if a District hospital can be carefully managed by applying the above suggestions, it may survive well.
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