在醫療政策規範及健保支付制度下，醫療院所需兼具高品質與低成本，但在醫療院所住院醫師人力不足或不均的環境下，直接衝擊各醫療產業的營運，因此衍伸了專科護理師。本研究旨在探討於現今醫療人力限制的環境下，專科護理師如何利用外部交易與內部交易成本（代理成本）成本的概念，以降低醫師與內外部的交易成本並擴大人力資源的運用，創造醫療服務的利機。由於醫療市場的資訊不對稱性，使得交易雙方討價還價的過程冗長；也因醫療的不確定性因素，這些都會增加交易成本。透過專科護理師的溝通平台降低內外部的資訊不對稱，減少交易成本；同時因其具備醫護專業知識及技能，也可以減少醫療的不確定性，間接帶來高品質的醫療服務。本研究藉由價值鏈管理創新的分析架構，從醫療產業的觀點下，其價值鏈本身可依病患或醫師的不同需求而變動，或是不同組合的選擇，利用模組化的方式整合醫療與護理服務，創造其以病人為中心的醫療服務價值。本研究的分析架構係除可用於泌尿外科，也可用於類似性質的科別及其他產業的應用。 This medical service ideal is under the medical strategy, that being the norm of medical services and a payment system such as a National Health Insurance which attempts to attain best quality and low cost in Taiwan. Utilizing the manpower of a resident doctor is not enough to resolve this dilemma in that it creates an unbalanced environment for hospitals as doctors are clustered in sectors and not distributed across the whole environment. Consequently this phenomenon has made a great impact upon the operation within the medical industry. However an innovative strategy can be redressed by the legal practice of nurse practitioners (NPs) for the medical service market. The objective of this study is to pose a strategy to remove the limitation of medical manpower, by a cost concept for external transaction costs and internal agency dependencies by the utilization of NPs. This strategy can reduce internal and external transaction costs as well as human resource operation whilst creating a good business model for the delivery of medical services.Due to information asymmetric, business transaction of frequently and uncertainty that can increase of transaction costs within the medical market. Going through the communication conduit of NPs can reduce internal and external of information asymmetric by the NPs have the time to be able to resolve the uncertainty of understanding a diagnoses and the process of an illness. This strategy at the same time provides for professional skills to be increased and distributed around the network of participants whilst presenting high quality medical services. This strategy analyses and remediates structure through the concept of value chain management (VCM) giving birth to innovation under a medical industry concept. The value chain will be changed with a malleability to morph itself according to different necessities in patients or doctors within different selections of a hospital. It makes use of module method to combine with medical treatment and nursing services the creation of a medical service value directed towards patient-centered provision. This study is not only use of division of urological but also relevant division and other industry application.
