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    Title: 非營利財團法人醫療機構永續經營策略之研究 - S 醫院之個案分析
    A Study of Sustainable Strategy for Not-For-Profit Medical Foundation - A case study of S medical foundation hospital
    Authors: 黃玉儀
    Huang, Yu-Yi
    Contributors: 詹文男
    黃玉儀
    Huang, Yu-Yi
    Keywords: 非營利財團法人醫療機構
    經營策略
    財務永續
    Date: 2021
    Issue Date: 2021-07-01 18:52:15 (UTC+8)
    Abstract: 財團法人醫療機構基本上屬於非營利的組織,在台灣全民健保架構下由於給付條件不佳,許多財團法人醫療機構的醫務收入已經大於支出,屢屢出現經營困境。基於此現象,本研究欲研究了解醫療機構是否應以非營利組織作為設立基礎,以及分析 S 團法人醫院個案,探討非營利財團法人醫療機構的永續經營的策略。
    本研究為定性研究,透過文獻分析以及深度訪談的方式探討非營利組織的影響力、非營利醫療機構與營利醫療機構優劣、非營利組織財務永續策略、國際成功非營利醫療機構典範的管理特色與策略,以及進行個案的情勢分析。根據本研究發現,以非營利組織立足的醫療機構相較於營利醫療機構,因此堅持維持非營利的醫療機構應是能夠為病人創造最大利益的做法。但是非營利醫療機構確實較常面對財務永續風險,因此必需根據自身情況採取合適的財務永續性的策略。以個案 S 院為例,可採取的策略有兩個重點,第一為創造價值,包括持續拉大與其他癌症治療機構病人存活時間的領先優勢、積極打開醫院能見度、改善病人治療前、中、後的生活品質、持續整合照護流程、動線以配合病人及家屬的方便性、以及增加安全感與信賴度。第二個重點為財務永續策略,包括增進效率、控制人力及物資的浪費、增加新病人、發展醫務以外收入以投資醫務本業帶來核心業務進步,如募捐、投資以及研究發展。
    在台灣現行的法規政策是鼓勵非營利財團法人醫療機構經營發展的,但是又因全民健保制度的限制,使得非營利財團法人醫療機構在醫務收入上難以在維持核心價值又不犧牲醫療品質的堅持下經營,本研究的結果建議非營利財團法人醫療機構應朝研究發展、投資以及募款等方向擬定財務永續的策略。
    Reference: 書籍
    1. Leonard L. Berry, K. D. S., (2008)。向梅約學管理(Management lessons from Mayo Clinic)。台灣:美商麥格羅台灣分公司,希爾國際股份有限公司。

    網際網路
    1. 衛生福利部醫事司中央健康保險署,長庚醫療財團法人財務報告-國一○
    八年度及民國一○七年度,上網日期 2021 年 02 月 21 日,檢自:
    https://dep.mohw.gov.tw/doma/cp-3175-15984-106.html.
    2. 財團法人國家衛生研究院. (2018-12-17), "證簡介." 上網日期 2021 年 04 月 17 , 檢自: http://accredit.nhri.org.tw/intro/.
    3. 國民健康局癌症防治組 癌症診療品質認證簡介. 癌症新探. 44. 上網日期 2021 年 04 月 17 , 檢自:http://www.tccf.org.tw/old/magazine/maz44/m7.htm
    4. 管理之道. (2018). "有關 SWOT 分析法的真相." 上網日期 2021 年 05 月 28 日, 檢自:https://kknews.cc/history/3z26xao.html.
    5. 認證小組, 財團法人國家衛生研究院臺灣癌症臨床研究合作組織(Taiwan Cooperative Oncology Group, TCOG) ,證結果,上網日期 2021 年 04 月 17 日, 檢自: http://accredit.nhri.org.tw/result/
    6. 衛生福利部,醫病共享決策介紹,上網日期 2021 年 04 月 26 日, 檢自: https://sdm.patientsafety.mohw.gov.tw/Public/Detail?sn=32&id=1035.
    7. 衛生福利部中央健康保險署,109 年全日平均護病比,上網日期 2021 年 04 月 29 , 檢自:https://data.gov.tw/dataset/119725.
    8. 衛生福利部中央健康保險署,健保署公布 108 年度 223 家院所財報與醫療服務申報情形,上網日期2021年04月17日, 檢自:https://www.mohw.gov.tw/cp-16-58829-1.html
    9. 衛生福利部統計處,108 年醫療機構現況及服務量統計年報,上網日期 2021 年 04 月 29 ,檢自:https://dep.mohw.gov.tw/DOS/cp-4931-54833-113.html
    10. 衛生福利部統計處,國民醫療保健支出(NHE),上網日期 2021 年 05 月 12 日,檢自:https://dep.mohw.gov.tw/dos/lp-2156-113.html

    英文部分
    書籍部分
    1. Alfred D. Chandler, J. (1962). Strategy and structure: Chapters in the history of the industrial empire, US:Cambridge, Mass.: M. I. T. Press.
    2. Ansoff, H. L. (1965). Corporate Strategy, US:McGraw-Hill, New York.
    3. Hay, R. D. (1990). Strategic Management in Non-Profit Organizations: An Administrator`s Handbook, US:Praeger Pub Text; Illustrated edition.
    4. Quinn, J. B. (1980). Strategies for Change: Logical Incrementalism, US : Homewood, Ill. : R.D. Irwin.
    5. Weihrich, H. (1982). "The TOWS Matrix A Tool for Situational Analysis." Long Range Planning 15(2): 54-66.
    6. William F. Glueck, L. R. J. (1989). Strategic Management and Business Policy, US: McGraw-Hill Education (ISE Editions); Internat.2r.e.
    7. Wolf, T. (1990). Managing a Non-Profit Organization, US, Fireside.

    專書論文
    1. Authors, (Year).Title, Publisher Location: Journals Title, pages.
    2. Alice Gugelev, A. S. (2015). "What’s Your Endgame?" Stanford Social Innovation Review(Winter 2015): 41-47.
    3. Morganti, L. M. S.-P. L. S. K. G. (2012). Financial Sustainability for Nonprofit Organizations -A Review of the Literature. RESEARCH REPORT, RAND Corporation.
    4. Seidner, B. (2018). The Balance Between Financial and Quality Performance in For-Profit Hospitals versus Non Profit Hospitals, Claremont Colleges.

    期刊
    1. David, G. (2009). "The convergence between for-profit and nonprofit hospitals in the United States." Int J Health Care Finance Econ 9(4): 403-428.
    2. Gordon, T. P., Saleha B. Khumawala, Marla Kraut, and Daniel G. Neely (2010). "Five Dimensions of Effectiveness for Nonprofit Annual Reports " Nonprofit Management and Leadership 21(2): pp. 209–228.
    3. Howard Thomas, N. V. (1988). "Research on strategic groups: Progress and prognosis." Journal of Management Studies 25(6): 537-555.
    4. Joynt, K. E., E. J. Orav and A. K. Jha (2014). "Association between hospital conversions to for-profit status and clinical and economic outcomes." JAMA
    312(16): 1644-1652.
    5. P. J. Devereaux, M., Holger J. Schu¨nemann, MD, PhD Nikila Ravindran, BSc Mohit Bhandari, MD, MSc Amit X. Garg, MD Peter T.-L. Choi, MD, MSc Brydon J. B. Grant, MD Ted Haines, MD Christina Lacchetti, MHSc Bruce Weaver, MSc
    John N. Lavis, MD, PhD Deborah J. Cook, MD, MSc David R. S. Haslam, MD, MSc Terrence Sullivan, PhD Gordon H. Guyatt, MD, MSc (2002). "Comparison of mortality between private for-profit and private not-for-profit hemodialysis centers: a systematic review and meta-analysis." JAMA 288(19): 2449-2457.
    6. P.J. Devereaux, P. T. L. C., Christina Lacchetti, Bruce Weaver, Holger J. Schünemann, Ted Haines, John N. Lavis, Brydon J.B. Grant, David R.S. Haslam, Mohit Bhandari, Terrence Sullivan, Deborah J. Cook, Stephen D. Walter, Maureen Meade, Humaira Khan, Neera Bhatnagar, Gordon H. Guyatt (2002). "A systematic review and metaanalysis of studies comparing mortality rates of private for-profit
    and private not-for-profit hospitals." Canadian Medical Association or its licensors 166(11): 1399-1406.
    7. Shah, B. R., S. W. Glickman, L. Liang, W. B. Gibler, E. M. Ohman, C. V. Pollack, Jr., M. T. Roe and E. D. Peterson (2007). "The impact of for-profit hospital status on the care and outcomes of patients with non-ST-segment elevation myocardial infarction: results from the CRUSADE Initiative." J Am Coll Cardiol 50(15): 1462-1468.

    網際網路
    1. About Mayo clinic, Retrieved 2021-04-18, 2021, from:
    https://www.mayoclinic.org/about-mayo-clinic
    2. Furst, J. (2021). "Meeting the challenges of a historic year: 2020 Mayo Clinic Performance Highlights.", Retrieved 2021-05-31, 2021, from https://newsnetwork.mayoclinic.org/discussion/meeting-the-challenges-of-a-historic-year-2020-mayo-clinic-performance-highlights/
    3. Wikipedia Mayo Clinic, Retrieved April 12 2002, from: https://g.co/kgs/gU2SYo
    Description: 碩士
    國立政治大學
    經營管理碩士學程(EMBA)
    108932169
    Source URI: http://thesis.lib.nccu.edu.tw/record/#G0108932169
    Data Type: thesis
    DOI: 10.6814/NCCU202100646
    Appears in Collections:[經營管理碩士學程EMBA] 學位論文

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