監所醫療業務委託外包監督機制之研究

Public Service Outsourcing and Monitoring Mechanism of Medical Service in Prisons

公私協力已成為一項重要的議題，其中委託外包是政府提供公共服務的一種選擇模式，由於公部門與私部門間的合作互動關係，已從傳統的科層關係逐漸朝向契約關係或公私協力夥伴關係，因此公私部門間合作關係的監督管理議題更形重要。本研究主要在探討公私部門間雙方互動的特性，以及如何採用不同的監督機制對委託外包進行管理。本研究為一探索性之質化研究，以台灣共十八家監獄及看守所之醫療業務委託醫療機構為對象，分別與各監所單位典獄長，或其授權之副典獄長、秘書、直接負責醫療業務的衛生科長、或實際負責醫療業務者，共四十位受訪者進行面對面的深度訪談，依合作方式整理出六個醫療業務委託外包個案，最後根據深度訪談個案分析，配合相關理論之討論提出相關的研究命題，以作為後續研究及實務運作之參考。

Public-private partakership has become a heated issue. Outsourcing is one of the popular alternatives for governments to provide public services effectively. Collaboration between public sector and private sector enhances the partnership. Meanwhile, this arouses the importance of management issues on managing the public-private cooperative relationships. This research aimed at exploring the characteristics of outsourcing activities and monitoring mechanism. Focusing on medical service outsourcing arrangements of prisons, this study was conducted by qualitative method. Totally, eighteen prisons in Taiwan were investigated. Primary data were collected by in-depth face-to-face interview. In this research, we interviewed forty wardens, vice-wardens and department chiefs who are in charge of medical activities. Six typical medical outsourcing arrangements represent the typical cooperative models between prisons and hospitals. Based on the in-depth case analysis, coupled with discussion from theoretical perspective, three propositions were proposed. Hopefully, this exploratory study contributes more understanding to the management of public service outsoursing contracts.