我國公辦民營醫院控制機制與經營績效之研究－－以契約生命週期觀點

A Study of Management Mechanisms and Performance in Management Contracts of Government-Owned Hospitals: Life Cycle Model Perspective

由於公共建設及社會福利支出大幅增加，政府在面臨財政壓力下，計劃將目前九十八家公立醫院交由民間經營，其中「公辦民營」醫院將成為社會福利民營化的主要方式國內已經多位學者進行公辦民營機構的研究，但多著重在探討委託經營之課責議題，或研究影響政府與民間雙方的合作因素。本研究希望透過對現階段我國公辦民營醫院之個案分析，分別以接受政府委託之民營醫療構機特性及公辦民營醫院的契約生命週期階段，來探討其控制機制之運用，以及對經營績效的影響。本研究採質性研究法，透過個案深入訪談進行探索性研究。對象為目前我國六家公辦民營醫院，接受訪談的對象皆為醫院院長或核心高階主管，透過受訪者綜理院務的豐富經驗，從中瞭解該醫院的控制機制及其經營績效。本研究依據深度的個案分析共推導出九個命題，期能提供後續研究以及公辦民營醫院實務管理之參考。

Management contract has become an important alternative to solve the long-term problems of inefficiency and financial crisis of government-owned hospitals. The literature on management contracts has centered primarily on the issues of accountabilities. Relatively less attention has focused on contract life cycle and its management mechanisms. This research aimed at exploring the correlation between the management mechanisms. This research aimed at exploring the correlation between the management mechanisms and performance. Particularly emphasized the management mechanisms that adopted by different stages of contract life cycle practiced in government-owned hospitals.
Qualitative research method was conducted to figure out the correlation between constructs which derived from literatures. This study focused on six government-owned hospitals which were operated through management contracts that offered by six trustee hospitals, including two medical centers and four regional hospitals. Primary data was collected by face-to-face interview. six interviewees including hospital executives and other department chiefs. Finally, this study concluded several major findings and proposed nine propositions for the reference of future research and managerial practice.