基於PLS-SEM模型探討醫院業務外包對績效影響之探討

The Impact of Hospital Outsourcing on Business Performance Based on PLS-SEM Model

在台灣的醫院因所有人民須納入全民健康保險，所以健保費已經成為其最主要收入來源，而醫院在面對全民健保局財務吃緊而大幅調整給付方式，已造成部分醫院停業、大型醫院合作、或為改善營收入和支出，採用國內外醫院以業務外包後之改善經營績效的案例做為借鏡，故部分醫院開始積極採取業務外包（委外）方式，做為減少成本、降低風險、增加收入、提升技術的方法來提高營運績效。除此醫院採用平衡計分卡作為改善營運績效之管理方法，藉由各構面的管理能夠全方位的有效提升績效。而本研究對業務外包採用平衡計分卡為基礎，探討對醫院績效可能產生的影響作為研究，並以結構方程模型（PLS-SEM）採歐洲基礎質量管理（EFQM）作為公立（非營利）醫院的模型架構，以平衡記分卡（BSC）作為私立（營利）醫院的模型架構，進行個別研究分析後，再將兩者比較在不同構面是否有顯著差異，希望本研究能找不同權屬的醫院找到最適切的業務外包對績效影響的層面，進而透過不同的構面和題項能夠找到提升績效管理工具。

In the Taiwan region, facing substantial adjustment of payment for financial constraints has caused some closures of hospital or cooperation with larger hospital. In order to improve revenue and expenditure, many hospitals take other domestic and foreign hospitals which successfully improve their business by outsourcing as example, begins to apply outsourcing actively as a way to reduce costs and reduce rick and increase revenue to elevate operational performance. In addition, the hospital has adopted the Balanced Scorecard as a means to improve its operational performance. It is hoped that the four dimensions will be managed in a comprehensive and effective way. (EFQM) was adopted as the model structure of public (non-profit) hospitals by the structural equation model (PLS-SEM), and the basic structure of the hospital was analyzed by using the Balanced Scorecard (BSC) as a model for private (for-profit) hospitals. After the individual research and analysis, we can compare the difference in each dimension. I hope this study can conclude the most appropriate business performance of outsourcing factors for hospitals from different ownerships and they manage diverse aspects and topics to find the tools that enhance performance management.