以醫學倫理與顧客價值觀點探討醫院產業服務創新價值創造之演進

Exploring evolution of value creation by service innovations in hospital industry based on the perspective of medical ethics and customer value

本研究之醫學倫理與顧客價值五大觀點為倫理價值、功能性價值、快樂性價值、關係性價值與情境性價值，採單一產業個案導向之質性研究方法，個案對象共篩選60 家，透過次級資料與深度訪談共蒐集536 件創新事件，依類型比對、解釋建構、時間序列分析、以及程序邏輯模式進行資料分析。本文獲得四項研究發現：一、價值創造以功能性價值為核心，情境性價值與關係性價值為輔。二、醫院層級越高對功能性價值越重視，而層級越低對關係性價值越重視。三、醫院功能性價值於各階段比例呈遞減趨勢，反觀關係性價值呈上升趨勢；情境性價值呈U 型演進，而倫理價值與快樂性價值則呈倒U 型演進。四、醫院層級高者所提供創新事件數於各階段比例呈大幅遞減趨勢，而層級低者則呈大幅上升趨勢。

The perspective consisting of medical ethics and customer value concerns five constructs: ethical value, functional value, hedonic value, relationship value and contextual value. This study adopts a single-industry case-oriented qualitative research method. A total of 60 hospitals were selected. Through secondary data collection and in-depth interviews, this study totally collected 536 innovation events. The data analysis is based on the methods of pattern-matching, explanation-building, timeseries and program logic model. The findings are: 1. The core value creation by service innovations is “functional value”, supplemented by “contextual value” and “relationship value”. 2. The hospitals with higher hierarchy pay more attention to “functional value”, while the hospitals with lower hierarchy pay more attention to “relationship value”. 3. The rate of innovation events creating “functional value” shows a declined trend, while that creating “relationship value” shows an increasing trend; the rate of innovation events creating “contextual value” shows an U-type curve, while that creating “ethical value” or “hedonic value” shows an inversed U-type. 4. The rate of innovation events provided by the hospitals with higher hierarchy shows a declined trend, while that provided by the hospitals with slower hierarchy shows an increasing trend.