健康照護服務生態系統之生成與發展：價值共創觀點

Shaping and Developing a Health Care Ecosystem: Value Co-Creation Perspective

本研究嘗試透過一個宏觀的角度，結合服務生態系統與價值共創觀點，探討一個組織結構較為複雜的長期照護產業，如何藉由價值共創活動形塑出「全人照護系統」，並探討該系統在生成的過程當中，如何藉由強而有力的價值主張、價值共創，以吸引利害關係人的參與及資源的投入，並讓利害關係人得以遵循，最終形成一個互相連結並能循環發展的「照護服務生態系統」。本研究透過質性研究的個案研究法，並以「斗六長泰老學堂照護服務生態系統的發展過程」為研究標的。研究結果發現，該照護服務生態系統循序漸進地以三階段從價值主張的建立、長泰老學堂內部照護系統的改善、在地社區照護生態系統的形成與發展，足以顯現價值主張與價值共創具有不同的階段性角色，以作為利害關係人活動與資源分享的指導原則。在過程中由主導者（斗六長泰老學堂執行長）從價值共創的觀點思考，應採取哪些合理的制度，讓所有參與的行動者皆能有所遵循，並在資源共享與服務交換過程中獲取利益，進而才能逐漸形成穩定的服務生態系統，而後才能擴大系統的影響範圍，吸引更多行動者的加入、進行更多元化、更密集的價值共創活動，最終並提升服務生態系統的總價值。

This study adopts the concept of service ecosystem and value co-creation to explore in a macro perspective the ways value co-creation activities have shaped a holistic care system in a long-term care agency that has a rather complex organizational structure. It further investigates how a strong value proposition along with vigorous value co-creation activities have been leveraged to attract and guide participation of different stakeholders in the process of creating a service ecosystem that is both coherent and scalable. Based on analyses of the qualitative case study of the Day Care Center of Douliu Changtai Senior Citizens' School, findings of the research indicate that the ecosystem is shaped and developed through three stages: identifying value proposition, inner-center level and community level. Value proposition and value co-creation play distinctive roles in different stages and are important organizing principles for attracting stakeholders' participation and sharing resources. In the process, the leader (CEO of Douliu Changtai Senior Citizens' School) adopted a value co-creation perspective to considering specific systems to be used for providing common guidelines for all participating actors. As benefits were gradually captured over time through the process of sharing resources and exchanging services, a stable service ecosystem has been formed as result. Finally, impacts of this system could be further expanded as more actors were attracted by diversified and intense activities of value co-creation, eventually leading to a greater value of the entire service ecosystem.