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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 劉順仁 | |
dc.contributor.author | Shao-Jung Li | en |
dc.contributor.author | 李紹榕 | zh_TW |
dc.date.accessioned | 2021-06-08T01:08:41Z | - |
dc.date.copyright | 2014-08-25 | |
dc.date.issued | 2014 | |
dc.date.submitted | 2014-08-18 | |
dc.identifier.citation | 參考文獻
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/18504 | - |
dc.description.abstract | 國家推行全民健保,樽節支出,使相當多的醫療機構面臨生存壓力。競爭使醫院認識到擴大行銷能力的重要性,但是如何能留住顧客,卻又是一個更嚴峻的問題,加強醫院管理也就勢在必行。醫院管理範圍廣闊,包括醫療品質管理、服務品質管理和經營管理等等,而管理的最終目的是提高醫療品質水準、提升醫院品牌形象、保障醫院永續經營。因此,在考量政府政策改變下,醫療機構無不思考如何尋求其他多元的經營管道,於是藉由委外合作策略尋求與外部合作的方式因應而生。
我們研究結果發現,醫療院所分科經營時需考慮其總體(外在)因素與個體(產業內)因素。單獨以心臟外科專科經營模式作商業運作,可以有足夠盈餘,但不足以支應Hybrid OR的龐大資本支出;必須在三個團隊規模下才有成功可能。相對地,若以心血管中心模式,合併健檢及後端遠距醫療,則能獲致巨大成功、甚至有不斷複製的可能。 本研究提供一個思考單科經營商業模式的參考架構,審視心臟外科單科及改採心血管中心商業模式運作之可行性,可供有興趣的研究學者參考。 | zh_TW |
dc.description.abstract | Implementation of national health care reform led a considerable number of medical institutions to face pressure for survival. Competition makes hospitals recognize the importance of expanding marketing capabilities, but how to retain customers, is a more serious problem. It is imperative to strengthen hospital management. Hospital management includes medical quality management, service quality management and business management, etc... The ultimate goal is to improve the management of medical quality standards, improve hospital brand image, and protect hospitals sustainable management. Therefore, in consideration of changes in government policies, the medical institutions are all thinking about how to seek other diversified business pipeline, so by outsourcing strategies of cooperation with external partners born.
Our study found that the overall external factors and individual (within the industry) factors should be considered in managing division operation of medical institutions. Business model in cardiac surgery specialist alone can have enough surplus, but cannot afford huge capital expenditure of Hybrid OR; Success may come true when the total scale became three teams. In contrast, the terms of the cardiovascular center model, with merge of health check and back-end telemedicine, is able to have massive success, and may even continue to replicate. This study provides an architecture for thinking outsourcing policy framework. About the feasibility of business model of cardiovascular surgery or cardiovascular center, researchers are interested in are available. | en |
dc.description.provenance | Made available in DSpace on 2021-06-08T01:08:41Z (GMT). No. of bitstreams: 1 ntu-103-P97744017-1.pdf: 7220276 bytes, checksum: c9e0dc453715206cc3a49b5340834784 (MD5) Previous issue date: 2014 | en |
dc.description.tableofcontents | 目錄
誌謝 iii 中文摘要 iv THESIS ABSTRACT v 目錄 vi 圖目錄 viii 表目錄 x 第一章 緒論 1 第一節 研究背景 1 第二節 研究目的 15 第三節 研究方法 16 第二章 文獻探討 18 第一節 醫療支付制度 18 第二節 策略聯盟 19 第三節 業務外包 23 第四節 醫療業務委外經營 28 第五節 Porter競爭策略 33 第六節 價值鏈 34 第七節 克利夫蘭醫療中心的典範 39 第三章 商業計劃 43 第一節 醫療專科經營模式—以心臟外科醫療業務委外經營計畫為例 43 第二節 心血管健康中心商業計劃 61 第四章 研究結果與分析 111 第一節、心血管中心計畫商業模式分析 111 第二節、心血管中心計畫競爭戰略分析 127 第三節、心血管中心計畫與台灣商業保險結合之可行性 132 第五章 結論與建議 139 第一節 結論 139 第二節 建議 141 參考文獻 143 附錄 148 圖目錄 圖1-1 血管疾病整合治療模式………………..…………………………………..………….…….5 圖1-2 心血管疾病整合治療模式…………………..………………………………..……………..6 圖1-3 Coronary Revascularization Trends in the United States, 2001-2008 From: JAMA. 2011;305(17):1769-1776…………………………………………….…………...….7 圖1-4 DRG給付制度CMI改變的影響(一)…………………………….………..…………….…10 圖1-5 DRG給付制度CMI改變的影響(二)………………………………….…….………….….10 圖1-6 2013美國職業及收入排行….…………………………………………………………...….11 圖1-7 Hybrid OR概觀………………………………………………………….…………………..12 圖1-8 研究架構一………………………………………………………...…………………...…..16 圖1-9 研究架構二……………………………………………………………...…………...……..17 圖2-1 競爭策略的立案…………………………………………………..………………………..33 圖2-2 價值鏈圖…………………………………………………..………………..………………35 圖3-1 敏盛心臟外科極盛時期體系內及周邊醫院服務……..……………….……………….…43 圖3-2 敏盛心臟外科人力編制圖……………………….…………………...…………..………..43 圖3-3 敏盛心臟外科歷年經營效益………………………………...………………………...…..44 圖3-4 核心能力…………………………………………………..………………...…………..….45 圖3-5 營運規劃………………………………………………………………..…………………..46 圖3-6 心血管外科五力分析…………………………………………………...………………….47 圖3-7 策略聯盟方式……………………………………...……………………..……………...…49 圖3-8 三級架構…………………………………………………………...…..………………...…49 圖3-9 醫院間的合作模式…………………………………….…………………………...………50 圖3-10 The Business Model Canvas,商業模式畫布………………………………………....…….50 圖3-11 收入來源…………………………………………………………………………….....….51 圖3-12 中型醫院適合的經營模式(From 台大柯文哲)……………………………………..…..63 圖3-13 歐美健康照護產業發展趨勢………………………………………………………...…...64 圖3-14 價值鏈的上下游延伸…………………..……………………………………..…………..64 圖3-15 從檢查到終端健康照護……………………………...…………………..………….……65 圖3-16 生理及心理的全面照顧……………………………………………...……………….…..67 圖3-17 1990-2010年中國城市居民主要疾病死亡率變化…………………………………….….68 圖3-18 2010年中國城市居民主要疾病死因構成比(%)………………….………………………69 圖3-19 流程變革………………………………….………..……………………………...………72 圖3-20 心血管健康中心營運模式………………………….………………………….…………73 圖3-21 心血管健康中心組織圖…..………………………………………...…………………….73 圖3-22 遠距系統架構(From工研院)…………………………………………….………………74 圖3-23 遠距健康照護的整合性服務平台(From工研院)……………………………….………74 圖3-24 醫療資訊系統整合示意圖……………………...……………………………………...…75 圖3-25 AON模式………………...………..……………………………………………………….77 圖3-26 怡和模式…………………..………………..………………………..………………...….78 圖3-27 怡和報價單…………………………………………………………………………….….78 圖3-28 加護病房示意圖(來源:台大心血管中心規劃)……………………………………..…82 圖3-29 Philips ICU吊塔系統……………………………………………………..………………..83 圖3-30 Philips相關產品…………………………………………………………..………………..83 圖3-31 心血管中心之遠距醫療照護營運模式…………………………….…………………….84 圖3-32 心臟外科發展規劃……………………....………………..………………………………89 圖3-33 TAVI:經導管置換心瓣膜手術………………………..………………..………………..91 圖3-34 融合式冠狀動脈心臟病治療……………..………….………………...…………………91 圖4-1 心血管中心計畫商業模式分析..........................................................................................111 圖4-2 心血管中心計劃六力分析..................................................................................................127 圖4-3 投保項目..............................................................................................................................132 圖4-4 投保項目………………......................................................................................................134 圖4-5 投保項目..............................................................................................................................136 圖5-1 各科評分之外包相關因素矩陣圖………………………………………………….…….139 表目錄 表1-1 Hybrid OR建議設備……………………………………………….…………….……..…...13 表1-2 Siemens手術室導管設備……………………………………………………………...……14 表2-1 醫院策略聯盟文獻整理……………………………………………...……………….....…20 表2-2 外包定義歸整表 ……………………………………………..…………………...…...…23 表2-3 醫事人員法規摘要整理………………………….………………..…….………………....29 表2-4 三項基本競爭策略的優點……………………………..………………………………..…34 表2-5 構成價值鏈的九項活動……………………..……………………………………...…..….35 表2-6 價值鏈中典型的差異化來源…………………………..……………………………….….37 表3-1 敏盛心臟外科成本結構………………………………………………...………….…..…..51 表3-2 護理成本估算……………………………………..…….……………………………...…..52 表3-3 ECMO葉克膜護理加給及績效獎金設計………….………………………………………52 表3-4 科成本結構………………………………………………………….…………………...…53 表3-5 支援外院收入估算………………………………...……………..………..……………….54 表3-6 外院支援開展收益變化…………………………………………...……..……………...…54 表3-7 Forecast………………………………………………………………………………..……..54 表3-8 以一個由2至3名主治醫師,整個團隊最終20人的發展版圖推估各種發展型態…………………………………………………...……………………………………………….55 表3-9 人員薪資…………………………………………………...……………………………….55 表3-10 固定成本………………………..………………………………………...……………….55 表3-11 不同型態支援成本…………………………………………………….……………….....57 表3-12 各類型發展投資效益………………………….………………………………………….57 表3-13 考慮機構發展到兩倍大時再開展聯盟系統之計算………………………………..……58 表3-14 本計畫心血管中心所設定之關鍵客戶…..………………………………………...…….75 表3-15 進入障礙與模仿障礙………..…………………...………………………...………….….76 表3-16 心導管室設備及間數…………..…………………..……………….……………….....…79 表3-17 手術室之用途及間數……………..…………………...………………………………….80 表3-18 疾病分類及工作內容………………………………………...…………………….……..85 表3-19 醫療人力規劃…………………………..…...………………………………...….…….…86 表3-20 心臟外科服務項目………………………..…………...…………….…………………....90 表3-21 心血管健康中心營運規劃時程…………..……………………………………...…...…..93 表3-22 心血管健康中心各區域配置規模及用途規劃一覽表……..………...……………….....95 表3-23 心血管健康中心設備編制………………..……….………..………………...…………..96 表3-24 心血管健康中心整建經費預估……………………………………………………...…...97 表3-25 心血管健康中心工程預算……………………...……………………………...…………98 表3-26 心血管健康中心年度預購儀器設備用途及預算一覽表…………...…………………...98 表3-27 一階段完全設置與分三階段設置之預算費用比較….…………………………….......100 表3-28 台灣盛弘公司資金成本.………………… ………………………………….…….…….102 表3-29 以30%成長率預估重點項目人次表………………………………………………....…102 表3-30 以30%成長率預估重點營收表……………………………………………...…….……102 表3-31 投資效益評估…………………………….………………………………………..…….103 表3-32 (期間設定20年,資金成本率為2%)………………………………………………...103 表3-33 大陸大型心血管醫院及台灣標竿醫院心血管中心列表…………………………....…104 表3-34 規模比較….………………………………………..………………………………….…106 表4-1 如何使用移情圖表………………………………………………………..………………113 表4-2 市場分析…………………………………………………….………………………….…121 表4-3 競爭分析………….……………………………………………………………...……......122 表4-4 關鍵趨勢:遠見…………………..……………………………………………………..…122 表4-5 宏觀經濟…………………………………………………………………………......……123 表4-6 評估商業模式…………………………….………………………………….……………125 表4-7 商業模式視角下的藍海戰略…………………………..…………………..……………..126 表4-8 策略定位的六項原則………………………….………………...…….………………….131 表4-9 投保項目……………………………..………………………..………………………..…133 表4-10 投保項目……………………………………………………………………..………..…135 表4-11 投保項目……………………………………………………………………..………..…137 | |
dc.language.iso | zh-TW | |
dc.title | 心血管中心商業模式研究 | zh_TW |
dc.title | Research of Business Model of Cardiovascular Center | en |
dc.type | Thesis | |
dc.date.schoolyear | 102-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 江炯聰,魏資文,朱子斌 | |
dc.subject.keyword | 外包,醫療產業,商業模式, | zh_TW |
dc.subject.keyword | Outsourcing,Healthcare Industry,Business model, | en |
dc.relation.page | 160 | |
dc.rights.note | 未授權 | |
dc.date.accepted | 2014-08-19 | |
dc.contributor.author-college | 管理學院 | zh_TW |
dc.contributor.author-dept | 會計與管理決策組 | zh_TW |
顯示於系所單位: | 會計與管理決策組 |
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ntu-103-1.pdf 目前未授權公開取用 | 7.05 MB | Adobe PDF |
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