平台化醫療管理公司在診所服務供應鏈中的角色與影響：效率提升與價值創造

Abstract

在台灣基層醫療體系長期面臨資源分散、經營壓力與制度侷限的背景下，傳統以個體診所為主的經營模式，逐漸暴露出在專業自主與組織治理之間難以平衡的矛盾。特別是在全民健保總額制度下，診所營運面臨報酬壓縮、法規限制與人力流動風險，形成制度性困境。近年興起的「平台化醫療管理公司」則以治理模組、資訊中台與合夥制度等方式，嘗試重構基層診所於供應鏈中的制度角色與價值定位，成為一種新型組織實驗。 本研究採用建構式質性研究方法，結合概念模型建構法、未來研究法與設計科學研究，針對平台治理邏輯與制度演化潛能進行理論建構與策略推演。研究聚焦於五大制度模組：治理制度設計、營運韌性支援、商品整合、異業槓桿與類合夥制度，探討平台如何藉由模組化邏輯與誘因設計重構診所治理結構與參與角色。進一步透過未來三角分析與情境規劃法，建構三種未來發展情境：「保守型穩健成長」、「平台深度滲透擴張」、「跨域主導型整合」，模擬不同制度開放與治理能力下，平台策略演化的可能路徑與風險挑戰。 研究發現指出，平台治理模式具備高度制度彈性與誘因整合潛能，能有效提升診所對治理制度的參與感與制度忠誠度，並具備整合異業資源與輸出治理標準的能力。本文進一步提出「類合夥制度」作為介於獨資與法人經營之間的第三治理模型，解決醫師專業角色與經營誘因脫鉤的困境，並構建「平台治理演化模型」，描繪平台制度從效率導向、複製導向至生態主導三階段的邏輯進程。整體而言，本研究補足現有文獻在醫療治理與平台制度設計領域的理論缺口，並對醫療政策、平台創業與制度輸出提供策略性啟發與實務建議。

Taiwan’s primary healthcare system has long been characterized by its fragmented clinic landscape, managerial burdens on individual physicians, and regulatory rigidity under the National Health Insurance’s global budget framework. Traditional clinic governance—often based on sole proprietorship or corporate ownership—has struggled to reconcile professional autonomy with organizational sustainability. Amid this landscape, platform-based medical management companies have emerged as institutional intermediaries, proposing modular governance structures, centralized operational systems, and quasi-partnership incentive schemes to reconfigure the structural role of clinics within the healthcare service supply chain. This study adopts a constructivist qualitative research strategy, integrating conceptual framework development, futures studies, and design science methodologies to examine the institutional logics, governance capabilities, and evolutionary trajectories of platform governance in the healthcare sector. The analysis is anchored in five core modules: governance structure design, operational resilience systems, integrated product management, cross-industry resource leverage, and quasi-partnership models. These modules are assessed not only in terms of their individual contribution but also as a coherent institutional architecture enabling distributed participation and strategic scalability. The study further utilizes the Futures Triangle and Scenario Planning to design three developmental scenarios—Defensive Consolidation, Platform Penetration, and Cross-Industry Orchestration—each reflecting a distinct combination of regulatory openness, resource integration, and institutional complexity. Findings indicate that platform governance enhances participation incentives, institutional trust, and systemic adaptability, allowing clinics to transition from executional endpoints to value-generating nodes. The proposed “quasi-partnership” model offers a third path beyond ownership-based and employment-based governance, aligning contribution with governance influence while preserving compliance flexibility. The research also proposes a three-stage model of governance evolution, ranging from efficiency-driven consolidation to replication-based scalability and ultimately to ecosystem-level orchestration. This study bridges a critical gap in the literature on platform institutions in healthcare, offering theoretical contributions and strategic insights for policy development, entrepreneurial practice, and institutional exportability in highly regulated service ecosystems.