探討醫療業務外包模式的關鍵成功因素:臺灣醫院與廠商合作的個案研究

Abstract

隨著醫療服務需求日益多元與人力資源配置壓力增長，醫療業務外包逐漸成為醫療機構提升營運彈性與服務效率之策略選項。然而，涉及臨床知識與病人互動的高專業性服務外包，仍存有制度設計、合作信任與品質控管等多重挑戰，相關成功經驗與實務模式亦有待釐清。鑑此，本研究旨在探討醫療業務外包模式之關鍵成功因素，分析其對醫療機構營運效率、病人參與與服務品質所可能產生之影響，並建構一套具實務操作性與評估邏輯之外包制度分析架構。 本研究以臺灣某專業廠商與T區域醫院及K醫學中心合作推動婦科自費療程(海芙刀)外包服務為研究個案，採用質性個案研究設計，透過半結構式深度訪談、內部文件、現場觀察與公開資料等進行多元資料蒐集，並運用 NVivo軟體進行主題式編碼與聚類分析，以掌握制度運作脈絡與關鍵節點。研究結果歸納出四大核心成功因素，包括:「外包設計與評估」、「專業團隊管理」、「病人關係管理與共享決策(CRM/SDM)」以及「設點之醫院支持」。其中，本研究特別指出，自費導向之醫療服務外包，在制度彈性、醫病溝通與病人參與方面具相對優勢，使SDM可在充分衛教與資訊揭露下落實於臨床實務，有效提升病人信任與醫療接受度。 此外，研究透過質性語料之共現頻次分析與概念圖構建，進一步驗證上述四項成功因素在制度導入與營運階段扮演之關鍵角色。研究亦強調，制度落地與永續不僅依賴委外廠商之設計與執行能力，更需醫療機構提供場域資源、制度授權與跨部門合作之支持條件。綜上所述，本研究提出一套可供制度規劃參考之醫療業務外包評估架構，亦為高專業性服務外包提供在地實證與理論連結。建議未來研究可擴大病人觀點調查、探索不同外包場域之比較分析，進一步強化醫療外包在永續治理與創新合作之實務應用潛力。

As healthcare services become increasingly diversified and medical institutions face growing pressure in workforce allocation, medical outsourcing has emerged as a strategic option to enhance operational flexibility and service efficiency. However, outsourcing highly professional services that involve clinical knowledge and patient interaction remains challenging due to issues related to institutional design, trust in cooperation, and quality control. To address these gaps, this study aims to explore the key success factors of medical outsourcing models, analyze their impact on hospital operational efficiency, patient participation, and service quality, and construct a practical and evaluative framework for outsourcing systems. This study investigates a case involving a professional vendor that collaborated with a regional hospital (T) and a medical center (K) in Taiwan to implement outsourced gynecological self-paid treatment services using High-Intensity Focused Ultrasound (HIFU). A qualitative case study methodology was adopted, incorporating semi-structured in-depth interviews, internal documents, field observations, and public data. Thematic coding and cluster analysis were conducted using NVivo software to identify operational dynamics and key nodes within the system. The findings identified four core success factors: (1) outsourcing design and evaluation, (2) professional team management, (3) patient relationship management and shared decision making (CRM/SDM), and (4) institutional support from the hosting hospital. This study particularly highlights that self-paid medical services offer advantages in terms of institutional flexibility, doctor-patient communication, and patient engagement, enabling SDM to be implemented effectively through comprehensive health education and transparent information, thus enhancing trust and treatment acceptance. Furthermore, this study applied co-occurrence frequency analysis and conceptual mapping of qualitative data to validate the critical roles of the above four factors in both implementation and operational phases. It also emphasizes that the success and sustainability of outsourcing systems depend not only on the vendor’s design and execution capabilities but also on the institutional conditions provided by the hospital, such as spatial resources, institutional authorization, and cross-departmental collaboration. In conclusion, this study proposes a contextually grounded and theoretically informed framework for evaluating medical outsourcing, offering insights for institutional planning. It also contributes empirical evidence on outsourcing knowledge-intensive healthcare services. Future research is recommended to incorporate patient perspectives, expand to different outsourcing contexts, and explore the potential of medical outsourcing in sustainable governance and innovative collaboration.