台灣的健康服務產業：以健康照護為例

Abstract

近年來在生育率下降、人口老化、醫療資源集中於中高齡人口、慢性病成為主要死因之趨勢下，為有效利用健保資源，政府積極引導企業跨足遠距照護，以照護替代長期住院，降低整體醫療費用。然我國以中小企業為主，對於需結合醫療器材、通訊技術、醫療、資訊管理等複雜度相對高之遠距照護，實難由單一企業提供服務，而需藉由異業結盟方能共創多贏。本文先由較大範圍之健康服務產業，利用SWOT模型，分析我國發展健康服務產業之策略。並從資訊服務提供者的角度，透過價值網分析與其他健康管理服務提供者之競合關係。 根據SWOT分析，從我國發展健康服務產業的角度，利用優勢必須善用政府的支持，整合硬體（遠距健康照護的技術平台）及軟體（個人生理資訊資料庫的標準、存取資料的認證標準），並且由政策面鼓勵企業聯盟以提供健康服務。避免弱勢則是設法解決照護人力不足問題，可以從如何增加照護人力（如訓練），以及如何在不影響照護品質下減少照護人力需求（如放寬遠距照護應用之服務行為）。利用機會是利用引發的長期照護需求，以及管理慢性及退化性疾病的健康管理商機。避免威脅是設法弱化威脅，提高付費服務的誘因（如所得稅扣抵）、放寬法令提供地區小型醫院轉型空間，政府介入主導縮短因應時間。 透過價值網分析，吾人建議以具規模經濟之服務提供者為主導，統合包括收費、利潤分配等，以著眼於長期利益，策略聯盟或外包業務與其他服務提供者，並爭取政府或保險業者之支持。

Under the trends in drop of fertility rate, aging of population, chronic diseases become main causes of the death, and the population at advanced age in medical resources are used and concentrated on in recent years, in order to utilize the resources of national insurance effectively, the government encourages enterprises to deal in telecare actively. Substitute long-term stay in hospital with healthcare to reduce the hospitalization cost of the whole. Since our country takes small and medium-sized enterprises as the core, telecare which combines medical appliances, communication technologies, medical treatment and information management is difficult to provide service by single-enterprise. It is necessary to form an alliance and create multi-win with the different family property. This text makes use of SWOT by more broad health service industry first to analyze development strategies of the health service industry is in our country. Secondly make use of value net to analyze co-opetition with other health management service providers from the view of the service provider of information. According to SWOT analysis use strengths to make the best of the support of the government to integrate hardware, the technological platform of telecare, and software, the standard of the personal physiological information database and authentication standard of the access materials. Encourage the coalition of companies to offer health service by the policy. Prevent weaknesses to try to solve the shortage of human resources from healthcare. We may think about increasing the manpower such as by training and reducing the manpower demand without sacrificing the quality such as by relaxing restrictions of telecare services. Use opportunities to take advantage of the business opportunities of long-term care demand, health management of chronic disease and degeneration. Prevent threats to weaken threats and increase the incentive to purchase service such as income tax exception or relaxing the legal restrictions to provide transition space for small scale regional hospital. The government must involve in leading role to shorten response time. Base on value net analysis we propose the service providers with scale economics take leading role, combine charging and profit distribution, etc. On the basis of long-term gain, utilize strategic alliance or contract with other service provider, and strive for government and insurer’s support.