| 摘要: | 教會醫院是戰後臺灣主要醫療資源之一，其宗旨多為秉持耶穌基督博愛濟世精神、服務貧苦或偏遠病患以達到醫療傳教。本論文以研究桃園聖保祿醫院組織管理為主，來瞭解臺灣天主教醫院的發展。民國40-50年代的桃園鎮，公共衛生環境差，醫療資源缺乏，亟需成立一所具規模的醫院。所以當沙爾德聖保祿女修會省會長貝克維修女前來桃園視察後，很快與藍澤民總主教達成創建醫院從事醫療傳教的共識。民國49年修會派遣修女至桃園地區先設立聖保祿診所，隨著人口漸增診所不敷使用，遂決定成立醫院，此舉遭到桃園開業醫的反對，加上創院的土地、資金、硬體、醫事人員等問題一再考驗著修女。最後靠著教友的協調、疏通人脈，才得以解決執業問題讓醫院順利開業。營運初期因有多位國防體系的軍醫協助，使得聖保祿醫院獲得地方上的肯定。 然而民國60年代後期，財團法人醫院林立帶動醫療環境的驟變、醫院企業化管理大行其道，缺乏企業管理的聖保祿醫院，營運日益衰退。為了在市場上生存，醫院決定耗費鉅資投入醫療設備競賽，首先擴建醫院並參與醫院評鑑以提升醫療品質。另一方面，聘請專業管理人才及培養專科醫師，與省立桃園醫院行醫療建教合作。在醫院合理的控制成本及有效管理之下，組織的效能提升，營收逐年上揚，醫院已漸具規模，聖保祿沒有忘記創院的宗旨「那裡有需要，就到那裡去」，走出醫院走向社區。民國81年成立院牧部，將社會服務、醫療傳愛、靈性關懷結合為一，帶領志工隊擴大服務民眾，又將觸角伸入社區照護，成立桃園第一家醫院附設居家護理機構。對於復興鄉山地醫療服務，一路從三民醫療站發展到巡迴醫療，完全不以營利為考量，來爭取民眾的認同。 本研究之對象為聖保祿醫院，是北部地區最早成立的天主教醫院；戰後初期天主教教友大量成長，對醫院早期發展很有助益；而擴建後在尋找醫務管理人才、醫事人員的過程中，也多仰仗教會人士的協助。這些因信仰帶領基督教友團結的力量，是醫院能夠持續經營的重要原因之一。 Missionary hospitals are one of the main health care resources in Taiwan since the end of World War II. These hospitals were established to follow Jesus’ commands to love others and to serve others, especially the poor or rural patients, in order to spread the Christianity. This thesis researches the organization and the management of the Saint Paul’s Hospital （SPH）in Taoyuan to understand the evolution of the missionary hospitals. In the 1950s, the town of Taoyuan was suffering from the lack of public healthcare and medical service resources. It was in dire need of a modern medical facility. After an expedition trip to Taoyuan, Mother Bernard, the former Provincial Superior of the Sisters of Saint Paul de Chartres, decided to establish a hospital for missionary services and the decision was immediately concurred by the Archbishop Lacchio. In 1960, the Congregation sent Sisters to Taoyuan to set up the Saint Paul’s clinic. However, because of a rise in population, the clinic was no longer able to serve the town’s needs; therefore, a decision was made to establish a hospital. This decision was opposed by the medical doctors in the Taoyuan area. Additionally, the Sisters were challenged by difficulties with site, funds, infrastructures and staff. With help from the Catholics, all permitting issues were finally resolved and the Hospital was eventually open for business. In the beginning, the SPH was staffed with the military doctors from the National Defense Department System. The military doctors were well received by the locals. In the late 1970s, the increase in hospitals that were set up by corporations changed the medical service sector. SPH operation managed by business organization became the trend in the industry. Lacking the support from a corporate management, the SPH was losing its business. To survive in the competition, the SPH decided to invest significant funds to the facilities and the equipments. First, it expanded the hospital building and started measuring staff performances to raise the service quality. Then, the SPH hired management professionals and began training programs for medical specialists. It teamed up with the Provincial Taoyuan Hospital for internships and training programs. With proper cost control and effective management, the efficiency of the hospital administration increased and its revenue grew steadily over the years. The SPH gradually reestablished itself in the area. In 1992, the Hospital set up the Pastoral Care Department to serve the communities, to provide medical services, and to spread the evangelization. The Department led a group of the volunteers to promote the community health. It also extended its service later into the nursing care and started the first Home Care Nursing Center in Taoyuan County. The health care that was delivered to Fushing Township in the mountains included a healthcare station at Sanmin Village and mobile clinic-van tours. They were all non-profit and focused only on serving the public. The object of this research is SPH, which is the earliest missionary hospital in the northern region. In the beginning of the post World War II era, the fast increase in numbers of the Catholics had been very helpful to the SPH establishment. Later on, after the Hospital’s expansion, churches were the greatest support for recruiting management professionals and staffing the SPH. The support from the Catholics, arising from their faith, was the main factor keeping the SPH in business. |
