自1995年實施全民健保以來，醫療生態有了巨大改變。至今全民健保的納保率已達99％以上，絕大部份醫療院所均與健保局簽約，中央健康保險局成為唯一支付醫療費用的機構。但由於健保局的資源分配政策，及轉診制度失敗，病人不分病情輕重，直接到到大醫院就醫，使基層診所的市場空間受到擠壓。研究者本人是基層診所服務已達10餘年的內科專業醫師，深刻瞭解想要在目前競爭激烈、峻險的醫療環境下妥善地經營診所，其生存不易。 本論文先對台灣醫療產業及基層診所作整體的介紹後，再深入探討個案診所的策略管理。研究者以有系統的方式來分析個案診所的策略管理程序：首先了解個案診所在策略規劃階段如何「衡外情」以掌控外界環境中的機會與迴避其威脅，和「量己力」以發揮其資源上的強勢和隱藏其弱勢，及如何產生策略結果，接著了解在策略執行階段如何進行因應的組織變革計劃，最後了解在策略控制階段如何做策略執行控制。 本研究藉由「基層診所經營策略管理之探討」，期待能提供基層醫療院所管理者一些建議與參考，使能了解如何分析診所內外對其有利與不利的因素，探討如何做策略管理以因應困難，提升自己的競爭力以及預測醫療產業的趨勢變化與擬定未來的最適競爭策略，幫助診所持續優勢經營，進而提高醫療服務的品質，幫助建立醫師、病患、與健保局之間良好關係。 Since the implementation of National Health Insurance (NHI) in 1995, the medical environment has been experiencing tremendous change. So far the rate of joining NHI has reached over 99%. Because of the contracts signed between the Bureau of NHI and the majority of hospitals and clinics, the Bureau of NHI becomes the only agency paying medical expenses. However，due to the resource-allocation policy of the Bureau of NHI and the failure of referral system, patients go directly to big hospitals to seek medical advice , regardless of their severity of symptoms. It causes clinics in the medical market space to be squeezed. The researcher who serves at the clinics more than 10 years is a physician. He deeply understands that it is not so easy to manage a clinic excellently under the competitive medical environment. After the overall introduction of Taiwan medical industry and primary care clinics, this paper will be discussed on the strategic management procedure by case study. The researcher analyzes the case in a systematic way. In the strategic planning stage, firstly he studies how the case “measures the external environment” to control it to take opportunities and avoid threats; secondly, how the case “measures its own resources” to utilize their strengths and hide their weaknesses, moreover how the strategy is resulted in. Then, in the strategic implementation stage, he studies how it executes organizational- change plan in response to the change of external environment. Finally, he studies how it controls the strategic execution under strategic control stage. By the study of “Business Strategy Management of Clinic”, it is expected to provide medical administrators of primary care institutions with some good recommendations, and help these managers analyze the inside-resource and outside-environment of clinics for favorable and unfavorable factors. This paper is discussed on how to do strategic management to cope with difficulties, and the strategic management of improving competitiveness for clinics. It is also discussed on how to predict the changing trends in medical industry, develop the optimal strategy in the future and help clinics operate for sustainable advantage. Furthermore it maybe improve the quality of medical services, help build up the good relations between doctors、patients and the National Health Insurance Bureau .
