| Summary: | 博士 === 國立臺灣大學 === 醫療機構管理研究所 === 88 === Facing rapid changes in global economics, health care organizations suffer more than other industries do because of their extraordinary and important positions. Therefore, the key idea is that health care managers must control the changeable conditions to make sure organizations'''' perpetuity. Appropriate strategies are the keys to handle sudden changes in economics. The process to form strategies determines the correct strategies.
Therefore, this study from the standpoint of how strategies make is focused on the related characteristics of strategic decision making, and the relationship among hospital top-management-team, external environment, hospital internal characteristics, and decision-making process. Further analysis carried on the impact of decision characteristics on organizational effectiveness and organizational commitment of middle-class managers.
Unit of analysis is set as organizational level. Our sample is mainly included quasi-area hospitals and higher level ones in Taiwan area. This study collects data through two designs. First is conducting a survey. The survey collects data regarding organizational commitment and related characteristics of decision-making and hospital top-management-team. Two-stage survey first inquires principles of sample hospitals, and then according to the team member lists they provides, we mail the other copies of questionnaires to decision-making team members and middle-class managers. Response rate from principles, decision-making team members and middle-class managers is 67.7%, 52.1%, and 34.2%, respectively. Second research design is to collect data about hospital effectiveness, internal characteristics and environment factors from official database of Department of Health, Bureau of National Health Insurance, Ministry of the Interior, and Directorate-General of Budget, Accounting and Statistics.
Results list below:
1. About effectiveness :
There is significant relationship between consensus and effectiveness especially for top-management-team members by controlling other related characteristics. Agreement in consensus has positive relationship with effectiveness in hospitals. Comprehensiveness in the strategic decision-making process has positive but not statistically significant relationship with organizational effectiveness. In addition, comprehensiveness has positive relationship with objective overall effectiveness. Consensus has positive and significant relationship with physician-based effectiveness index.
Homogeneity in demographic variables among decision-making team members has negative relationship with organizational effectiveness. There is no significant relationship between effectiveness and internal and external control characteristics. Size has positive and significant relationship with organizational effectiveness. Ownership is associated with organization effectiveness.
2. About commitment :
Comprehensiveness in decision-making process has positive and significant relationship with organization commitment, especially for middle-class managers. Consensus also has positive relationship with organization commitment.
There is no significant relationship between demographic variables of decision-making team members and organization commitment. Size has no association with organization commitment. Organization commitment has positive relationship with certain types of ownership, especially middle-class managers of religion and private medical college hospitals.
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