| Summary: | 碩士 === 臺北醫學大學 === 醫務管理學系 === 91 === Due to the continuous revolutions of the national health insurance payment system, the management of hospitals has been seeking for a better strategy to cope with the changes. The purpose of this study was to explore the factors associated with strategic choices of hospitals in response to the global budget payment system.
This study employed Shortell’s model by dividing strategies into three types: institutional-level response, managerial-level response, and technical-level response. This cross-sectional study investigated 127 hospitals in Taiwan (including district teaching hospitals and higher) by sending them structured questionnaires. In the end, 75 hospitals returned the questionnaires, and the response rate was 59.1%. The results of the study indicated that on the institutional-level response to the global budget payment system, most hospitals adopted the strategy of educating their staff more about the revolutions of the global budget payment system. On the managerial-level response, the majority of hospitals adopted the strategy of enhancing their financial management and constructing a better cost accounting system. Finally, on the technical-level response, most hospitals employed the strategy of establishing a referral system.
The results of the study also showed that strategies on the institutional-level were influenced by hospital ownership and the service volume after the implementation of the global budget payment system. Hospital level, degree of market competition, and change of operating income after the implementation of the global budget payment system were significant indicators of strategies on the managerial-level that hospitals would adopt.
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