| Summary: | 碩士 === 國立臺北大學 === 公共行政暨政策學系 === 97 === Because of the change of medical market and the impact of National Health Insurance, ten Taipei City hospitals were merged into one hospital in 2005.The integration of hospitals can improve the operational efficiency and maintain the characteristics in public health. However, the process of the construction of governing model was affected by the external environmental changes and the one’s position in public health, adjusted itself continuously in order to seek niche under the constraints of institutional environment. The author discussed the process and the change of governing model of Taipei City hospitals from 2005 by document analysis and in-depth interview. In addition, this research proposed the methodology in the basis of institutional change theory and governance theory, besides to understand the details of institutional environment mould the construction of governing model, the research also analyzed the role and the interaction of multiple actor and the result of the construction of governing model. Finally, the author tested the theory of discovery and addressed suggestions of practice and follow-up study.
The research discovered that the construction of Taipei City hospital governing model was limited to the institutional environment, which also adjusted dynamically to seek the sustainable development. To sum up, this research case shows list characteristic:
1. It drove the building of governance model because of operational inefficiency and the fast change of medical environment.
2. The SARS played the important catalyst in this research case;
3. The thought of leader directed the way of building of governance model.
4. The councilors play roles as the mediator of multiple-interest, and intervene in the process of construction.
5. The difference of organization culture made the governance model work unsuccessfully.
6. The constructing process faced lots of objection because of lacking of communication which led to a common consensus.
7. The governance model is still adjusted continuously and seeking for the balance point between efficiency and public interest.
There is something we could notice, this research also found one important: in this case, although the environmental impacts on construction of governing model is great, the relationship network organized by decision-elite not only promote this organizational change scheme, but also shape the direction of the construction of governing model.
Key words: Taipei City Hospital, institutional change, governing model, new institutionalism
|
|---|
