| 摘要: | 本研究主要目的在探討護理之家之經營管理問題，包括護理之家經營管理制度之建立、組織運作法則、市場生存競爭與機構利潤之平衡、社會責信之履行，以及經營管理之危機。本研究透過瞭解護理之家經營(決策)者與管理者如何從市場競爭觀點，思考其經營策略、經營模式、經營品質、與經營利潤，並在機構發展成長歷程中規畫長治久安之道。本研究採用質性研究之深入訪談法與焦點座談法進行資料蒐集，研究範圍以新北市護理之家為主，研究對象包括決策者2位與管理者3位。本研究結果顯示，政府開放民間經營長期照護機構政策已逾十載，隨著法令日漸週延，業者經營模式應已從開拓市場的打天下模式，演進到專業服務的治理天下模式，但從訪談資料中發現，護理之家經營者仍處於打天下模式，主要與機構經營管理之危機有關，包括：（一）護理之家日漸增加，市場競爭導致經營利潤減少；（二）專業人力短缺，尤其護理師及照服員聘任及留任不易，影響專業服務；（三）法令規定日漸嚴謹、制度性束縛增加，且法令修訂後，設備修繕與汰換成本增加；（四）經營者面臨評鑑之壓力，內部管理與績效控管之重要性日增，但優秀管理者尋覓不易。總之，護理之家在運作上仍以市場機制及企業經營為主要法則，面對外部制度改變、資源連結不易等難題，決策者與管理者如何運用經營管理策略加以克服，是機構走向專業服務的關鍵之一。最後，本研究亦針對護理之家有關政府政策、社會資源與社會需求等面向提出建議。
The purpose of this study was to explore the nursing home operations management issues, including the establishment of nursing home management system, law of organizational operation, balance of market competition and the institutional profits and the fulfillment of social accountability, as well as operating and managing crisis. In this study, through an understanding market competition point of view of the nursing home operators (decision makers) and managers, to think about their business strategy, business model, management quality, and operating profit, and in the growth process of institutional development planning for long-term stability.
This study adopted qualitative research methods, including in-depth interviews and focus groups method to collect data from the new Taipei nursing homes, the subjects of this study, including 3 decision-makers and 2 managers. The results of this study show that the policy of the government opened up private long term care facility has more than 10 years. As the Act increasingly comprehensive, the management situation of the nursing homes are still the opening market model (conquer mode), instead of expectation for the professional service model (the ruling and governing model). For the sake of the crisis of institutional management, including: (a) nursing homes is increasing, the market competition lead to reduced operating profit; (b) the shortage of professional manpower, especially to hire and retain the nurses and nurse aides is not easy so that the professional services was affected; (c) the revised Act increased institutional constraints, also increasing the cost of equipment repair and replacement; (d) the operator is facing the pressure of evaluation , the increasing importance of the internal management and performance control, but good managers is not easy to hire.
In short, the main operational rule of nursing home is still market mechanisms and business model. The decision makers and managers of nursing homes must apply management strategies to overcome the problems while facing external system changes and the resources linking process. That’s one of the keys to develop professional service. Finally, this study also recommend for the nursing home about government policies, social resources and social needs of the community-oriented. |
