博碩士論文 etd-0306109-125528 詳細資訊


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姓名 羅英瑛(Ying Ying Lo) 電子郵件信箱 E-mail 資料不公開
畢業系所 人力資源管理研究所(Institute of Human Resource Management)
畢業學位 博士(Ph.D.) 畢業時期 97學年第2學期
論文名稱(中) 血液透析中心策略聯盟的相關因素:以體制理論與資源依賴理論觀點 
論文名稱(英) Factors Associated with Strategic Alliance among Hemodialysis Centers: A Fusion of Institutional and Resource Dependence View
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    摘要(中) 本研究運用資源依賴理論與制度理論來討論影響透析中心參與策略聯盟的因素,主要的研究目的涵蓋:(1)探討透析中心目前參與策略聯盟的情形,包括策略聯盟對象的種類、數目以及正式化的程度。(2)探討影響透析中心參與聯盟的因素(3)探討影響透析中心參與策略聯盟正式簽約的因素(4)探討影響透析中心參與策略聯盟對象數量的因素。
    透過問卷發放與次級資料的收集,共回收有效問卷219份進行實證分析。結果發現透析中心在決定參與策略聯盟時,主要是由其所面臨的體制環境所導致的強制性、規範性與模仿性的同質的結果,體制環境的力量勝過於組織內部外部資源豐富性複雜性的影響。但是當透析中心一旦參與聯盟之後,組織會依據其內部環境與外部環境豐富性、複雜性來決定是否與聯盟對象簽訂正式化契約,而組織聯盟對象的數量則未能在本研究的理論變項中找到影響的因素。
    本研究瞭解資源依賴理論與體制理論在組織參與策略聯盟不同的階段與程度上所扮演的角色,研究結果除了結果可驗證理論架構外,也可作為實施保險制度時政策制定的參考,並可對實務界提供經營的參考。
    摘要(英) The research has applied both Resource Dependence Theory and Institutional Theory to analyze the organization and the market factors that will influence the hemodialysis centers in adopting a strategic alliance, contracting with and choosing the number of strategic partners. The followings have been examined and analyzed:
    1) the current trend of hemodialysis centers’ strategic alliance, including variety of alliance partners, number of strategic alliance, and the degree of an alliance.
    2) the factors that will cause hemodialysis centers to adopt a strategic alliance.
    3) the factors that will affect the hemodialysis centers to contract with their strategic alliance partners.
    4) the factors that influence centers’ choosing alliance partner(s).
    Questionnaires and collection of secondary dada were conducted. The empirical analysis of the 219 valid questionnaires shows that hemodialysis centers’ strategic alliance decision is influenced by coerce, normativeness and mimicry caused more by institutional environment than by resource environment. However, after an alliance has been adopted, the resource environment has more influence than institutional environment in deciding whether to contract with strategic partners. The research found the number of strategic alliance partners is not influenced by the resource or institutional environment factors.
    This research found both theories play different roles at the different stages of adopting strategic alliance and contracting with partners. The finding not only can help examine the theory framework but also be quite useful to insurance policy decision making and to centers’ daily operation.
    關鍵字(中)
  • 體制
  • 資源依賴
  • 策略聯盟
  • 透析中心
  • 關鍵字(英)
  • institutional
  • Strategic alliance
  • hemodialysis centers
  • resource dependence
  • 論文目次 第 一 章 緒 論 1
    第一節 研究背景與動機 1
    第二節 研究目的 3
    第 二 章 文 獻 探 討 5
    第一 策略聯盟 5
    第二節 理論依據探討影響策略聯盟因素的研究 18
    第三節 台灣透析產業情況 39
    第 三 章 理 論 與 假 設 48
    第一節 資源依賴理論(RESOURCE DEPENDENCE THEORY) 48
    第二節 研 究 架 構 64
    第 四 章 研 究 方 法 65
    第一節 研究設計 65
    第二節 研究變項 65
    第三節 研究對象與資料來源 72
    第四節 分析方法 72
    第 五 章 研 究 結 果 75
    第一節 樣本基本資料 75
    第二節 樣本的聯盟對象與項目分佈 75
    第三節 參與策略聯盟與未參與聯盟透析中心在各項因素上之差異 82
    第四節 透析中心參與策略聯盟後,是否有正式簽約在各項因素上的差異 85
    第五節 透析中心參與策略聯盟後,聯盟對象數量在各項因素上的相關與差異 88
    第六節 自變項相關分析 90
    第七節 資源特性對透析中心參與聯盟影響之分析 93
    第八節 有參與聯盟之透析中心資源特性對正式簽約影響之分析 97
    第九節 有參與聯盟之透析中心資源特性對聯盟對象數目影響之分析 100
    第十節 有參與聯盟之透析中心體制特性對參與聯盟與否之影響分析 103
    第十一節 有參與聯盟之透析中心體制特性對正式簽約影響之分析 105
    第十二節 有參與聯盟之透析中心體制特性對聯盟對象數目影響之分析 107
    第十三節 所屬醫院是否參策略聯盟對透析中心參與聯盟影響之分析 109
    第十四節 連鎖系統中其他成員參與聯盟情形對透析中心參與聯盟之影響分析 110
    第 六 章 討 論 116
    第 七 章 結 論 與 建 議 125
    第一節 結論 125
    第二節 研究貢獻 127
    第三節 未來研究建議 129
    第四節 研究限制 130
    第 八 章 參 考 文 獻 131
    參考文獻 Aldrich, H. (1976). Resource Dependence and interorganizational relations: local environment service offices and social service sector organizations. Administration & Society, 7 (4), 419-453.
    Alexander, J. A., & Amburgey T. L. (1987). The dynamics of change in the American hospital industry: transformation or selection? Medical Care Review, 44 (2), 279-321.
    Alexander, J. A., & Fennell, M. (1986). Patterns on decision making in multihospital systems. Journal of Health and Social Behavior, 27 (1), 14-27.
    Alexander, J. A., & Morrisey, M. A. (1989). A resource-dependence model of hospital contract management. Health Services Research, 24 (2), 259-284.
    Alexander, J. A., Scott, W. R. (1984). The impact of regulation on the administrative structure of hospitals: toward an analytic framework. Hospital & Health Services Administration, 29 (3), 71-85.
    American Hospital Association. (1990). American hospital association guide to the healthcare field 1989 edition. Chacigo:AHA.
    Banaszak-Holl, J., Zinn, J. S., & Mor, V. (1996). The impact of market and organizational characteristics on nursing care facility service innovation: A resource dependency perspective. Health Services Research, 31 (1), 97-117.
    Burns, L. R. (1990). The transformation of the American hospital: from community institution toward business enterprise. Comparative Social Research, 12, 77-112.
    Burns ,L. R., Bazzoli, G. J., Dynan, L., & Wholey, D. R. (2000). Impact of HMO market structure on physician-hospital strategic alliances. Health Service Research, 35 (1), 101-32.
    Burt, R.S.(1987). Social contagion and innovation: cohesion versus structural equivalence. The American Journal of Sociology, 92 (6), 1287-1335.
    Cardwell, R.& Bolon, D. (1996). Strategic alliances and hospitals: a US perspective. Journal of Management In Medicine, 10 (2), 40-46.
    Clement, J. P., D’Aunno T., & Poyzer B. L.(1993). The financial performance of diversified hospital subsidiaries. Health Service Research, 27 (6), 741-63.
    Clement, J. P., McCue, M. J., Luker, R. D., Bramble, J. D., Rossiter, L. F., Ozcan, Y. A., & Pai, C. W. (1997). Strategic hospital alliances: impact on financial performance. Health Affairs, 16 (6), 193-203.
    Colene, C. & Sullivan, D. (1981). An analysis of the effects of perspective reimbursement programs on hospital expenditure. Health Care Financing Review, 2 (3), 1-40.
    Contractor, F., & Lorange, P. (1988). Why should firms cooperate? The strategy and economics basis for cooperative ventures. In F. Contractor, & P. Lorange (Eds.), Cooperative strategies in international business. Lexington, MA: Lexington Books.
    Cook, K., Shortell, S. M., Conrad, D. A. & Morrisey, M. A. (1983). A theory of organizational response to regulation: the case of hospitals. Academy of Management Review, 8 (2), 193-205.
    Dansky, K. H., Milliron, M., & Gamm, L. (1996). Understanding hospital referrals to home health agencies. Hospital and Health Services Administration, 41 (3), 331-342.
    D’Aunno, T. A., & Zuckerman, H. S. (1987). The emergence of hospital federations: An integration of perspectives from organizational theory. Medical Care Review, 44 (2), 323-343.
    D’Aunno, T. A., Succi, M., & Alexander J. A. (2000). The role of institutional and market forces in divergent organizational change. Administrative Science Quarterly, 45, 679-703.
    Deephouse, D. L. (1996). Does isomorphism legitimate? Academy of Management Journal. 39 (4), 1024-1039.
    Department of Health (2008). www.doh.gov.tw
    DiMaggio, P. P., & Powell, W. W. (1983). The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields. American Sociological Review, 48, 147-160.
    Fennell, M. L. (1980). The effects of environmental characteristics on the structure of hospital clusters. Administrative Science Quarterly, 25 (3), 485-510.
    Fennell, M. L. & Alexander, J. A. (1987). Organizational boundary spanning in institutionalized environments. The Academy of Management Journal, 30 (3), 456-476.
    Galaskiewicz, J. (1985). Interorganizational relations. Annual Review of Sociology, 11, 281-304.
    Galaskiewicz, J. & Wasserman, S. (1989). Mimetic processes within an interorganizational field: an empirical test. Administrative Science Quarterly, 34 (3), 454-479.
    Gaynor, M. & Gertler, P. (1995). Moral hazard and risk spreading in partnerships. The Rand Journal of Economics. 26 (4), 591-613.
    Gulati, R. (1998). Alliances and networks. Strategic Management Journal, 19 (4), 293-317.
    Halverson, P. K, Kaluzny, A. D. & Young, G. J. (1997). Strategic alliances in healthcare opportunities for the veterans affairs healthcare system. Hospital & Health Services Administration, 42 (3), 383-410.
    Huwang, S. J., Yang, W. C., & Chen, S. S. (2000). 1999 National dialysis surveillance in Taiwan. Acta Nephrologica, 14 (4), 139-228.
    Hwang, Y. S., Park, S. H. (2007). The organizational life cycle as a determinant of strategic alliance tactics: research propositions. International journal of management, 24 (3), 427-435.
    Iecovich, E. (2001). Resource dependencies of old age homes: Definitions and measurements. Administration in Social Work, 25 (2), 21-37.
    Kaluzny, A. D. & Zuckerman, H. S. (1992). Strategic alliances: Two perspectives for understanding their effectives on health services. Hospital & Health Services Administration, 37 (4), 477-490.
    Ketchen, D. J., Thomas, J. B., & Snow, C. C. (1993). Organizational configurations and performance: A comparison of theoretical approaches. Academy of Management Journal, 36 (6), 1278-1313.
    Kirby, E. G., Sebastian, J. G., & Homberger, K. D. (1998). The effect of normative social forces on managed care organizations: Implications for strategic management/ practitioner response. Journal of Healthcare Management, 43 (1), 86-96.
    Lee, L. L. (2001). Performance evaluation of different types pf hospital strategic alliances on Taiwan. Unpublished Master’s Thesis. Taipei Medical University, Taipei, Taiwan, R.O.C.
    Luke, R. D., Begun, J. W., & Pointer, D. D. (1989). Quasi firms: strategic interorganizational forms in the health care industry. Academy of Management Review, 14 (1), 9-19.
    Meyer, J. W. & Rowan, B. (1977). Institutional organizations: formal structure as Myth and ceremony. American Journal of Sociology, 83, 340-363.
    Meyer, J. W. & Scott, W. R. (1992). The organization of social sectors. In Meyer, J. W. & Scott W. R. (Eds.), Organizational Environments: Ritual and Rationality (pp. 129-175). Beverly Hills: Sage Publications.
    Meyer, J. W., Scott, W. R., & Deal, T. E. (1992). Institutional and technical sources of organizational structure: explaining the structure of educational organizations. In Meyer, J.W. & Scott W.R. (Eds.), Organizational Environments: Ritual and Rationality (pp. 45-67). Beverly Hills: Sage Publications.
    Pfeffer, J., & Salancik, G. R. (1978). The External control of organizations: A resource dependence perspective. New York: Harper and Row Publishers.
    Oliver, C. (1990). Determinants of institutional relationships: Integration and future directions. Academy of Management Review, 15 (2), 241-265.
    Oliver, C. (1991). Strategic responses to institutional processes. Academy of Management Review, 16 (1), 145-179.
    Parkhe, A. (1993). Strategic alliance structuring: A game theoretic and transaction cost examination of interfirm cooperation. Academy of Management Journal. 36 (4), 794-829.
    Peltzman, S. (1976). Toward a more general theory of regulation. Journal of Law and Economic, 19 (2), 211-244.
    Porter, M. E. (1985). Technology and competitive advantage. The Journal of Business Strategy, 5 (3), 60-77.
    Proenca, E. J., Rosko, M. D, & Zinn, J. S. (2000). Community orientation in hospitals: an institutional and resource dependence perspective. Health Services Research, 35 (5), 1011-1035.
    Raudebbush and Bryk, (2000), Hierarchical Linear Modeling: Application and data analysis methods (2nd ed.). Thousand Oaks, CA: Sage.
    Roggenkamp, S. D. (2000). Inter-organizational relationships of medical groups: Influence of market and organizational factors. ( Doctoral dissertation, Virginia Commonwealth University). A AT 9964798.
    Schermerhorn, J. R., Jr. & Shirland, L. E. (1981). Hospital administrators felt needs for interorganizational cooperative and actual cooperative outcomes by their hospital. Decision Science, 12, 486-501.
    Scott, W. R. (1987). The adolescence of institutional theory. Administrative Science Quarterly, 32, 493-511.
    Scott, W. R. (2001). Institutions and Organizations. Thousand Oaks, Calif.: Sage Publications.
    Sherer, P. D., Lee, K. (2000). Institutional change in large law firms: a resource dependence and institutional perspective. Academy of Management Journal. 45 (1), 102-119.
    Shortell, S. M. (1988). The evaluation of hospital systems: unfilled promises and sell-fulfilling prophesies. Medical Care Review, 45 (2), 177-214.
    Singh, J. V., House, R. J., Tucker, D. J. (1986). Organizational change and organizational mortality. Administrative Science Quarterly, 31 (4), 587-611.
    Socolar, R. S., Kelman, L. S. (2002). Part-time faculty in academic pediatrics, medicine, family medicine, and surgery: The views of the chairs. Ambulatory Pediatrics, 2 (5), 406-413.
    Song, Y. I. (1995). Strategic alliances in the hospital industry: A fusion of institutional and resource dependence views. Academy of management journal, Briarcliff Manor, 271-275.
    Stigler, G. Y. (1971). The economic theory of regulation. Bell Journal of Economics and Management Science, 2 (1), 3-21.
    Suchman, M. C. (1995). Management legitimacy: strategic and institutional approaches. Academy of Management Review, 20 (3), 571-610.
    Thompson, J. D. (1967). Organizations in Action. New York: McGraw-Hill Book Company.
    Tolbert, P. S. & Zucker, L. G. (1983). Institutional sources of change in the formal structure of organizations; the diffusion of civil service reform 1880-1935. Administrative Science Quarterly, 28 (1), 22-39.
    Tompson, J. D. (1967). Organizations in action. New York: McGraw-Hill.
    Trinh, H. Q. & O’Connor, S. J. (2002). Helpful or harmful? The impact of strategic change on the performance of U.S. urban hospitals. Health Service Review, 37 (1), 145-171.
    Ulrich, D., & Barney, J. B. (1984). Perspectives in organizations: Resource dependence, efficiency and population. Academy of Management Review, 9 (1), 471-481.
    Uzzi, B., Barsness, Z. I. (1998), Contingent employment in British establishments: organizational determinants of the use of fixed-term hires and part-time workers. Social Forces, 76 (3), 967-1007.
    Walston, S. L., Kimberly, J. R.,& Burns, L. R. (1996). Owned vertical integration and heath care: promise and performance. Health Care Management Review, 21 (1), 83-92.
    Worthington, N. L.& Piro, P. A. (1982). The effects of hospital rate-setting programs on Volumes of hospital services: A preliminary analysis. Health Care Financing Review, 4 (2), 47-66.
    Zajac, E. J., D’Aunno, T. A.,& Burns, L. R. (2000) .Managing Strategic Alliance. In Shortell, S.M. and Kaluzny, A.D. (Eds.), Health Care Management Organization Design and Behavior . NY, Albany: Delmar, 307-329.
    Zinn, J. S., Proenca, J., & Rosko, M. D. (1997). Organizational and environmental factors in hospital alliance membership and contract management: A resource-dependence perspective. Hospital & Health Services Administration, 42 (1), 67-86.
    Zinn, J. S., Weech,R. J.,& Brannon, D. (1998). Resource dependence and Institutional Elements in Nursing Home TQM adoption. Health Services Research, 33(2), 261-273
    Zucker, L. G. (1987). Institutional theories of organization. Annual Review of Sociology, 13, 443-464.
    Zuckerman, H. S. & D’Aunno, T. A. (1990). Hospital alliances: Cooperative strategy in a Competitive Environment. Health Care Management Review. Frederick: Spring , 15 (2), 21-30.
    Zuckerman, H.S. & Kaluzny, A. D. (1991).Strategic alliances in health care: the challenges of cooperation. Forntiers of health services management, 7(3), 3-23.
    Zuckerman, H.S., Kaluzny, A.D.& Ricketts, T.C. (1995). Alliances in health care: What we know, what we think we know, and what we should know. Health care manage review, 20(1), 54-64.
    中央健康保險局 (2007). www.nhi.gov.tw / index.asp
    中華民國腎臟基金會 (2007). www.kidney.org.tw
    台灣腎臟醫學會 (2007). www.tsn.org.tw
    李ㄧ鳴 (2004)。總額預算制度下基層透析診所的發展模式分析。長庚大學醫務管理研究所碩士論文。
    李珞琳 (2001)。醫療機構策略聯盟型態及其績效評估。台北醫學院/醫學研究所碩士論文。
    李素慧 (2003)。總額預算制度下基層透析診所的經營策略研究。台灣大學國際企業研究所碩士論文。
    徐永堂 (2005)。跨組織資源合作與經營滿意關係之研究--以台灣血液透析中心為例。暨南國際大學國際企業學系碩士論文。
    高省 (2003)。台灣透析產業之競爭動態與經營策略之研究。台灣大學國際企業研究所碩士論文。
    黃旭全、許怡欣 (2003).不同權屬別型態醫療院所之經營策略調查。醫院,36(1), 19-26。
    黃尚志 (2000)。臺灣地區八十八至八十九年度透析評估工作報告。臺灣腎臟醫學會雜誌,14 (2002),139-228。
    陳端容 (2002)。台灣醫療產業的組織合作:不對等合作關係運作機制之探討。台灣社會學第三期, 119-162。
    張苙雲、朱永昌(1994)。組織場域的浮現:台灣醫療產業的研究。中央研究院民族學研究所集刊, 77, 157-192。
    張瓊文 (2000)。全民健保制度與醫院合作經營之研究。國立成功大學企業管理學系碩士論文。
    彭朱如、王維元、張錦文& 黃松共 (1997)。從跨組織關係理論觀點探討醫院間的合作策略。中原學報, 25 (4), 1-16。
    彭朱如、司徒達賢 & 于卓民 (2000)。醫療產業跨組織合作方案與管理機制之關係。管理學報, 17 (2), 221-268。
    蔡志宏 (2001)。巨變時代下中型醫院策略聯盟之研究。中國醫藥學院醫務管理研究所碩士論文。
    盧瑞芬、謝啟瑞(2003)。臺灣醫院產業的市場結構與發展趨勢分析。經濟論文叢刊,31 (3), 107-153.
    羅芳怡 (2002)。競爭優勢來源、網絡中心性及績效之研究-以參與醫療聯盟群之醫院為例。靜宜大學企業管理研究所碩士論文。
    嚴玉華 (2002)。網路觀點之醫療產業合作動機、合作策略類型、統治機制與經營績效之研究。長榮管理學院經營管理研究所碩士論文。
    口試委員
  • 林妍如 - 召集委員
  • 李英俊 - 委員
  • 溫金豐 - 委員
  • 葉淑娟 - 指導教授
  • 陳世哲 - 指導教授
  • 口試日期 2009-03-05 繳交日期 2009-03-06

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