臺灣的醫療產業自全民健保開辦以來，醫療需求日益增加，也造就了許多大型醫學中心的蓬勃發展，根據台灣的醫療服務經營型態可區分為醫學中心、區域醫院、地區醫院與基層診所。隨著經濟起飛與社會經濟環境的變遷，民眾的就醫習慣也出現轉變，逐漸呈現偏向醫學中心與基層診所的二極化趨勢，導致中小型地區醫院在經營上面臨諸多困境。此外，台灣亦正面臨人口老化、少子化及疾病型態轉變等挑戰，使得消化系統相關疾病的發生率快速上升，國人十大癌症死因中，就有食道癌、胃癌、大腸癌、肝癌、胰臟癌等五大癌症跟消化系統有關，且還有許多所謂的現代文明病，如胃食道逆流、大腸息肉、胃潰瘍等，因此消化系統疾病的醫療市場需求非常的大。隨著醫療技術進展，近年來新的內視鏡診斷及治療技術誕生，但醫學中心受限於健保總額制及空間有限，使得內視鏡中心營運面臨飽和困境、民眾排檢等待時間攏長，而中小型醫院則有人員招募不易、進入門檻高等問題，均使得民眾無法享用高品質醫療照護。近年來連鎖加盟診所、健檢外包的風氣日漸盛行，但連鎖內視鏡中心的營運模式尚未發展，因此，本研究以某醫學中心等級之消化內視鏡中心為主要品牌企業，探討以其連鎖品牌進行中小型地區醫院外包及加盟模式的經營策略。研究方法將先進行文獻探討，以暸解醫療產業加盟、外包的法律規範，進行專家訪談，了解連鎖經營模式的潛在利益及風險，再以多種策略分析工具，探討「連鎖內視鏡中心」的競爭、成長策略，並建構一個新商業營運模式，以達成醫學中心品牌、中小型醫院、民眾三贏的最終目的。

Since the launch of Taiwan's National Health Insurance program, the growing demand for medical services has driven the expansion of large medical centers. Taiwan’s healthcare institutions can generally be categorized into medical centers, regional hospitals, district hospitals, and primary clinics. Recent socioeconomic developments have polarized patient care-seeking behavior, favoring either large-scale medical centers or small primary clinics, while small- and medium-sized district hospitals face increasing operational challenges. Simultaneously, Taiwan is experiencing rapid demographic shifts, including population aging and declining birth rates, along with a rising prevalence of digestive diseases. Five of the top ten cancer-related causes of death—esophageal, gastric, colorectal, liver, and pancreatic cancers—are associated with the digestive system, alongside other common conditions such as gastroesophageal reflux disease, gastric ulcers, and colonic polyps. These factors have led to a significant increase in demand for digestive healthcare services.
Although recent advances in endoscopic diagnostic and therapeutic technologies have improved clinical capabilities, constraints in medical centers—such as global budgeting and space limitations—have led to service saturation and prolonged waiting times. Meanwhile, small- and medium-sized hospitals face difficulties in staffing and entry barriers, resulting in a gap in access to high-quality care. While franchised clinics and outsourced health screening services have gained popularity, standardized operational models for franchised endoscopy centers remain underdeveloped.
This study investigates a new business model for franchised digestive endoscopy centers, using a high-level medical center as the core brand. The research methodology includes a review of legal frameworks for franchising and outsourcing in healthcare, expert interviews to explore potential risks and benefits, and application of strategic analysis tools to assess competitive and growth strategies. The ultimate goal is to establish a sustainable operational model that benefits medical center brands, regional hospitals, and patients alike.

論文審定書 i
摘要 ii
Abstract iii
目錄 v
圖目錄 vi
表目錄 vii
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的與流程 11
第二章 文獻探討與策略分析工具 14
第一節 醫療產業外包與加盟模式的法律規範及其研究創新性 14
第二節 產業環境PEST分析方法 19
第三節 波特五力分析模型 21
第四節 SWOT分析 23
第五節 STP分析和4P行銷組合 25
第六節 商業模型分析 28
第三章 研究方法 30
第一節 研究設計 30
第二節 個案訪談設計 32
第四章 個案分析 34
第一節 內視鏡營運模式分析 34
第二節 連鎖經營之內視鏡中心商業模型分析 51
第五章 結論與建議 56
第一節 研究結論 56
第二節 未來建議 58
參考文獻 60

一、 英文文獻
Arnold, D. R., Porterfield, R. I., & Smith, C. D. (1998). E-SWOT: Extension of a practical tool for small business. Small Business Institute Director’s Association, 294–303.
Borden, H. (1964). The concept of the marketing mix. Journal of Advertising Research, 4(2), 2–7.
DeSilets, L. D. (2008). SWOT is useful in your tool kit. Journal of Continuing Education in Nursing, 39(5), 196–197. https://doi.org/10.3928/00220124-20080501-11
Dewhurst, M., Hancock, B., & Ellsworth, D. (2013). Redesigning knowledge work. Harvard Business Review, 91(1), 58–64.
Hamel, G. (2000). Leading the revolution: How to thrive in turbulent times by making innovation a way of life. Harvard Business School Press.
Hooley, G., Piercy, F., & Nicoulaud, B. (2012). Marketing strategy and competitive positioning (5th ed.). Pearson.
Johnson, G., & Scholes, K. (1999). Exploring corporate strategy: Texts and cases (6th ed.). McGraw-Hill.
Kotler, P. (2000). Marketing management: Analysis, planning, implementation, and control (10th ed.). Pearson Prentice Hall.
Kotler, P. (2003). Marketing management (11th ed.). Pearson Prentice Hall.
Magretta, J. (2002). Why business models matter. Harvard Business Review, 80(5), 86–92.
McCarthy, E. J., & Perreault, W. D. (1960). Basic marketing: A management approach. Richard D. Irwin.
Morris, M., Schindehutte, M., & Allen, J. (2005). The entrepreneur’s business model: Toward a unified perspective. Journal of Business Research, 58(6), 726–735. https://doi.org/10.1016/j.jbusres.2003.11.001
Osterwalder, A., & Pigneur, Y. (2010). Business model generation: A handbook for visionaries, game changers, and challengers (Vol. 1). John Wiley & Sons.
Porter, M. E. (1980). Competitive strategy: Techniques for analyzing industries and competitors. Free Press.
Porter, M. E. (1985). Competitive advantage: Creating and sustaining superior performance (1st Free Press ed.). Free Press.
Richardson, J. (1993). Parallel sourcing and supplier performance in the Japanese automobile industry. Strategic Management Journal, 14(5), 339–350. https://doi.org/10.1002/smj.4250140505
Smith, W. R. (1956). Product differentiation and market segmentation as alternative marketing strategies. Journal of Marketing, 21(1), 3–8. https://doi.org/10.1177/002224295602100102
Timmers, P. (1998). Business models for electronic markets. Electronic Markets, 8(2), 3–8. https://doi.org/10.1080/10196789800000016
Tseng, P. H., Lee, Y. C., et al. (2012). Association of diabetes and HbA1c levels with gastrointestinal manifestations. Diabetes Care, 35(5), 1053–1060. https://doi.org/10.2337/dc11-2051
Weihrich, H. (1982). The SWOT matrix—A tool for situational analysis. Long Range Planning, 15(2), 54–66. https://doi.org/10.1016/0024-6301(82)90120-0

二、 中文文獻
大嶋祥譽（2021）。麥肯錫思考模型活用法。大是文化。
張金山、董光、王徵（2009）。基於SWOT分析的企業競爭情報獲取途徑研究。情報科學，27(5)，672–679。
陳美惠（2003）。醫院採行醫療業務委外經營方案之研究─以台灣南部地區醫院為例（碩士論文）。國立中山大學人力資源管理研究所在職專班。
陳惠芳、范春寶、謝明娟、魏美珠、楊美雪、韓揆（1999）。醫院外包管理相關探討。醫院，32(1)，73–78。
陳銘樹、郭恆宏（2024）。醫療行銷管理。全華出版社。
曾光華（2004）。行銷管理：理論解析與實務應用。前程文化。

三、 網路資料
國家發展委員會（無年份）。中華民國人口推估（105至150年）。http://www.ndc.gov.tw
陳芳哲（2006）。血液透析中心屬性、委外考慮因素與委外決策之關係（碩士論文）。台灣碩博士論文知識加值系統。https://ndltd.ncl.edu.tw
陳操斐（2008）。台灣醫療產業資產活化與擴充策略之研究（碩士論文）。台灣碩博士論文知識加值系統。https://ndltd.ncl.edu.tw
監察院公報（2011）。公立醫院將核心醫療業務外包影響醫療專業性與公益性。監察院公報。https://www.cy.gov.tw/News_Content.aspx?n=795&s=5862
衛生福利部（2010）。衛生福利法規檢所系統－醫療機構業務外包作業指引。https://mohwlaw.mohw.gov.tw/FLAW/FLAWDAT0202.aspx?lsid=FL093925
衛生福利部（2023）。國人死因統計結果。https://www.mohw.gov.tw/cp-16-79055-1.html
聯合報新聞（2020）。胃食道逆流健保數據。聯合報健康頻道。https://health.udn.com/health/story/5976/4347376
醫療法（2023）。全國法規資料庫。https://law.moj.gov.tw/LawClass/LawAll.aspx?PCode=L0020021
闕光威（無年份）。連鎖診所品牌的法律架構。安永台灣法律服務。https://www.ey.com/zh_tw/insights/law/legal-entity-liability-of-medical-clinic-chains