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題名:醫療機構之人力資源管理實務、員工承諾與經營績效的關係~模糊理論與灰色理論的整合運用~
作者:郭幸萍 引用關係
作者(外文):Hsing-Ping Kuo
校院名稱:國立成功大學
系所名稱:企業管理學系碩博士班
指導教授:張淑昭
吳萬益
學位類別:博士
出版日期:2004
主題關鍵詞:灰關聯分析策略類型模糊集合理論醫院人力資源管理實務績效員工承諾Employee CommitmentHRM PracticePerformanceHospitalStrategic typeGrey Relation AnalysisFuzzy Set Theory
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  台灣的全民健保制度從民國84年開始實施後,台灣的醫療機構經營環境面臨重大的改變,要如何改善營運的效率引起廣泛的討論與注意。在醫院中,要如何控制營運的成本變成最重要的課題,其中尤其是人力資源管理的成本佔總營運成本的比率最高。台灣的醫院經營環境複雜且競爭,根據文獻探討及研究的迫切性的結果,本研究欲探討以下四個問題:(1)不同策略類型的醫院,其人力資源管理實務的實行狀況是否不同?(2)每一種人力資源管理實務對醫院的績效是否有不同程度的影響?(3)每一種人力資源管理實務對醫院的績效基於不同策略類型的醫院是否有不同程度的影響?(4)員工承諾在人力資源管理實務與醫院的績效的關係之間是否扮演著中介的角色?本研究主要的目的在於使用灰色系統理論的灰關聯分析和模糊集合理論來探討台灣醫療機構之人力資源管理實務與醫院的績效的關係。
資料收集來自於台灣地區50家大型醫院,本研究的問卷填答者包括15位醫管界專家、50位決策者,92位人力資源部門之相關資深工作人員及主管以及370位醫院的員工,本研究一共分為三個階段,質性訪談的部份用來輔助後續研究的發展與量性分析:第一階段主要在於透過專家的訪談來了解人力資源管理實務本質及醫院績效指標的建構;第二階段則著重於經由專家的意見藉由模糊集合理論來建構醫院之人力資源管理實務之衡量內容;第三階段則藉由灰色系統理論的灰關聯分析,旨在探討人力資源管理實務、員工承諾及與醫院績效的關係。
  本研究的研究結果如下:(1)不同策略類型的醫院,其人力資源管理實務的實行狀況確實不同;(2)每一種人力資源管理實務對醫院的績效有不同程度的影響,在11個人力資源管理實務中,員工參與、內部工作機會及人力資源規劃是前三個對醫院的檔案記錄績效影響較高的主要人力資源管理實務,另外,職業安全、團隊工作及激勵性報酬制度是前三個對醫院的認知績效影響較高的主要人力資源管理實務;(3)每一種人力資源管理系統對醫院的績效有不同程度的影響;(4)每一種人力資源管理實務對醫院的績效基於不同策略類型的醫院有不同程度的影響;(5)員工承諾的中介效果存在於人力資源管理實務與醫院績效的關係間,但不大於直接效果;(6)從灰關聯分析的結果來看,本研究發現員工承諾會受人力資源管理實務實行程度的影響。
  因此,由於經營環境的不同,醫院管理者在配置人力資源管理實務及系統之前需要審慎的評估經營環境,從本研究的灰關聯分析結果來看,醫院可以評估其管理目標根據那些人力資源管理實務與不同類型績效之灰關聯度較高的人力資源管理實務來作為資源配置的優先順序考量,讓醫院管理者作更有效的資源配置。
  In Taiwan, National Health Insurance (NHI) program is started to implement from 1995. Since then, the healthcare institutions in Taiwan have changed considerably and how to improve the operation efficiency has created very high attention. How to control the operational cost is the most important issue for hospitals. Furthermore, the cost of HRM is the highest percentage of total operational cost. Operating hospitals today in Taiwan is increasingly instantaneous, and competitive. According to the research background and literatures review, there are four questions of this study. (1)Does different strategic type have different implementation level of HRM practices in hospitals? (2) Does each HRM practice have a different degree of influence on hospitals’ performance? (3) Does each HRM practice have a different degree of influence on hospitals’ performance based on different strategic type? (4) Does the employee commitment served as a mediate role between the relationship of HRM practices and performance? The research purpose of this study is to explore the relationship between the HRM practices and performance in the Taiwanese healthcare institutions by using the grey relation analysis of the Grey System Theory and the Fuzzy Set Theory.
  The data was gathered from 50 large-scale hospitals in Taiwan. The respondents of this study included 15 experts, 50 decision-makers, 92 personnel of HR department, and 370 employees. This study was divided into three phases, the qualitative analysis is used to complement the quantitative analysis. Phase Ⅰ aimed to investigate what the nature of HRM practices is and what the indicators of hospitals’ performance are actually in the healthcare industry through experts’ interview. Phase Ⅱ focused on constructing the HRM practices by using the fuzzy logic based decision model. Phase Ⅲ explored the relationship between the HRM practices, employee commitment, and hospitals’ performance by using the grey relation analysis of Grey System Theory.
  The results of this study summarized as follows: (1) Different strategic type has the different implementation level of HRM practices in hospitals. (2) Each HRM practice has a different degree of influence on hospitals’ performance. Among 11 HRM practices, employee participation, internal career opportunities, and HR planning are regarded as three of the main practices for impacting hospital archival performance. Furthermore, among 11 HRM practices, employment security, teamworking, and incentive compensation are regarded as three of the main practices for impacting hospital perceptual performance. (3) Each HRM system has a different degree of influence on hospitals’ performance. (4) Each HRM practice has a different degree of influence on hospitals’ performance based on different strategic type. (5) The mediating effect of employee commitment existed between the HRM practices and organization performance, but not larger than the direct effect. (6) From the results of the grey relation analysis, this study found that the employee commitment was affected by the HRM practices critically.
  Thus, owing to differences in managerial environments, hospitals may need to carefully evaluate operating environment before allocating HRM systems to operating systems. From the above results, hospitals could initially allocate their resources and evaluate their managerial objective to those significant contribution systems and practices of HRM according to the priority of grey relation coefficient.
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