自91年7月實施「醫院總額支付制度」以來，總額支付制度對醫院的經營產生莫大的衝擊，各醫院無不積極採取相關之因應措施，以達最佳之營運績效。而為瞭解總額支付制度實施後醫院所採取之因應措施對醫院績效之影響，本研究以某區域教學醫院為例，對醫院員工進行問卷調查，以探討此醫院對總額支付制度之各項因應措施後，員工對組織承諾之影響。研究結果發現，員工對醫院總額支付制度因應措施普遍有高度之認知程度與認同程度，且員工對因應措施之認知與認同程度對提升員工組織承諾具有正面之影響，其中以「節流」措施之影響性最高，值得該醫院持續推動，亦可提供相關醫療機構因應總額支付制度之參考。

To achieve equilibration of National Health Insurance's fiscal revenues and expenditures, "Dental global budget payment system" and "Hospital global budget payment system" have been undertaken by Bureau of National Health Insurance (will be referred as NHI here and after) since July, 1998 and July, 2002, respectively. The implementation of these global budget payment systems has shown great impact on administration effort in either medical centers or hospitals. Thus, many medical organizations have engaged and tried to reach planned operation performance as possible as they could. This study is trying to understand the effectiveness of various counter strategies taken by hospitals to deal with these global budget payment systems by keeping eyes on a district teaching hospital. Measurements, data and public opinions have been collected from this local hospital and subsequently provided raw material for further analysis and discussion. The result shows the corresponding strategies taken substantially boosted up the operational performance which indicated these effective counter measurements actually neutralized the negative impact brought by Global Budget Payment Systems. Data collected by questionnaires for hospital employees suggested a high extent of recognition and identification toward those measurements taken exclusively for Global Budget Payment Systems. The evidence proves that the recognition and identification for these counter measurements by employees gave positive influence on employees' organizational promises. However, effort of cost saving played a most important role among all. And this cost saving effort deserves continual undertaking and serves as a valuable reference to other medical groups as well.