臺灣地區近年來醫療環境變化快速，尤其是全民健康保險的實施使醫院間的競爭愈來愈激烈，許多醫院面臨既要降低成本又要維持醫療品質的壓力下，而調整其經營策略。由於醫院經營策略的調整，醫院社工部門的功能亦有所改變。 本研究選擇 82 家醫院發出 190 份問卷，由任職四年以上資深社工人員填妥寄回， 有效問卷 89 份，問卷回收率為 46.8%。 本研究結果顯示： 一、全民健保實施後，大部分醫院社會工作項目的執行程度有增加，只有少部分減少。增加程度最大的為「殘障鑑定工作」；減少程度最大的為「協助醫療費用補助申請」。 二、在醫療環境與衛生政策上，醫院社工人員認為對其工作影響最大為「人口結構老化」，其次為「家庭機能改變」；而「醫療發展基金的設立」則對工作影響最小。 三、對於未來醫院社會工作部門功能的轉變，以「處理病患個人問題」增加最多，其次為「出院服務」；而減少的工作主要為「公共關係」及「行政工作」。

　　　　　Medical care environment has changed rapidly for the past few years in Taiwan. Increasing competition after the implementation of the National Health Insurance has made many hospitals to adjust their management policies in order to lower their cost and maintain their qualities of health care. The adjustments on the management plicies have also changed the function of social workers in hospitals. In this research, 82 hospitals were selected and 190 questionnaires were distributed to senior social workers with experience of 4 years or more. 89 questionnaires returned are valid and the returning rate is 46.8%. The result of this research shows as follows: 1. After the implementation of National Health Insurance, most of social work has been increased and only a small part of it decreased. The one increased most is the authentication of disability and the one decreased most is the assistance for applying for medical care subvention. 2. For the medical care environment and health policy, socials workers considered that the aging of population morphology has the most influence on their jobs, the change of family function is the second most important factor, and the establishment of medical care development foundation has the least influence. 3. For the changes of the functions of social work in the hospitals, the one increased most is to deal with personal problems of the patients and secondly, the services for discharging. On the other hand, the public relation and administration work has been decreased.