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系統識別號 U0002-1707201303204800
中文論文名稱 以平衡計分卡為基礎之醫院治理與內部控制機制之研究—本體論為方法
英文論文名稱 The Study of Balanced Scorecard in Hospital Governance and Internal Control - Using Ontology Approach
校院名稱 淡江大學
系所名稱(中) 管理科學學系企業經營碩士在職專班
系所名稱(英) Executive Master’s Program of Business Administration(EMBA) in Management Sciences
學年度 101
學期 2
出版年 102
研究生中文姓名 陳伶俐
研究生英文姓名 Ling-Li Chen
學號 700620460
學位類別 碩士
語文別 中文
口試日期 2013-06-29
論文頁數 99頁
口試委員 指導教授-廖述賢
委員-倪衍森
委員-廖衛邦
中文關鍵字 本體論  平衡計分卡  醫院治理  內部控制 
英文關鍵字 Ontology  The Balanced Scorecard  Internal Control  Hospital Governance 
學科別分類
中文摘要   組織在營運過程中,為尊重其利害關係人之權益及健全組織之經營,須以良好內部控制制度為基礎,來強化組織管理機制,醫療機構如同一般企業在面臨醫療市場轉變,及全民健保制度衝擊下,其醫療服務品質及管理績效之良窳,日益受到重視。
  醫療機構屬非營利事業,但若長期處於虧損,恐將無法永續經營,為能達到永續經營目標,醫院管理者應推動並落實「內部控制制度」,保障機構免於因人為缺失而造成損失,並降低錯誤與舞弊發生之可能性,以增進工作效率,維護財物安全,如此便可實現經營理念,亦可降低經營管理風險。
  本研究選擇某公立醫院為研究對象,以本體論為方法,建構與設計其本體圖,診斷其內部控制制度,及檢視其醫院治理機制,並運用平衡計分卡強化內部控制機制,解決組織存在之部分問題,進而健全醫院治理機制。
  本研究結果發現個案醫院嘗試以平衡計分卡解決內部控制機制執行過程,發現其遭遇些許挑戰,例如:各科部室對內部控制制度不熟悉、教學研究單位無成本觀念、公家體系公務人員抗拒心態、制式化之法規,及行政部門比醫療部門難以訂定目標與指標等。
  儘管有些許挑戰尚待克服,但對於長久獨立於市場運作之公立醫院而言,平衡計分卡不失為一有效檢視組織與環境互動關係,並整合組織各部門運作,以進行資源配置之工具。
英文摘要   In order to respect the stakeholders’ rights and to better integrate management, Internal Control is emphasized to assist the organization’s management systems during operation. Healthcare institutions are facing market changes just as any general enterprise. The intersection of the National Health Insurance System, the healthcare service quality and management effects are presently of concern.
  Healthcare institutions are non-profit businesses. If any business encounters long-term deficit problems, it may become insolvent. To maintain sustainable management targets, the hospital administrator should put an Internal Control System into effect. Such an implementation will protect the institution from loss caused by human error and reduce the possibility of errors and dishonesty. In addition, it promotes work efficiency, increases safety and can lead to not only good management but also reduce management risks.
  The research chose a public hospital as the study object. It uses an Ontology Approach as the study method to construct and design the blueprint and to examine the Internal Control Systems and the Hospital Governance System. In order to solve problems in the organization and enforce a Hospital Governance System, it is effective to put the Balanced Scorecard into effect.
  The results of this study pointed out some challenges upon trying to implement the Internal Control system. Some of these challenges consist of unfamiliarity in departments, no cost consciousness in continuing education and research, resistant attitudes in government officers, standard legislation, and difficulties formulating goals and norms.
  Many public hospitals have long been excluded from healthcare market operations. The Balanced Scorecard is viewed as an effective tool to examine the interactions between an organizations and the environment even though challenges are present and must be overcome for successful implementation. In addition, the Balanced Scorecard can also be used to integrate department’s organizations and distribute resources.
論文目次 目錄
謝辭 II
中文摘要 III
英文摘要 IV
目錄 V
表目錄 VII
圖目錄 VIII
第一章 緒論 1
1.1研究動機 1
1.2研究目的 1
1.3研究流程 3
第二章 文獻探討 5
2.1本體論 5
2.2利害關係人 12
2.3內部控制 16
2.4平衡計分卡 22
2.5醫院治理 29
第三章 研究方法 36
3.1個案研究法 36
3.2本體發展與設計 36
3.3本體之應用 46
第四章 個案研究 50
4.1個案選擇 50
4.2背景說明 50
4.3醫院治理機制流程圖 58
4.4內部控制制度流程圖 59
4.5平衡計分卡實施現況與流程圖 69
第五章 醫院治理與內部控制機制之探討—系統展示 73
5.1個案醫院平衡計分卡系統展示 73
5.2個案醫院內部控制系統展示 78
5.3個案醫院醫院治理系統展示 83
第六章 結論與建議 88
6.1研究結論 88
6.2研究建議 89
6.3研究限制 91
參考文獻 92

表目錄
表2-1醫療法之醫療機構定義 31
表4-1個案醫院職掌表 55
表4-2醫療照護循環控制作業及重點 61
表4-3醫療服務收入及收款循環控制作業及重點 65
表4-4採購及付款循環控制作業及重點 67
表4-5人事薪工循環控制作業及重點 68

圖目錄
圖1-1研究流程圖 3
圖2-1本體論種類 8
圖2-2人在醫療體系所扮演之多重角色 16
圖2-3平衡計分卡之四個構面架構圖 26
圖3-1利害關係人本體圖 38
圖3-2平衡計分卡本體圖 40
圖3-3內部控制本體圖 42
圖3-4醫院治理本體圖 46
圖3-5內部控制制度主要流程圖 47
圖3-6醫院治理機制內外關係圖 48
圖4-1個案醫院組織圖 52
圖4-2個案醫院行政部門組織圖 52
圖4-3個案醫院醫療支援部門組織圖 53
圖4-4個案醫院醫療部門組織圖 54
圖4-5個案醫院教學研究部門組織圖 54
圖4-6醫院治理流程圖 58
圖4-7門診醫療流程圖 60
圖4-8急診醫療流程圖 61
圖4-9醫療服務收入及收款流程圖 64
圖4-10採購及付款流程圖 66
圖4-11人事薪工流程圖 68
圖4-12個案醫院策略地圖 71
圖4-13平衡計分卡流程圖 72
圖5-1個案醫院系統登入畫面 73
圖5-2個案醫院系統查詢畫面 74
圖5-3個案醫院系統查詢畫面 75
圖5-4個案醫院系統查詢畫面 75
圖5-5個案醫院系統查詢畫面 76
圖5-6個案醫院平衡計分卡查詢畫面 77
圖5-7個案醫院平衡計分卡畫面 77
圖5-8個案醫院醫療批價系統登入畫面 79
圖5-9個案醫院醫療系統登入畫面 80
圖5-10個案醫院醫療系統查詢畫面 81
圖5-11個案醫院會計系統登入畫面 82
圖5-12個案醫院會計系統 83
圖5-13個案醫院100年度總院收入結構 84
圖5-14個案醫院100年度總院成本結構 85
圖5-15個案醫院91年至100年固定資產投資 87
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