Abstract

Since National Health Insurance (NHI) implemented in 1995, the dramatic changes of medical environment in Taiwan have forced many hospitals to adjust their operation strategies. The study investigates eligible hospitals with quantitative method and explores the adoption of inter-hospital cooperative operation alternatives as well as its influence factors. The study finds that: (1) Most hospitals in Taiwan still adopt "formal affiliations" and "shared or cooperative services" arrangements at present. But the increasing tendency of "strategic alliance" and "operational chain" arrangement becomes obviously. (2) Even NHI has more impact on local hospitals, the adoption degree of local hospital’s cooperative operation is lower than those of medical centers and regional hospitals. (3) The organizational culture and characteristics may influence the adoption degree of hospital cooperative operation. The more precise organizational objective and commitment are, the higher the adoption degree of cooperative operation is. (4) Operation strategies may influence the adoption degree of hospital cooperative operation. Hospitals with "prospector" or "analyzer" strategy have more proactive attitudes toward inter-hospital cooperation. (5) Cooperative operations may bring benefits both for hospitals and their located area. Hospitals with higher expected benefits for themselves have slightly higher adoption degree than those for their located areas. (6) Public hospitals have higher adoption degree of cooperative operations, such as "informal affiliations", "shared or cooperative services" and "strategic alliance", than those of juridical and private hospitals. And juridical hospitals have higher adoption degree of "operational chain'. The larger the hospital size is, the higher the adoption degree of cooperative operation is.