| Summary: | 碩士 === 國立臺灣大學 === 商學研究所 === 90 === After the National Health Insurance (NHI) program was carried out 7 years ago, the medical environment in Taiwan has insidiously changed. The medical resources gradually centralized into the urban area. The size of health care systems gradually changed toward two extremes (i.e., medical centers with a bed number over 1,000 beds vs. one-doctor out-patient clinics). As the medical expense seriously expanded in the past years, the NHI Bureau set up a series of new payment policies to tight the medical expense. The hospital reaction to the new payment scheme varied. Business process reengineering (BPR) and outsourcing of non-competitive business, which are frequently used in the manufacturing industry, have been adopted in hospital management to survive in such adverse circumstances.
In 2001, the National Taiwan University Hospital (NTUH) carried out a radical BPR in hospital materials management and outsourced its distribution activity. The logistics company, which had won the contracts, was required to organize the medical drug and material suppliers, to re-establish the supplying process, and to distribute medical drugs and materials to 35 dispensaries and 165 nursing stations. The contracted logistics company agreed that all of these activities should be performed gratuitously. The aims of present study are: to evaluate advantages and disadvantages of this program (for NTUH); to evaluate the feasibility of free charge (for logistics company); to analyze the possible difficulties in carrying out the program; and to search for the key success factors.
Before outsourcing, the NTUH had three large warehouses to store medical drugs and materials for daily uses in medical practice. On request, the suppliers had to deliver their medical drugs and materials within 7 days to NTUH for ascertaining and stocking. Twice a week, the warehouse man summarized supplements list of each dispensary and nursing station, then arranged warehouse operators to pick up, to pack, and to distribute the drugs and materials to each dispensary or nursing station. In the new business model, suppliers are required to send their goods to the contracted logistics company or the latter takes goods back from the suppliers. The logistics company then, according to different requirement of each dispensary and nursing station, picks and packs goods into different boxes. On the next day, the logistics company should distribute these boxes to NTUH, directly to the stations without stocking into the warehouses. NTUH would not pay any fee to the logistics company and could save a total expense of 1.5 million each year.
As NTUH will require the suppliers to send their goods to nursing stations or dispensaries, the logistics company could negotiate with suppliers to contract to transport their goods, including both the outside delivery (from supplier to hospital port) and inbound distribution (from hospital port to nursing station or dispensary) business. Through professional arrangement, the logistics company should re-organize the whole supply process and could obtain financial benefits from suppliers.
When the logistics company began to implement this new model, several difficulties appeared, such as argument between the company and suppliers over the logistic fees; active hostile or passive non-cooperative attitudes of some suppliers. Continuous negotiation with all sincerity should be the only way to solve these problems.
After careful analysis, the key success factors for this new business model are: skillful application of information technology on controlling the material flowing activities and expansion of same business activities to nearby large hospitals to reach the scale of economy. Invitation of the suppliers to take participation in establishing the new supply process seems also crucial, especially to eliminate suppliers’ hostility.
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