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2 The Business Model in Taiwan s Specialist Hospitals from Transaction cost Perspectives By Wen-Chung Feng Advisor: Prof. Jau-Shin Hon A Thesis Submitted to Tunghai University in Partial Fulfillment of the Requirements for the Degree of Master of Business Administration July 2009 Taichung, Taiwan

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4 The Business Model of Taiwan s Specialist Hospitals from Transaction Cost Perspectives Student: Wen-Chung Feng Advisor: Prof. Jan-Shin Hon Department of Industrial Engineering and Enterprise Information Tunghai University ABSTRACT Under the fast changing environment of healthcare policies by National Health Insurance, Hospitals could not make profits by providing more healthcare services under the payment of fee for services like before. Especially, it is difficult for district hospitals to survive if they could not reduce the transaction costs and the agency costs between the patients, the Bureau of National Health Insurance, and the supplier merchant. Nowadays for the shortage of payoff system, the development of hospital has been limited. The traditional medical service is one doctor to one patient for one disease. The idea of health service has been changed to integrated health service. How do district hospitalssurvive in this circumstance? How do they change their business models in order to lower the transaction costs and promote the quality of service at the same time. District hospital must diversify their services to specialist practices, such as orthopedic specialist, cosmetic center, rehabilitation center, hemodialysis center and respiratory care center. We find the most common strategies employed to achieve win-win goal by vertical integration, strategic alliance and medical value chain management. This study presents three successful business models: orthopedic specialist hospitals, dental clinics and ophthalmology clinics. Even the small-medium size hospitals and clinics can create the best competition by providing specialist practices. Keywords: Business ModelValue Chain ManagementTransaction Cost II

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20 Choise) (Market Choice) (Vertical Integration) Frequency Occasional transaction Recurrent Transaction ( Investment Characteristics ( ) Nonspecific Mixed( Idiosyncratic ( ) Market Governance Trilateral Governance ( Bilateral Governance Unified Governance :Willamson(1979,pp.253) 15 Williamson(1985) (The Economic Institution of Capitalism) (Crossetal1997;Weigel1999) 22 11

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51 19Benbasat, I.D.K.Goldstein,and M.Mead,The Case Research Strategy in Studies of Information SystemMISQuestytly,Vol.11,Sep.1987,pp Coase,R.H,The Nature of Firm,Economica, Vol.4,1937,pp Coase,R.H,The Market,the Firm and the Law,1998,Chicago,The University of Chicago press. 22Cross,J,MJ, Eral,andJ.L,sampler, Transformation of IT Function at British Petroleum,MIS Quarterly,Vol.21,Dec.1997,pp Fama, E.F,and M.C.Jensen, Separation of Ownership and Control. Journal of law and Economics, Vol.26, 1983a, pp Lacity,M.C.andR. Hirschheim,Information System Outsourcing: Myths,Metaphors andrealities,1993,john Wily & Sons,N Y. 25Porter, M.E,Competitive Strategy;Techniques for Analyzing Induestries and Competitors,1980,Free Press,New York. 26Porter,M.E.,Competitive Advantage,1985,Free Press,New York. 27Porter,M.E., Toward a Dynamic Theory of Strategy,Strategic Management Journal, Vol.12,1991,pp Roulac,S.E, Real estate Value Chain Connection:Tangible and Transparent,The journal of Real Estate, Sacromento, 1999,pp Williamson,O.E,The Economics Institutions of Capitalism, 1975,New York: Free Press. 30Willamsons, O.E,The Economics Institutions of Capitalism; Firms, Markets. and Relational Contracting,1985,New York; Free Press. 31Williamson,O.E, Transaction-cost Economics:The Governance of Contractual Relations, Journal of Law and Economics, Vol.22,1979,pp Yin,R.K.,Case study Research Design and Methods,

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<4D6963726F736F667420576F7264202D20ACE3B051BDD7A4E5A874A6433130302D3520BB4FC657A4F4AA47A57EBE50A46AB3B0AABAB2A3BE50BEF7A8EE2E646F63> 研討論文系列 100-5 臺灣水果外銷大陸的產銷機制 :Zespri or Sunkist? 呂雅茹指導教授 : 羅竹平中華經濟研究院編中華民國 100 年 2 月臺灣水果外銷大陸的產銷機制 : Zespri or Sunkist? 摘要建議成立二家互補又競爭的農企業,