dc.contributor.advisor | 陳敦源 | zh_TW |
dc.contributor.advisor | Chen, Don Yun | en_US |
dc.contributor.author (Authors) | 王光旭 | zh_TW |
dc.contributor.author (Authors) | Wang, Guang Xu | en_US |
dc.creator (作者) | 王光旭 | zh_TW |
dc.creator (作者) | Wang, Guang Xu | en_US |
dc.date (日期) | 2009 | en_US |
dc.date.accessioned | 9-Apr-2010 17:08:28 (UTC+8) | - |
dc.date.available | 9-Apr-2010 17:08:28 (UTC+8) | - |
dc.date.issued (上傳時間) | 9-Apr-2010 17:08:28 (UTC+8) | - |
dc.identifier (Other Identifiers) | G0932565012 | en_US |
dc.identifier.uri (URI) | http://nccur.lib.nccu.edu.tw/handle/140.119/38763 | - |
dc.description (描述) | 博士 | zh_TW |
dc.description (描述) | 國立政治大學 | zh_TW |
dc.description (描述) | 公共行政研究所 | zh_TW |
dc.description (描述) | 93256501 | zh_TW |
dc.description (描述) | 98 | zh_TW |
dc.description.abstract (摘要) | 本研究的焦點主要圍繞在兩大主軸:社會鑲嵌性與決策,探討在行動者間社會網絡的關係結構下,決策的影響力與決策行為的社會性。換言之,本研究認為決策並非僅是理性的產物,更多的時候,反而是理性與非理性因素交互作用的結果。也就是說,決策必然鑲嵌在決策者間的社會網絡關係結構,任何的決策都無可避免的必須考量到決策者間的關係型態所造成的限制。本研究使用牙醫與中醫總額支付委員會作為研究的個案,除了讓社會網絡與決策網絡的邊界更清楚,更符合研究校度之外,也希望能夠進一步透過兩個案的分析,一方面透過社會網絡分析瞭解兩支付委員會可能的權力分佈與結構,二方面分析影響決策權力分佈與決策產出的關係機制為何,並藉此來驗證決策的社會鑲嵌性此一概念。本研究使用事務討論、信任支持、法規諮詢與資源交換四個社會關係網絡來測量行動者在決策過程中的社會關係,並用以驗證決策者的決策影響力與決策的一致性是否鑲嵌在這四個網絡的結構當中。本研究透過社會網絡的問卷蒐集了牙醫支委會18筆與中醫支委會21筆資料(N=56),並透量化社會網絡分析方法中的集中性指數、派系、網絡密度、區截模型與縮影矩陣、MDS分析與QAP的相關與迴歸分析等分析工具,從個體、小團體層次、與總體的結構層次,分析牙醫與中醫支委會的行動者在網絡中的關係型態與位置角色。此外,更透過上述分析中所獲得的集中性指數的分析結果當作自變項,並放入迴歸模型之中,藉以驗證是否對集體決策產出的觀感造成影響。總的來說,本研究可歸納以下研究結論:一、在牙醫與中醫支付委員會的個案中,委員決策的影響力與決策行為,確實都受到四個社會網絡結構的影響,驗證了決策的社會鑲嵌性此一觀點;二、無論從個體、小團體或總體結構的分析層次,得到的分析結果都很類似,具有決策影響力並與其他行動者有密切的社會關係的行動者,在牙醫支委會有牙醫全聯會的H11, H16與健保局的A2,但中醫支委會的部分,就沒有健保局的代表,反而僅有中醫全聯會代表,顯見在牙醫部門當中,權力的分佈屬於公、私部門間二元的機制,但中醫的部分僅有集中在中區中醫師;三、委員的出席確實會受到委員個人政策影響力與資源交換網絡的顯著影響,顯示個人政策影響力愈大,與其他委員資源交換關係愈頻繁的委員,參與會議的意願較高;四、從影響集體決策產出觀感的因素來說,事務討論關係與在事務討論網絡的派系重疊程度對集體決策產出的觀感有顯著且正面的影響,個人的決策影響力與年資反而有負面且顯著的影響。本研究大的貢獻,一驗證了決策的社會鑲嵌性此一觀點,決策必須將社會關係變項考量,二是在公共行政領域中第一本以系統化的方式使用社會網絡分析工具的論文,非但具有示範性的作用,也跨越了過去公共行政網絡研究過於喻象的分析缺陷。根據分析結果,本研究提出以下四點政策建議:一、中醫支委會的健保局代表應當夠積極的與中醫全聯會的代表建立溝通的關係,以構築決策影響力的社會基礎;二、委員會中若不具決策影響力,又在社會關係上沒有跟其他行動者互動,則應考慮其存在的實質意義;三、由於年資長短對決策觀感會有負面影響,健保局應更積極的與年資較久的委員溝通請益,瞭解他們為何會對委員會的運作績效有負面的想法,藉以強化委員會的功能;四、加強委員之間的總額事務討論的交換意見的關係,有助於集體決策的產出。 | zh_TW |
dc.description.abstract (摘要) | Decision making is a collective activity rather than an individual option. In literature, collective action can be symbolized as a network. The concept of network has emerged as an intellectual centrepiece in the field of public administration and the speedy development of social network analysis has facilitated “network research” to go beyond only a metaphor. However, most previous decision theories based on the concept of rationality have not seriously considered a network’s impact on the policy process. This research attempts to verify the causal relationship between social embeddedness and decision-making by examining how policy elites’ personal interactions shape individuals’ decision-making behaviour, influential power and the collective decision performance. This research focuses on the result of the mutual influence between rational and non-rational factors. Two cases (the Dental and Chinese Medicine Global Budget Payment Committees) are discussed by applying quantitative social network analysis in order to systemically expand the current understanding of the power distribution and its influential factors in these two decision making committees in Taiwan’s National Health Insurance domain. In regard to methodology, four participants’ social networks were designed not only to examine the social relationship between these committee members but also to analyse the phenomenon of social embeddedness in these two cases. There are totally 39 successful respondents (apx. 80% response rate, N=56) and these raw data were analysed by the indicators such as network centrality index, cliques, network density, block model, image matrix, MDS and QAP correlation, hierarchical regression in order to answer the research questions. Furthermore, this research is based on three analytical levels in social network analysis: “individual relationship”, “small group” and “global structure”, and not only explores the connection, power exercise and decision-making behaviour between these committee members but also analyses their role and position through the perspective of global network structure. The research verifies the hypothesis “decision-making is embeddeded in the structure of the actors’ interconnected social relationships” and utilizes the quantitative social network analytical method systematically to let network study go beyond a metaphor in the research field of public administration. I conclude that the distribution of the decision-making power and behaviour are both influenced by the committees’ social networks. Furthermore, the power distribution in the dental committee is two cores between the dental association and the BNHI, but the committee of Chinese Medicine is just one core of the Chinese Medicine association. With regard to attendance network as the independent variable, two factors significantly and positively influence the committee members’ attendance network: “decision-making influential network” and “resource exchange network”. Finally, the factors of “the NHI affair discussion network” and “the affair discussion clique centrality degree” have positive statistical significance but relatively the factors of “personal decision making influence” and “seniority” have negative statistical significance on the interviewees’ perception of the collective policy outcome. | en_US |
dc.description.tableofcontents | 第一章 緒論 1第一節 研究方向的思考與動機 2第二節 研究背景與範圍 9第三節 問題意識 15第四節 章節安排 18第二章 理性、權力與決策 21第一節 決策理論的基礎概念:理性 vs 權力 22壹、決策理論的基礎:理性 22貳、決策理論的基礎:權力 24參、小結 28第二節 制度層次:決策產出受到制度環境所引導 29壹、決策產出的權力結構與國家角色 30貳、決策處於高度制度化的環境 33第三節 網絡層次:決策行為是一種社會行為 36壹、被遺忘的分析起點:社會結構 37貳、決策行為受到社會(網絡)結構所定位 39參、公共行政的分析傳統與社會網絡的關連性 43第四節 行為層次:決策行為反映結構限制 49第五節 社會網絡對決策的解釋策略 52第六節 本章小結:以「關係」為基礎的決策研究 55第三章 研究設計與方法 59第一節 研究個案背景與特質 59壹、總額支付制度背景與概述 59貳、總額支付委員會 64第二節 概念界定與分析架構的操作化 68壹、概念界定 68貳、分析架構與初步假設 70參、分析概念的操作化 73第三節 資料蒐集 76壹、現有文獻蒐集 76貳、深度訪談法 78參、菁英網絡問卷 80第四節 資料分析 83壹、內容分析 83貳、官方統計資料分析 84參、網絡分析 84肆、統計分析 89第五節 本章小結 92第四章 決策網絡的影響機制:個人層次 95第一節 牙醫支付委員會 96壹、決策網絡的個人影響力機制 96貳、誰的社會網絡聲望高? 99參、牙醫委員決策行為與影響力的社會鑲嵌性 106第二節 中醫支付委員會 110壹、決策網絡的個人影響力機制 110貳、誰的社會網絡聲望高? 114參、中醫委員決策行為與影響力的社會鑲嵌性 121第三節 本章小結 125第五章 決策網絡的影響機制:小團體層次 131第一節 牙醫支付委員會 133壹、四個社會網絡的派系分析 133貳、派系成員的重疊性程度分析 137參、牙醫派系參與與決策影響力和決策行為的關連性 141第二節 中醫支付委員會 147壹、四個社會網絡的派系分析 147貳、派系成員的重疊性程度分析 151參、中醫派系參與與決策行為和影響力的關連性 155第三節 本章小結 160第六章 決策網絡的影響機制:整體層次 165第一節 牙醫支付委員會 167壹、社會網絡的整體結構特質 167貳、多重社會網絡的結構與分化特質 168參、四個社會網絡的角色分析 177第二節 中醫支付委員會 179壹、社會網絡的整體結構特質 179貳、多重社會網絡的結構與分化特質 181參、四個社會網絡的角色分析 190第三節 本章小結 193第七章 具有決策管理意涵的影響因素分析 197第一節 支付委員會出席狀況的影響因素分析 199第二節 委員支委會決策產出績效的影響因素分析 203壹、資料來源與處理方式 206貳、分析模型的再檢視與待驗假設 209參、各變數描述性統計分析 212肆、支付委員會集體決策成效觀感的影響因素分析 214伍、小結 217第三節 本章小結 219第八章 結論與建議 223第一節 研究發現摘要與討論 224第二節 實務政策建議 233第三節 研究貢獻 236第四節 研究限制與未來研究方向建議 239壹、研究限制 240貳、未來研究方向建議 242參考書目 245附錄一 總額執行面兩委員會之比較 261附錄二 支付委員會設置要點 263附錄三 牙醫與中醫委員名單 265附錄四 菁英網絡問卷 267附錄五 牙醫四社會網絡聲望關係圖 279附錄六 中醫四社會網絡聲望關係圖 281附錄七 牙醫社會網絡派系參與分層類聚圖 283附錄八 中醫社會網絡派系參與分層類聚圖 285附錄九 牙醫多重網絡區截位置分割表 287附錄十 中醫多重網絡區截位置分割表 289附錄十一 佛羅里達州立大學網絡課程大綱 291附錄十二 文內使用名詞釋義 297 | zh_TW |
dc.format.extent | 3710436 bytes | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | en_US | - |
dc.source.uri (資料來源) | http://thesis.lib.nccu.edu.tw/record/#G0932565012 | en_US |
dc.subject (關鍵詞) | 網絡 | zh_TW |
dc.subject (關鍵詞) | 鑲嵌 | zh_TW |
dc.subject (關鍵詞) | 決策 | zh_TW |
dc.subject (關鍵詞) | 社會網絡分析 | zh_TW |
dc.subject (關鍵詞) | 健保總額 | zh_TW |
dc.subject (關鍵詞) | 總額支付委員會 | zh_TW |
dc.subject (關鍵詞) | network | en_US |
dc.subject (關鍵詞) | embeddedness | en_US |
dc.subject (關鍵詞) | decision-making | en_US |
dc.subject (關鍵詞) | social network analysis | en_US |
dc.subject (關鍵詞) | the NHI global budget payment system | en_US |
dc.subject (關鍵詞) | Committee of the Global Budget Payment System | en_US |
dc.title (題名) | 決策的社會鑲嵌性及其影響:台灣中醫及牙醫健保總額支付委員會決策機制之分析 | zh_TW |
dc.title (題名) | The social embeddedness of the decision-making and its influence: The analysis of the decision-making mechanisms in the Chinese medical and dental global budget payment committees in Taiwan | en_US |
dc.type (資料類型) | thesis | en |
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