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題名 以B型企業架構探討食物藥局商業模式
Exploring the Business Model of Food Pharmacy with Benefit Corporation Structure作者 李禹妡
Lee, Yu-Hsin貢獻者 鄭至甫
Jeng, Jyh-Fu
李禹妡
Lee, Yu-Hsin關鍵詞 B型企業
商業模式九宮格
食物藥局
營養諮詢
膳食處方箋
B benefit corporation
Business model canvas
Food as medicine
Food pharmacy
Food prescription
Nutrition consultation日期 2021 上傳時間 1-Mar-2022 16:58:10 (UTC+8) 摘要 隨著老年化人口，慢性病患者數逐漸攀升，根據健保署109年統計台灣慢性病醫療費用占率已從民國99年的39.9%攀升到109年的47.9%，當中很多慢性病都是因營養不均衡所引起，進而造成健保沉重的負擔。全民健康保險預算也是年年增加，110年度健保總額更是大舉突破7,800億，由於台灣在醫療支出的比重上向來是治療大於預防，再加上健保的便利性，國人普遍健康識能不足，缺乏自我健康照護之意識，導致慢性疾病的發生率與盛行率近年來是有增無減。引發慢性疾病的原因有許多，但大多的慢性疾病是可以透過正確的飲食，達到預防或病程控制以及疾病逆轉。根據國健署資料統計2009-2018年18歲以上成人過重與肥胖盛行率高達43.9%，其中男性比例為55.1%，女性則有32.5%（林惠琴，2020）。此外「102-105年國民營養健康狀況變遷調查」也指出7－12 歲的兒童及青少年期過重加上肥胖的盛行率亦高達 24.3－28.4%。與其他亞洲國家相比，我國成人及兒童肥胖比率更是為亞洲之冠。肥胖與過重問題正是引起三高，俗稱代謝症候群的主因之一，若不適時早期預防，早期治療，將導致高血壓與心血管疾病人口不斷攀升。美國近年興一種創新照護模式，由Geisinger Health提出「食物藥局」的概念Fresh Food Farmacy Plan（FFF），由醫師為糖尿病患者開立食材處方箋，病患可持處方箋至指定商店免費領取新鮮蔬食；除此之外，由醫師、營養師、護理師、藥劑師、健康照護師等所組成的專業諮詢團隊將全程作為病人最佳後援，給予其正確的自我照護知識，用藥知識及健康識能等。該計畫自2016年6月開始推行迄今已為美國4,828家庭提供超過76,000頓餐食。截至目前為止FFF計畫已有顯著成效，參加該計畫的患者在體重、血壓、三酸甘油脂及膽固醇的測量結果取得了顯著效果。據統計患者連續參加計畫18個月後，大幅降低死亡或併發症風險至40%，糖尿病用藥量平均降低0.5-1.2%，至今FFF已協助患者節省了近 150 萬美元的醫療保健費用。這是一個在醫療費用支出上，相較於用藥物或任何醫療處置行為較低的疾病照護計畫，因此本研究目的在於分析了解國外已運行成功模式，導入至台灣市場的商業模式。台灣醫療服務產業向來被視為非營利事業，營養諮詢服務於健保給付上也尚未成熟，由於美國醫療計畫可透過商業保險來支付，但以單一健保支付系統為主的台灣，若要將此醫療服務概念導入至台灣市場，便要思考獲利模式及可行性。近年興起的B型企業，係以企業獲利、公平正義及社會公益三大核心做為營運訴求，這無疑是為當今的醫療服務產業提供了一個全新且顛覆的思維：在追求企業最大獲利的同時，與解決公眾利益之社會問題及環境問題，事實上一點都不衝突，反而透過創造獲利最大化，才能支應企業更穩定且永續性的發展。
With the aging population, the number of patients with chronic diseases has gradually increased. According to the statistics of the National Health Insurance Administrative (NHIA) in 2020, medical expenses for chronic diseases in Taiwan has risen from 39.9% in 2010 to 47.9% in 2020. Many chronic diseases are caused by malnutrition, and the chronic diseases have become a huge burden to healthcare system. The NHI budget is also increasing year by year, the total NHI global budget has greatly exceeded 780 billion in 2021. Due to the Taiwan’s healthcare system is more focusing on treatment rather than prevention, coupled with the convenience of healthcare system, the general health awareness of the public is insufficient. Lack of self-care awareness has caused the incidence and prevalence of chronic diseases to increase in recent years.There are many causes of chronic diseases, yet many of these chronic diseases are preventable or be controlled and be reversed by a balanced diet. According to statistics from the NHIA, the prevalence rate of overweight and obesity among Taiwanese adults over 18 years old from 2009 to 2018 was as high as 43.9%, of which 55.1% were males and 32.5% were females (Lin, 2020). The "Nutrition and Health Survey in Taiwan in 2013-2016" also pointed out that the prevalence of overweight and obesity in children and adolescents between 7-12 years old is also as high as 24.3-28.4%. Compared with other Asian countries, Taiwan has the highest obesity rate among Asia countries. Obesity and overweight are one of the main causes of metabolic syndrome. If it is not treated as soon as possible, the population of hypertension and cardiovascular disease will continue to increase.The prevention-focused diet has been proved as a cost-effective model comparing with the traditional medicine therapy and which can have a major beneficial impact on health. Therefore, the purpose of this research is to analyze and understand the successful models that have been run abroad and to propose a business model to introduce to the Taiwan market.Since the healthcare sector is defined as a non-profit organization in Taiwan, and a single-payer healthcare system as well. Under the Taiwan National Health Insurance system, nutritional consultation service is not the priority focusing, so that the reimbursement scope is also limited. Hence, promoting the Food is Medicine / Food Pharmacy concept to Taiwan, it has to consider its business model and profitability. The B Corporations are a new business concept that balance purpose and profit based on three core value – Profit for Good, Fair Trade and Social Justice. This is undoubtedly providing disrupting thinking for the healthcare sector. Pursuing maximum corporate profit does not conflict with the social and environmental problems of solving public interests at all. On the contrary, only maximizing profits can support the company`s development sustainability. The United States currently implements related "food therapy" programs, which have proven to be the most cost-effective care model, especially in the early stages of disease and prevention, and has successfully constructed an innovative and stable healthcare business model.參考文獻 Andrea T. Feinberg, M., Slotkin, J. R., Hess, A., & Alistair R. Erskine, M. (2017, 2017/1219). How Geisinger Treats Diabetes by Giving Away Free, Healthy Food. Harvard Business Review. Retrieved 05/11 from https://hbr.org/2017/10/how-geisinger-treats-diabetes-by-giving-away-free-healthy-foodChristofferson, T. (2019). Curable, How an Unlikely Group of Readical Innovators is Trying to Transform our Health Care System. Chelsea Green Publishing. https://www.chelseagreen.com/2019/the-fresh-food-farmacy/FAO. (2021). Hunger and food insecurity. FAO. Retrieved 05/11 from http://www.fao.org/hunger/en/FAO, I., UNICEF, WFP and WHO. (2020/07/13). The state of food security and nutrition in the world 2020. F. a. A. O. o. t. U. Nations. https://www.who.int/publications/m/item/state-of-food-security-and-nutrition-in-the-world-2020FOUNDARY, J. (2021). Opportunities in Food As Medicine. https://jsf.co/resources/industry-research/opportunities-in-food-as-medicine/Gardner, B., Bruijn, G.-J. d., & Lally, P. (2011, 10). A systematic review and meta-analysis of applications of the Self-Report Habit Index to nutrition and physical activity behaviours. Annals of Behavioral Medicine, 42(2), 174–187. https://doi.org/10.1007/s12160-011-9282-0Harmsen, M. (2020). Health Systems Innovating to Address Food Insecurity https://repository.library.georgetown.edu/handle/10822/1059729Health, S. (2016). Fresh Food Pharmacy. http://www.springboardhealthy.org/wp-content/themes/springboard/assets/downloads/Project_Framework_Fresh_Food_Pharmacy_12_8_16_Final.pdfHess, A. (2021). Can patients prescribed fruits and vegetables achieve better health outcomes? Geisinger Steele Institute for Health Innovation. Retrieved 05/11 from https://www.greenbrownblue.com/fresh-food-farmacy/Juliana A. Donohue, T. S., Lauren Park Martin. (2021/03). The food pharmacy: Theory, implementation, and opportunities. American Journal of Preventive Cardiology, 5. https://www.sciencedirect.com/science/article/pii/S2666667720301458Meg Tirrell, J. G. (2018, 06/21). Diabetes defeated by diet: How new fresh-food prescriptions are beating pricey drugs. CNBC. https://www.cnbc.com/2018/06/20/diabetes-defeated-by-diet-new-fresh-food-prescriptions-beat-drugs.htmlNEWSROOM, F. (2021). GIANT company donates $200k to Geisinger `Fresh Food Farmacy` program. Retrieved 0602 from https://fox56.com/news/local/giant-company-donates-200k-to-geisinger-fresh-food-farmacy-programNicholson, H. (2016, 03/01z). 10 FACTS ABOUT FOOD SECURITY. Fair Trade Foundation Retrieved 2021/05/11 from https://www.fairtrade.org.uk/media-centre/blog/10-facts-about-food-security/NPOs編輯室. (2017). 透視 B 型企業：究竟是共益企業，還是行銷手段？. 公益交流站. Retrieved 0715 from https://npost.tw/archives/33222RENDER, H. (2019, 05/26). Thinking of Forming a New For-Profit Health Care Enterprise? Why a Benefit Corporation May Be Right for Your Organization. https://www.hallrender.com/2019/07/10/thinking-of-forming-a-new-for-profit-health-care-enterprise-why-a-benefit-corporation-may-be-right-for-your-organization/Seligman, H. K., & Schillinger, D. (2010, 07). Hunger and Socioeconomic Disparities in Chronic Disease. New England Journal of Medicine, 363(1):6-9. https://doi.org/10.1056/NEJMp1000072Virani, V. Michael Fratkin, Founder of ResolutionCare. Doctorpreneurs Retrieved 07/09 from https://doctorpreneurs.com/michael-fratkin-founder-resolutioncare/WAZAIII.COM. (2020). 健康飲食的商機. WAZAIII.COM. Retrieved 07/15 from https://www.wazaiii.com/articles?id=LifestyleHealthyFoodWhite, N. D. (2020, 04/26). Produce Prescriptions, Food Pharmacies, and the Potential Effect on Food Choice. Am J Lifestyle Med, 2020 Jul-Aug( 14(4)), 366–368. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7692008/pdf/10.1177_1559827620915425.pdfWHO. (2021a, 04/13). Noncommunicable diseases. WHO. Retrieved 05/20 from https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseasesWHO. (2021b). Transform food systems. Retrieved 2021/05/11 from http://www.emro.who.int/nutrition/food-systems/index.html[Record #10 is using a reference type undefined in this output style.]孫書恩. (2016, June). 台灣B型企業之企業社會責任的實務研究.楊銘欽, 譚家惠, 廖芷嫻, 張維辛, & 黃俊哲. (2015). 我國主要非傳染病之疾病負擔及經濟衝擊評估. 衛. 年度委託研究計畫. https://grbdef.stpi.narl.org.tw/fte/download4?docId=2736505&responseCode=8452&grb05Id=8392202江艾恩. (2020). 商業興觀點／餐飲業的六大趨勢. 經濟日報. Retrieved 0715 from https://money.udn.com/money/story/8944/4682889社企流. (2021/05/30). B 型企業：重新定義好企業. https://www.seinsights.asia/columnist/5547胡鄉治. (2016). 營養師識別吸引與專業認同之研究: 主觀幸福感中介效果 國立台中教育大學]. http://ntcuir.ntcu.edu.tw/handle/987654321/9997衛福部. (2019, 2020/06/15). 108年度死因統計. 衛福部. Retrieved 05/20 from https://dep.mohw.gov.tw/dos/lp-4927-113.html賴苡汝, 廖梨伶, 謝藍琪, & 李貞慧. (2014). 台灣營養師工作壓力、工作滿意度、職業倦怠和離職傾向之現況與相關性. 台灣衛誌 33(6). http://www.publichealth.org.tw/upload/files/33%206%20Recommended.pdf趙正敏, 蔡銘振, & 鄭博文. (2010). 以改良法探討影響民眾選擇健檢機構之因素: 和缺口理論法之比較. 醫務管理期刊, 11(2), 95-111. https://www.airitilibrary.com/Publication/alDetailedMesh?DocID=16086961-201006-201008260022-201008260022-95-111郭文清, & 林瑩昭. (2016). 營養標示態度與行為、組合價格促銷對消費者購買意願之研究－以便利超商消費者為例. 休閒事業研究, 14(4). https://doi.org/10.6746/LIR.201612_14(4).0004郭芝榕. (2016, 2016/03/31). 拒當黑心商人！B型企業不只追求獲利，影響力商業模式在台灣發酵. 數位時代. Retrieved 07/09 from https://www.bnext.com.tw/article/39077/BN-2016-03-31-145025-44陳永峯. (2018). 台灣長期照護之社會企業經營模式 一以白金產業飲食為例 國立臺中教育大學管理學院]. http://ntcuir.ntcu.edu.tw/handle/987654321/13467陳珮蓉, & 黃勝堅. (2017 11/30). 以價值為基礎的營養照護. 北市醫學雜誌, 14, 86 - 95. https://doi.org/10.6200/TCMJ.2017.14.SP.09高小兔. (2013). 商業模式是什麼？其實就是你生存的本事！. 科技橘報. https://buzzorange.com/techorange/2013/03/12/what-is-business-model/ 描述 碩士
國立政治大學
經營管理碩士學程(EMBA)
108932185資料來源 http://thesis.lib.nccu.edu.tw/record/#G0108932185 資料類型 thesis dc.contributor.advisor 鄭至甫 zh_TW dc.contributor.advisor Jeng, Jyh-Fu en_US dc.contributor.author (Authors) 李禹妡 zh_TW dc.contributor.author (Authors) Lee, Yu-Hsin en_US dc.creator (作者) 李禹妡 zh_TW dc.creator (作者) Lee, Yu-Hsin en_US dc.date (日期) 2021 en_US dc.date.accessioned 1-Mar-2022 16:58:10 (UTC+8) - dc.date.available 1-Mar-2022 16:58:10 (UTC+8) - dc.date.issued (上傳時間) 1-Mar-2022 16:58:10 (UTC+8) - dc.identifier (Other Identifiers) G0108932185 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/139177 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 經營管理碩士學程(EMBA) zh_TW dc.description (描述) 108932185 zh_TW dc.description.abstract (摘要) 隨著老年化人口，慢性病患者數逐漸攀升，根據健保署109年統計台灣慢性病醫療費用占率已從民國99年的39.9%攀升到109年的47.9%，當中很多慢性病都是因營養不均衡所引起，進而造成健保沉重的負擔。全民健康保險預算也是年年增加，110年度健保總額更是大舉突破7,800億，由於台灣在醫療支出的比重上向來是治療大於預防，再加上健保的便利性，國人普遍健康識能不足，缺乏自我健康照護之意識，導致慢性疾病的發生率與盛行率近年來是有增無減。引發慢性疾病的原因有許多，但大多的慢性疾病是可以透過正確的飲食，達到預防或病程控制以及疾病逆轉。根據國健署資料統計2009-2018年18歲以上成人過重與肥胖盛行率高達43.9%，其中男性比例為55.1%，女性則有32.5%（林惠琴，2020）。此外「102-105年國民營養健康狀況變遷調查」也指出7－12 歲的兒童及青少年期過重加上肥胖的盛行率亦高達 24.3－28.4%。與其他亞洲國家相比，我國成人及兒童肥胖比率更是為亞洲之冠。肥胖與過重問題正是引起三高，俗稱代謝症候群的主因之一，若不適時早期預防，早期治療，將導致高血壓與心血管疾病人口不斷攀升。美國近年興一種創新照護模式，由Geisinger Health提出「食物藥局」的概念Fresh Food Farmacy Plan（FFF），由醫師為糖尿病患者開立食材處方箋，病患可持處方箋至指定商店免費領取新鮮蔬食；除此之外，由醫師、營養師、護理師、藥劑師、健康照護師等所組成的專業諮詢團隊將全程作為病人最佳後援，給予其正確的自我照護知識，用藥知識及健康識能等。該計畫自2016年6月開始推行迄今已為美國4,828家庭提供超過76,000頓餐食。截至目前為止FFF計畫已有顯著成效，參加該計畫的患者在體重、血壓、三酸甘油脂及膽固醇的測量結果取得了顯著效果。據統計患者連續參加計畫18個月後，大幅降低死亡或併發症風險至40%，糖尿病用藥量平均降低0.5-1.2%，至今FFF已協助患者節省了近 150 萬美元的醫療保健費用。這是一個在醫療費用支出上，相較於用藥物或任何醫療處置行為較低的疾病照護計畫，因此本研究目的在於分析了解國外已運行成功模式，導入至台灣市場的商業模式。台灣醫療服務產業向來被視為非營利事業，營養諮詢服務於健保給付上也尚未成熟，由於美國醫療計畫可透過商業保險來支付，但以單一健保支付系統為主的台灣，若要將此醫療服務概念導入至台灣市場，便要思考獲利模式及可行性。近年興起的B型企業，係以企業獲利、公平正義及社會公益三大核心做為營運訴求，這無疑是為當今的醫療服務產業提供了一個全新且顛覆的思維：在追求企業最大獲利的同時，與解決公眾利益之社會問題及環境問題，事實上一點都不衝突，反而透過創造獲利最大化，才能支應企業更穩定且永續性的發展。 zh_TW dc.description.abstract (摘要) With the aging population, the number of patients with chronic diseases has gradually increased. According to the statistics of the National Health Insurance Administrative (NHIA) in 2020, medical expenses for chronic diseases in Taiwan has risen from 39.9% in 2010 to 47.9% in 2020. Many chronic diseases are caused by malnutrition, and the chronic diseases have become a huge burden to healthcare system. The NHI budget is also increasing year by year, the total NHI global budget has greatly exceeded 780 billion in 2021. Due to the Taiwan’s healthcare system is more focusing on treatment rather than prevention, coupled with the convenience of healthcare system, the general health awareness of the public is insufficient. Lack of self-care awareness has caused the incidence and prevalence of chronic diseases to increase in recent years.There are many causes of chronic diseases, yet many of these chronic diseases are preventable or be controlled and be reversed by a balanced diet. According to statistics from the NHIA, the prevalence rate of overweight and obesity among Taiwanese adults over 18 years old from 2009 to 2018 was as high as 43.9%, of which 55.1% were males and 32.5% were females (Lin, 2020). The "Nutrition and Health Survey in Taiwan in 2013-2016" also pointed out that the prevalence of overweight and obesity in children and adolescents between 7-12 years old is also as high as 24.3-28.4%. Compared with other Asian countries, Taiwan has the highest obesity rate among Asia countries. Obesity and overweight are one of the main causes of metabolic syndrome. If it is not treated as soon as possible, the population of hypertension and cardiovascular disease will continue to increase.The prevention-focused diet has been proved as a cost-effective model comparing with the traditional medicine therapy and which can have a major beneficial impact on health. Therefore, the purpose of this research is to analyze and understand the successful models that have been run abroad and to propose a business model to introduce to the Taiwan market.Since the healthcare sector is defined as a non-profit organization in Taiwan, and a single-payer healthcare system as well. Under the Taiwan National Health Insurance system, nutritional consultation service is not the priority focusing, so that the reimbursement scope is also limited. Hence, promoting the Food is Medicine / Food Pharmacy concept to Taiwan, it has to consider its business model and profitability. The B Corporations are a new business concept that balance purpose and profit based on three core value – Profit for Good, Fair Trade and Social Justice. This is undoubtedly providing disrupting thinking for the healthcare sector. Pursuing maximum corporate profit does not conflict with the social and environmental problems of solving public interests at all. On the contrary, only maximizing profits can support the company`s development sustainability. The United States currently implements related "food therapy" programs, which have proven to be the most cost-effective care model, especially in the early stages of disease and prevention, and has successfully constructed an innovative and stable healthcare business model. en_US dc.description.tableofcontents 致謝 I摘要 IIIABSTRACT V目 錄 VII表目錄 IX圖目錄 X第一章 緒論 1第一節 研究背景與動機 1第二節 研究目的 3第三節 名詞解釋 4第二章 文獻回顧 8第一節 台灣慢性疾病負擔現況 8第二節 國內營養照護現況概述 11第三節 B型企業架構下的創新醫療模式 14第三章 研究方法 18第一節 研究架構 18第二節 分析工具 19第三節 研究方法 21第四章 分析與商業模式提案 23第一節 研究個案背景介紹 23第二節 個案分析 27第三節 健保制度下台灣營養諮詢現況 33第四節 食物藥局商業模式 36第五章 結論與建議 42第一節 討論 42第二節 結論 44第三節 研究限制 45參考文獻 47 zh_TW dc.format.extent 1948752 bytes - dc.format.mimetype application/pdf - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0108932185 en_US dc.subject (關鍵詞) B型企業 zh_TW dc.subject (關鍵詞) 商業模式九宮格 zh_TW dc.subject (關鍵詞) 食物藥局 zh_TW dc.subject (關鍵詞) 營養諮詢 zh_TW dc.subject (關鍵詞) 膳食處方箋 zh_TW dc.subject (關鍵詞) B benefit corporation en_US dc.subject (關鍵詞) Business model canvas en_US dc.subject (關鍵詞) Food as medicine en_US dc.subject (關鍵詞) Food pharmacy en_US dc.subject (關鍵詞) Food prescription en_US dc.subject (關鍵詞) Nutrition consultation en_US dc.title (題名) 以B型企業架構探討食物藥局商業模式 zh_TW dc.title (題名) Exploring the Business Model of Food Pharmacy with Benefit Corporation Structure en_US dc.type (資料類型) thesis en_US dc.relation.reference (參考文獻) Andrea T. 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