| Abstract: | 摘要醫療服務業不是製造業生產線，醫療關乎人命，遇到緊急事件，如緊急刀、急救、大災難，須投入相當多各種專業人力，人力運用有不確定性及持續性之需求，且是自主性非常高的產業，很難用僵化的工時來規範。人力資源是整體運作的關鍵，而任何與人力資源有關的勞工政策都會影響勞雇雙方，並帶來衝擊，再加上台東地區醫事人員聘用之困境，因而亟想探討勞基法工時規範對台東地區醫院的影響，及其他先進國家的相關政策適用醫界之可行性。本研究採用質性研究訪談法，以立意抽樣方式，選取台東地區6 家醫院管理者及醫事人員，和一位政府部門人士，計13 位，對於相關議題形成結論與建議。研究結果顯示，相同工時規範對台東地區6 家醫院人力運作之衝擊與因應策略有雷同與差異。各醫院在面對新制法令管理成本皆增加、人力運作上以在職者加班因應、實務上有待命之需求、醫事人員召聘困難。差異處： 1.非私立醫院：已實施週休二日，人力上有公職人員可以運作，然一例一休因優先由公職人員加班，加班成本更高。2.規模小的私立醫院：因業務量及人員較少，沒有明顯影響。3.規模大的私立醫院：已增聘人員、調整排班方式及增加超時報備作業，以符合工時規範，但人力缺口無法補足，當人力無法負荷，最後會考慮調整診次、床數。就其他國家工時規範之啟示，認同實施政策宜漸進式推展，至於變形工時週期更長或工時帳戶等做法，贊同者認為更有彈性，也有考量國內勞資協商機制尚未成熟，不宜貿然實施。研究建議，對於人員不易召聘，可協商離退員工以非典型就業方式返回職場，爭取醫護專校學生實習機會，以增補人力。善用變形工時制及加速人員培訓，以期人力更有彈性運作。強化資訊管控機制以降低管理成本。加強法令宣導，既可促進勞資雙方之共識且可避免違法。對於勞動政策，法令修正執行宜考量行業別、地域性差異，廣納建言，因地制宜，循序漸進且給予更彈性作為。
AbstractMedical service is not a production line of manufacturing industry. Medical carehighly relates with human life, in case of emergency, such as emergent surgery, first aid,and catastrophe, it is necessary to invest tremendous various professional manpower.The exertion of manpower includes demands of uncertainty and persistency, which is ahigh spontaneous industry with a difficulty in standardization by rigid working hour.Human resource is the key to overall operation and all labor policies concerning withhuman resources may affect both parties of labor and employer and give shock to them.In addition, on account of the predicament of employing medical personnel in Taitungdistrict, it induces the author to explore the influence of working hour regulation inLabor Standards Act on the hospitals in Taitung district as well as the feasibility ofapplication of relevant polices of other developed countries in the medical circle of ourcountry. The study adopted interview survey of qualitative research and chose a total of13 persons who are the administrators and medical personnel in six hospitals aroundTaitung district and an officer in the government department by means of purposivelysampling as the research target for making the conclusion and suggestion of the studyregarding relevant issues.According to the result of the study, it showed that slight similarity and differencesexisted in the impact and countermeasures of manpower exertion in the six hospitals ofTaitung district in terms of an identical working hour regulation. When facing newregulation, it appeared that each hospital in the study increased their administrationexpenses, correspond overtime of the incumbent accordingly in terms of manpowerexertion and have the demand of stand-by in practice as well as a difficulty inemployment of medical personnel. On the other hand, concerning differences amongthem, it could divide into three parts. Firstly, for the case of non-private hospital, as ithas implemented two-day weekend, public servants may be exerted for manpowerdispatching, however, the overtime cost would be higher since the public servants is thefirst priority for overtime due to one fixed day off and one flexible rest day. Secondly,in the case of small-scale private hospital, it did not bring obvious impact owing to thefewer business and personnel. Lastly, in the case of large-scale hospital, these hospitalshave employed more personnel, adjusted shit schedules and added overtime reportoperation in line with the regulation of working hour. Nevertheless, as it is not easy tocompensate the shortage of manpower, accommodation of number of outpatient andnumber of bed may be considered in the event of insufficient manpower. Besides, interms of the enlightenment of the working hour regulations in other countries, itrecognized that the policy shall be launched step by step. As for the longer cycle withiiiflexible working hours, working time account system etc., the favorers consider thatthey are more flexible, while others think it is not proper in view of unfamiliarity ofdomestic consultant mechanism of labor and employer.Per the study, it may suggest that consulting retirees to return to workplace viaatypical employment and striving for the opportunity of internship for college ofmedical care due to the difficulty in employing medical staff in the light ofcompensation of manpower. Moreover, it can make use of flexible working hour systemand accelerate employment training for reaching higher flexibility of manpowerexertion. Further, it can not only reinforce information management mechanism in orderto decrease administration cost, but also intensify the propaganda of the regulation topromote the consensus between labor and employer without violating the law. Inaddition, concerning implementation and revision of labor policy as well as relevantregulation, it shall take industry categories and territoriality difference into account,receive broad suggestions, suit its measures to local conditions, and improve graduallywith higher flexibility and adaptability. |
