健康照護服務生態系統之生成與發展：價值共創觀點

Shaping and Developing a Health Care Ecosystem: Value Co-Creation Perspective

陳靖惠(Ching-Hui Chen)；林明杰(Ming-Ji James Lin)；方世杰(Shih-Chieh Fang)；商育綸(Yu-Lung Shang)

健康照護 ； 價值主張 ； 價值共創 ； 服務生態系統 ； health care ； value proposition ； value co-creation ； service ecosystem

科技管理學刊

23卷2期（2018 / 06 / 01）

1 - 30

繁體中文

本研究嘗試透過一個宏觀的角度，結合服務生態系統與價值共創觀點，探討一個組織結構較為複雜的長期照護產業，如何藉由價值共創活動形塑出「全人照護系統」，並探討該系統在生成的過程當中，如何藉由強而有力的價值主張、價值共創，以吸引利害關係人的參與及資源的投入，並讓利害關係人得以遵循，最終形成一個互相連結並能循環發展的「照護服務生態系統」。本研究透過質性研究的個案研究法，並以「斗六長泰老學堂照護服務生態系統的發展過程」為研究標的。研究結果發現，該照護服務生態系統循序漸進地以三階段從價值主張的建立、長泰老學堂內部照護系統的改善、在地社區照護生態系統的形成與發展，足以顯現價值主張與價值共創具有不同的階段性角色，以作為利害關係人活動與資源分享的指導原則。在過程中由主導者（斗六長泰老學堂執行長）從價值共創的觀點思考，應採取哪些合理的制度，讓所有參與的行動者皆能有所遵循，並在資源共享與服務交換過程中獲取利益，進而才能逐漸形成穩定的服務生態系統，而後才能擴大系統的影響範圍，吸引更多行動者的加入、進行更多元化、更密集的價值共創活動，最終並提升服務生態系統的總價值。

This study adopts the concept of service ecosystem and value co-creation to explore in a macro perspective the ways value co-creation activities have shaped a holistic care system in a long-term care agency that has a rather complex organizational structure. It further investigates how a strong value proposition along with vigorous value co-creation activities have been leveraged to attract and guide participation of different stakeholders in the process of creating a service ecosystem that is both coherent and scalable. Based on analyses of the qualitative case study of the Day Care Center of Douliu Changtai Senior Citizens' School, findings of the research indicate that the ecosystem is shaped and developed through three stages: identifying value proposition, inner-center level and community level. Value proposition and value co-creation play distinctive roles in different stages and are important organizing principles for attracting stakeholders' participation and sharing resources. In the process, the leader (CEO of Douliu Changtai Senior Citizens' School) adopted a value co-creation perspective to considering specific systems to be used for providing common guidelines for all participating actors. As benefits were gradually captured over time through the process of sharing resources and exchanging services, a stable service ecosystem has been formed as result. Finally, impacts of this system could be further expanded as more actors were attracted by diversified and intense activities of value co-creation, eventually leading to a greater value of the entire service ecosystem.

1. Adner, R.,Kapoor, R.(2010).Value creation in innovation ecosystems: How the structure of technological interdependence affects firm performance in new technology generations.Strategic Management Journal,31(3),306-333.
2. Anderson, J. C.,Narus, J. A.,Van Rossum, W.(2006).Customer value propositions in business markets.Harvard business review,84,1-4.
3. Aoki, K.,Lennerfors, T. T.(2013).The new, improved keiretsu.Harvard Business Review,91(9),109.
4. Chandler, J. D.,Lusch, R. F.(2015).Service systems: a broadened framework and research agenda on value propositions, engagement, and service experience.Journal of Service Research,18(1),6-22.
5. Dutton, J. E.,Worline, M. C.,Frost, P. J.,Lilius, J.(2006).Explaining Compassion Organizing.Administrative Science Quarterly,51(1),59-96.
6. Frow, P.,McColl-Kennedy, J. R.,Hilton, T.,Davidson, A.,Payne, A.,Brozovic, D.(2014).Value propositions: A service ecosystems perspective.Marketing Theory,14(3),327-351.
7. Frow, P.,McColl-Kennedy, J. R.,Payne, A.(2016).Co-creation practices: Their role in shaping a health care ecosystem.Industrial Marketing Management,56,24-39.
8. Grönroos, C.(2011).Value co-creation in service logic: A critical analysis.Marketing Theory,11(3),279-301.
9. Hardyman, W.,Daunt, K. L.,Kitchener, M.(2015).Value co-creation through patient engagement in health care: a micro-level approach and research agenda.Public Management Review,17(1),90-107.
10. Iyer, B,Davenport, T. H.(2008).Reverse engineering Google's innovation machine.Harvard Business Review,86(4),58-68.
11. Joiner, K. A.,Lusch, R. F.(2016).Evolving to a new service-dominant logic for health care.Innovation and Entrepreneurship in Health,3,25-33.
12. Lauver, D. R.,Ward, S. E.,Heidrich, S. M.,Keller, M. L.,Bowers, B. J.,Brennan, P. F.,Kirchhoff, K. T.(2002).Patient-centered interventions.Research in Nursing & Health,25(4),246-255.
13. Maglio, P. P.,Spohrer, J.(2008).Fundamentals of services science.Journal of the Academy of Marketing Science,36(1),18-20.
14. McColl-Kennedy, J. R.,Vargo, S. L.,Dagger, T. S.,Sweeney, J. C.,Kasteren, Y. V.(2012).Health care customer value cocreation practice styles.Journal of Service Research,15(4),270-389.
15. Morgan, S.,Yoder, L. H.(2012).A concept analysis of person-centered care.Journal of Holistic Nursing,30(1),6-15.
16. Normann, R.(2001).Reframing Business: When the Map Changes the Landscape.Chichester, UK:John Wiley.
17. Payne, A. F.,Storbacka, K.,Frow, P.(2008).Managing the co-creation of value.Journal of the Academy of Marketing Science,36(1),83-96.
18. Payne, A.,Frow, P.,Eggert, A.(2017).The customer value proposition: evolution, development, and application in marketing.Journal of the Academy of Marketing Science,1-23.
19. Pitelis, C.(2012).Clusters, entrepreneurial ecosystem co-creation, and appropriability: a conceptual framework.Industrial and Corporate Change,21(6),1359-1388.
20. Prahalad, C. K.,Ramaswamy, V.(2004).The Future of Competition: Co-Creating Unique Value With Customers.Harvard Business Press.
21. Ramaswamy, V.,Gouillart, F. J.(2010).The power of co-creation: Build it with them to boost growth, productivity, and profits.Simon and Schuster.
22. Ramaswamy, V.,Ozcan, K.(2014).The co-creation paradigm.Stanford University Press.
23. Ramaswamy, V.,Ozcan, K.(2018).What is co-creation? An interactional creation framework and its implications for value creation.What is co-creation? An interactional creation framework and its implications for value creation,84,196-205.
24. Ranjan, K. R.,Read, S.(2016).Value co-creation: concept and measurement.Journal of the Academy of Marketing Science,44(3),290-315.
25. Sweeney, J. C.,Danaher, T. S.,McColl-Kennedy, J. R.(2015).Customer effort in value cocreation activities: Improving quality of life and behavioral intentions of health care customers.Journal of Service Research,18(3),318-335.
26. Tantalo, C.,Priem, R. L.(2016).Value creation through stakeholder synergy.Strategic Management Journal,37(2),314-329.
27. Vargo, S. L.(2011).Market systems, stakeholders and value propositions: Toward a servicedominant logic‐based theory of the market.European journal of marketing,45(1/2),217-222.
28. Vargo, S. L.,Lusch, R. F.(2016).Institutions and axioms: An extension and update of service dominant logic.Journal of the Academy of Marketing Science,44(1),5-23.
29. Vargo, S. L.,Lusch, R. F.(2011).It's all B2B and beyond: Toward a systems perspective of the market.Industrial Marketing Management,40(2),181-187.
30. Vargo, S. L.,Lusch, R. F.(2004).Evolving to a new dominant logic for marketing.Journal of marketing,68(1),1-17.
31. Williamson, P. J.,Meyer, A. D.(2012).Eco-system Advantage: How to successfully harness the prower of partners.California Management Review,55(1),24-46.
32. 行政院新聞傳播處(2017)，「長照2.0，照顧的長路上更安心」，行政院全球資訊網，取自：https://www.ey.gov.tw/hot_topic.aspx?n=A1C2B2C174E64DE7。
33. 楊寧茵(2015)，小兵立大功 志工成Age UK 整合照顧服務成功關鍵，社企流網，取自：http://www.seinsights.asia/article/3290/3324/3488。
34. 楊寧茵(2015)，Buurtzorg 掀起荷蘭居家照護產業的寧靜革命，公益交流網，取自：http://npost.tw/archives/20799。
35. 詹其峰、邱泰源、陳慶餘(2013)。臺灣三全健康照護模式。台灣醫界，56(2)，29-36。

1. 蔡文龍,徐濟世(2021)。以設計思考開發運用臉部表情辨識學習狀態之非同步遠距教學系統。科技管理學刊，26(2)，25-53。
2. 盧姸蓉,胡亞平,邱紹群(2023)。台灣消費者共創IKEA品牌價值意願之研究。管理資訊計算，12(1)，11-24。
3. 周信輝(2022)。商業生態系統發展基礎之服務設計思考。科技管理學刊，27(2)，1-25。