消費者需要「精品級」的醫療服務嗎？
付費服務可以幫助醫療院所提供所有病人更好的照顧
作者MARIA A. GORDIAN & PAUL D. MANGO
原文刊登於: The McKinsey Quarterly, 2004 Number 1
美國各醫療院所正為了如何因應高漲的醫療需求而傷腦筋。在擁有三百個病床的醫療院所中，儘管百分之九十都已床位滿載甚至供不應求，但由於存款利率過低，他們並沒有足夠的財務能力來擴充床位數目。而且不論財務狀況如何，急診醫護人員不足的問題，讓醫療院所根本不敢收納更多病人進來。醫療資源的不足，早已經造成嚴重的影響。不僅無法快速運送轉診病人，病人也往往要很久才能預約到醫生的時間，而每次診斷的時間也不夠長。
不過，問題通常也帶來機會。針對美國非營利性質的醫療院所做的一項調查就發現，因為醫療供需不平衡以及醫護服務品質的低落，有越來越多的消費者願意付出較多的金錢來換取更好的服務。
醫療院所可以針對特定消費者推出特別的精品級服務，不但病人能更快速的獲得照顧，同時還是整合了各專科資源的醫療服務。在住院期間，也能保持一種舒適、便利的生活方式。部分非營利性質的醫療院所已經開始推廣這樣的服務了，但有些醫院還在觀望中。他們之所以猶豫，是因為兩個原因。一個是哲學性的思考，一個則是經濟上的考量。前者，是擔心為了迎合有錢的病人，醫院將犧牲到無力負擔精品級醫療的病人的服務品質。不過，事實上，這些增加的收入非常有機會為所有的病人都帶來更好的醫療服務。但在這裡，我們主要要討論的是經濟上的考量：有多少消費者願意付費，值不值得醫院真的推出精品級醫療服務？
我們進行了一項全國性的調查，接受調查的有2200個家庭，家中平均年收入高於八萬美金。我們測試了五種不同價位的精品級醫療服務，讓受訪者決定要購買哪一種。經濟富裕的醫療消費者，大致上可平均分成三種族群：務實的、穩健的、理想主義的。務實的人相信，病人可以選擇付費來換取更好的服務。穩健的人平時對這個議題沒什麼特別的立場，但當他們生病時，立場就跟務實的人類似。理想主義者則相信，高品質的醫療服務是人民的權利，而非有錢人的特權。
這項調查並不是全面徹底的清查，也不能代表決定性的結果，但對於醫療院所來說還滿有用的。他們可以用來參考，看看是否要投資去做精品級的醫療服務。在務實與穩健的族群中，四分之三的人將醫療服務視同為其他的服務產業：他們可以接受付多一點費用換取更好的服務。大約百分之六十三的務實族群宣稱，即使成為家庭支出的最大宗，他們也願意付出相當的代價來獲取更快速、更能整合醫療資源、更舒適便利的醫療服務。理想主義的族群中，也有不少人願意這麼做。他們很在乎花了錢是不是就能夠得到快速的服務，不過大約四分之一的人表示願意花錢換取舒適的醫療服務。整體而言，醫院不但能夠從提供整合資源、舒適的醫療服務中賺到錢，也能夠大幅改善醫院的聲望。如果醫院能夠提供給有錢病人更快捷的醫療服務，那麼一定就能夠扭轉沒錢病人肯定遭受冷落的錯誤推論。
我們的調查結果顯示，在有一百萬中等收入居民的城市中，一個擁有600個床位、非營利性質的醫療院所若能提供更快速、醫療資源更整合、更舒適便利的精品級醫療服務，營收就會顯著增加。利潤大約在30到55個百分比，可以為一家普通的醫院每年多增加六百萬美金的利潤。對過去四年來利潤衰退了百分之六十的這個產業來說，無疑是一筆很大的數字。
不過，挖掘出市場商機是一回事，能不能掌握機會又是另外一回事。要提供精品級醫療服務的醫院會面臨到許多挑戰（下面列表）。要克服這些問題，管理階層必須投注資源並建立一致的溝通策略，去面對這個新模式在醫療體系中可能引起的感性或理性的爭議。
【精品級醫療服務所面臨到的挑戰】
＊速度（例如：病人打電話進來，很快就能得到所需的協助）
轩＞需要哪個層級的管理人員參與：高層
轩＞如何提供服務：與醫生、病人組成共同體
轩＞成功關鍵：維持高品質、標準的作業方式，確保服務的提供
轩＞初創期的困難：說服醫生改變傳統的服務方式
轩＞如何宣傳：要避免損及醫院的聲譽，必須解釋一般不富裕的病人並未分擔這部份的成本
＊整合（例如：病人及其家人在面對重大疾病時，能夠得到必要的建議、支援）
轩＞需要哪個層級的管理人員參與：高層
轩＞如何提供服務：醫院內部必須發展這樣的服務機制
轩＞成功關鍵：投入資源去設計、維護這項個人化的服務
轩＞初創期的困難：徵募、訓練人員來提供這項個人化的服務
轩＞如何宣傳：透過大眾傳播的方式宣傳這項服務，針對特定的目標對象進行行銷，例如心臟病病人
＊舒適／便利（例如：提供給病人SPA服務，比如說全身按摩、腳底按摩）
轩＞需要哪個層級的管理人員參與：低層
轩＞如何提供服務：跟相關服務的廠商合作
轩＞成功關鍵：發展嚴謹的外包管理機制
轩＞初創期的困難：克服內部人員可能產生的負面想法
轩＞如何宣傳：在醫院內各個醫療點向病人宣傳，透過大眾傳播方式對外建立好的名聲
【原文】
A consumer view of boutique health care
Fee-based services could help hospitals provide better care for all patients.
MARIA A. GORDIAN AND PAUL D. MANGO The McKinsey Quarterly, 2004 Number 1
US hospitals are struggling to meet rising demand. Among health care facilities with at least 300 beds, 90 percent are at or over capacity. Most of them can急 finance more beds, because of a low debt rating, and in any case an acute nursing shortfall is constraining their ability to admit more patients. This capacity gap has adversely affected the speed of delivery as well as the availability and duration of appointments with physicians.1 Yet in every problem lies an opportunity. For US nonprofit hospitals, a new study suggests, the disparity between supply and demand and the attendant decline in service levels have boosted the number of consumers willing to pay more for better service.
Hospitals now have an opportunity to supply target customers with differentiated, "boutique" services that would offer easier access to and greater integration of health care2 and enhanced comfort and convenience during hospital stays. Some nonprofit hospitals have already begun to promote these services, but others are holding back, principally for two reasons镥ne philosophical, the other economic. The philosophical concern is that catering to affluent patients will diminish the quality of care for those unable to pay more.3 In reality, the extra revenues are likely to mean better service for all patients. Here we focus on the economic concern: whether enough customers are willing to pay for boutique services to make it worthwhile for hospitals to offer them.
We conducted a national consumer survey of 2,200 respondents of households with annual incomes of more than $80,000 and tested five types of boutique offerings at different price levels to determine which services customers would purchase. Affluent health care consumers fall into three segments of equal size: pragmatic, moderate, and idealistic. Pragmatists believe that patients should be free to pay for better service. Moderates don急 have strong opinions about the matter閲ntil they fall ill, when they become more like pragmatists. Idealists feel that high-quality health care is a right, not a privilege.
While this study is neither exhaustive nor definitive, it may be useful for hospitals that are considering investments in boutique services. Three-quarters of the pragmatists and moderates view health care much as they do the offerings of other service industries: they accept paying a premium for better services. Some 63 percent of the pragmatic consumers declare themselves willing to pay substantially more, on top of their current bills, for health care services that meet their needs for access, integration, and comfort and convenience. This willingness extends even to the idealists, one-quarter of whom would pay more for greater comfort, though they are concerned about paying for services related to access. Overall, integration and comfort not only represent the most lucrative opportunities for a hospital but can also improve its reputation substantially. Facilities that provide patients with quicker access to care for higher fees, by contrast, must find ways to counter the perception that nonaffluent customers will be disadvantaged as a result.
The survey results suggest that the average 600-bed nonprofit hospital, in a city of one million people with average incomes, could generate meaningful incremental revenues by offering boutique services for access, integration, and comfort and convenience. With potential margins from 30 to 55 percent, they could bring an average hospital as much as $6 million in incremental profit annually镢ot an insignificant amount in an industry where operating-profit margins have eroded by nearly 60 percent over the past four years.
Recognizing a market opportunity is one thing, seizing it quite another. Hospitals that offer boutique services will face stiff challenges (exhibit). To meet them, management must dedicate resources and develop consistent communications strategies to address the powerful emotional and philosophical debates this new approach may provoke within the hospital community.
［練習習作，請勿盜用］
文章定位：
