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Open Access Highly Accessed Research article

The study on the outsourcing of Taiwan's hospitals: a questionnaire survey research

Chih-Tung Hsiao1, Jar-Yuan Pai23* and Hero Chiu4

Author Affiliations

1 Department of Economics, Tunghai University, Taichung 40704, Taiwan, R.O.C.

2 Department of Healthcare Services Administration, Chung Shan Medical University, Taichung 402, Taiwan, R.O.C.

3 Chung Shan Medical University Hospital, Taichung 40201, Taiwan, R.O.C.

4 Department of Counseling and Applied Psychology, National Taichung University, Taichung 40306, Taiwan, R.O.C.

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BMC Health Services Research 2009, 9:78  doi:10.1186/1472-6963-9-78

Published: 13 May 2009



The aim of this study was to assess the outsourcing situation in Taiwanese hospitals and compares the differences in hospital ownership and in accreditation levels.


This research combined two kinds of methods: a questionnaire survey and the in-depth interview to two CEOs of the sample hospitals. One hospital is not-for-profit, while the other is a public hospital and the research samples are from the hospital data from Taiwan's 2005 to 2007 Department of Health qualifying lists of hospital accreditation. The returned questionnaires were analyzed with STATISTICA® 7.1 version software.


The results for non-medical items showed medical waste and common trash both have the highest rate (94.6 percent) of being outsourced. The gift store (75 percent) and linen (73 percent) follow close behind, while the lowest rate of outsourcing is in utility maintenance (13.5 percent). For medical items, the highest rate of outsourcing is in the ambulance units (51.4 percent), while the hemodialysis center follows close behind with a rate of 50 percent. For departments of nutrition, pharmacy, and nursing however, the outsourcing rate is lower than 3 percent. This shows that Taiwan's hospitals are still conservative in their willingness to outsource for medical items. The results of the satisfaction paired t-test show that the non-medical items have a higher score than the medical items. The factor analysis showed the three significant factors in of non medical items' outsourcing are "performance", "finance", and "human resource". For medical items, the two factors are "operation" and satisfaction". To further exam the factor validity and reliability of the satisfaction model, a confirmative factor analysis (CFA) was conducted using structure equation modeling (SEM) method and found the model fitting well.


Hospitals, especially for public hospitals, can get benefits from outsourcing to revive the full-time-equivalent and human resource limitation.