林能白Lin, Neng-Pai臺灣大學:醫療機構管理研究所范姜素玉Chiang, Su-Yu FanSu-Yu FanChiang2010-05-052018-06-292010-05-052018-06-292009U0001-1808200917333700http://ntur.lib.ntu.edu.tw//handle/246246/180899背景與目的：在全球面臨人口老化、慢性疾病負擔增加及醫療費用成長等挑戰下，促使社區初級照護的需求日益升高。又由於SARS、新流感疫情及食物安全諸多問題等一再威脅民眾健康，引發自然健康飲食風潮，惟市面上雖有很多標榜健康概念的餐飲選擇，但其實僅少數符合健康飲食標準。本研究著眼於嬰兒潮世代銀髮族自我照顧的需要與重視的價值，希望綜合所發掘的商機及相關創新研究，擬構社區健康餐飲服務平台結合其他照護服務之複合營運模式，作為發展銀髮族整合性照護服務企業之參考。究方法：本研究進行健康飲食產業分析、個案研究以探索相關解決方案及營運模式，再分析健康照護產業趨勢以找到潛在市場迎合未被滿足需要。此外，從創新研究以掌握營運模式創新、技術創新及新產品與服務創新等方向，以導出內部技術基礎發展模式，主要研究結果為營運模式基本架構。研究架構主要依需求驅動的供需因果關係，即依銀髮族對社區健康餐飲及人本照護服務的需求，關連上述供給面的研究。究結果：就健康飲食產業分析結果，「天然健康」、「當地生產」、「更健康的選擇」、「食物安全」及「自我健康管理」等項，已成為健康飲食的主要趨勢，「在家用餐」、「社區平台-虛擬與非虛擬」、「負擔得起的小奢華」、「全球化多樣性」等項，則為與生活方式有關的飲食趨勢，而「特別為銀髮族設計食物」預期將成為高齡化社會的新趨勢。次就個案營運模式比較結果，在產業微笑曲線佈局上，美國Whole Food Market專攻右半端成為全球有機食品零售通路領導品牌；台灣統一聖德科斯有機門市同時佈局兩端，創造高附加價值之利潤空間，而永豐餘生技偏重生產製造，且無法達到規模經濟，顯示經營與研發能量均不足。從健康照護產業分析中，發掘人本、以家庭為基礎及由跨領域團隊提供整合性服務等趨勢及人口老化導致各國居家照護市場成長。綜上，擬構營運模式基本架構中，市場定位為社區健康餐飲服務複合企業，目標市場為鎖定嬰兒潮世代之中高消費銀髮族，提供健康餐飲服務並整合照護服務方案，與其他業者作區隔。產品或服務線分為健康餐飲事業部（包括健康加值型奢華餐廳等）、照護服務事業部（以在宅服務為主）及諮詢與工作室。論與建議：社區初級照護網絡的供給缺口帶來潛在商機，最迫切的是嬰兒潮世代銀髮族未被滿足的在地老化需求，必須在社區內發展整合照護服務方案，經發掘銀髮族自我健康管理的特別飲食方案及在宅服務等具有潛在商機。創新營運模式並建構銀髮族為中心的價值網絡，提供以家為基礎的整合服務方案，透過健康餐飲事業部、照護服務事業部及諮詢與工作室之複合營運模式，以核心價值與社區內初級照護組織、家庭醫師診所及醫院等發展合作關係，並發展虛擬（網路等）與非虛擬（餐廳）之社區平台。整合價值鏈並以微笑曲線佈局，以跨領域專業團隊提供差異化的健康飲食與照護服務作為行銷訴求，蓄積研發能量以發展關鍵技術，創新機能性食物與飲料，達到發展品牌及智慧財產權的目的，並以創造高附加價值的利潤空間為最終目標。Background and objective：Confronting the challenges of aging population, increasing burden of chronic diseases and growing expenditure on health care globally, the demand for primary care in communities is rising. Furthermore, problems like SARS, flu and food safety threaten health more and more, causing the popularity of a natural and healthy diet fashion. lthough there are lots of diet choices in the market emphasizing the “healthy diet” concept, but only a few of them actually meet the criteria of healthy diets. This study focuses on the needs and rising expectations to self-care of the baby-boomer generation. Thus, through exploring new opportunities and related innovative researches, this study tries to create a compound business model aimed at aligning healthy diet services with other care services. This study provides reference information for developing integrated care services businesses.ethods：In this study, we conducted industry analysis and case study to find out solutions and business models on healthy diet-related sectors. Furthermore, we analyzed the health care trends to address the unmet needs, and then, highlighted issues about the business model innovation, technological innovation and product vs. service innovation. The main outcome was the framework of the business model. The study framework is based on demand-driven cause-effect relations between supply and demand to outline the supply approaches, i.e. focused on the demand of healthy diet services and person-centered care services. esults：According to the result of the analysis of healthy diet industry, the items of "inherently healthy","locally grown", "providing healthier diet options", "food safety" and "self-management of health" have become the primary trends of healthy diet. The items of "dining at home", "community platform- virtual and non-virtual", "affordable luxury" and "globalization and variety" are those of lifestyle-related trends, while the new trend of "specific foods for older persons" is expected to address the needs of aging societies. By further comparing the business models, the result indicates that Whole Food Market aims at the right side of the smile curve to be the world''s leading retailer of natural and organic foods. Santa Cruz Organic Foods, Uni-president focuses on the two sides of the smile curve concurrently to create much higher profits or the added values. Green & Safe, Yuen Foong Yu Group emphasizes on production and manufacturing activities. Due to the shortages of management skills and R&D capacity, Yuen Foong Yu Group fails to achieve economies of scale. According to the analysis of health care industry, an increasing trend of providing person-centered, family-based and integrated care services through the multidisciplinary teams is found, and also the aging population is the main reason contributing to the growing demand for home care in several countries. Overall, to create an initial framework for the business model, the market position is identified as a compound business of healthy diet services in communities. It focuses on the target market which is the group of baby boomers enjoying middle to high consumption lifestyle and aims at providing healthy diet services with integrated solutions of care that is distinct from others. The product or service lines is divided into three categories: healthy diet services（consists of value-added luxury restaurants, etc.）, care services （aims at in-home services）and consulting & workroom. onclusions and Recommendations：The supply gaps exist in the primary care networks in communities offer potential opportunities for private sector: The most urgent need is the unmet demand of aging baby boomers for aging in place that should be satisfied with integrated care services solutions embedded in communities. Potential opportunities in the specific diet solutions for self-management of health and in-home services are also discovered. Create the business model to organize the elderly-centered value networks: to provide home-based integrated services solutions, and develop the collaborative relationships with primary care organizations, family physicians clinics, hospitals and etc. through the compound of healthy diet services, care services and consulting & workroom. Finally, develop virtual (Internet, etc.) and non-virtual platforms (restaurants). Integrate the value chain and develop according to the smile curve: to enhance competitive strength by building multidisciplinary teams of the healthy diet and care services and to cumulate R&D capacity for developing key technologies aimed at functional foods and beverages innovation. Ultimately, to achieve goals of branding, managing intellectual property rights and creating high value-added profits.目 錄試委員會審定書………………………………………………………..i謝.……………………………………………………………………….ii文摘要.…………………………………………………………………iii文摘要…………………………………………………………………. v一章　緒論...............................................................................................1一節　研究背景............................................................................................1二節　研究動機............................................................................................2三節　研究目的............................................................................................3二章 文獻探討.......................................................................................4一節　WHO健康飲食及照護相關報告...........................................................4二節　國外健康飲食實證研究.....................................................................17三節　國外健康照護實證研究.....................................................................26四節　國內健康飲食及照護相關文獻...........................................................29三章　研究方法……………………………………………………....31一節　研究設計……………………………………………………….....31二節　研究架構………………………………………………………….36三節　研究流程………………………………………………………….37　四章　研究結果………………………………………………………38一節　國內外健康飲食產業分析……………………………………….....38二節　國內外健康飲食個案研究……………………………………….....54三節　健康飲食產業趨勢及個案模式之比較……………………………..65四節　國內外健康照護產業分析………………………………………...66五節　內部技術基礎之發展模式……………………………..…..……....78六節　營運模式基本架構………………………………………….....84五章　討論…………………………………………………………....92一節　機能性食物與飲料的發展與健康飲食商機………………………….92二節　虛擬平台的創意空間與潛在商機……………………...……………95六章　結論與建議...………………………………………………….97一節　結論....…………………………………………………………...97二節　研究限制…………………………………………………….........98三節　後續研究建議.......……………………………………………...…99考文獻……………………………………………………………....100目錄2-1-1不同飲食模式食物組合與份量及其營養成分之例示……………….…122-1-2吃蔬菜水果的好處…………………………………………………132-2-1低脂飲食介入組與控制組對癌症的試驗結果比較……………………202-3-1居家照護個案健康資源利用之比較…………………………………264-1-1食品科技雜誌發表十大食物趨勢……………………………………384-1-2消費者基於與健康有關的訴求而購買食物的比例……………………404-1-3 英國民眾購買有機食品帶回家情形…………………………………474-1-4日本鮮食未來差異化方向…………………………………………514-1-5台灣目前健康餐飲營運模式………………………………………534-2-1 Whole Food Market的財務概況………………………………….574-3-1飲食趨勢與個案模式比較…………………………………………654-4-1我國65歲以上老人居住環境調查結果……………………………754-4-2我國高齡化與少子化並存現象……………………………………765-1-1 2006年營養品產業概況……………………………………………92目錄2-1-1初級照護網絡………………………………………………….…….52-1-2生命週期內維持身體功能………………….…………………………62-1-3醫療與社會服務的三種支持等級…………………………………...…72-1-4針對65歲以上老人提供服務與支持的網絡……………………………72-1-5身體質量指數圖示……………………………………………….….112-1-6供給缺口圖示………………………………………………………162-1-7目標顧客與需求驅動的健康策略…………………………………….162-2-1a平均體重變化情形比較……………………………..……...……….182-2-1b平均體重與平均體能變化情形比較…………...……….…………….192-2-2健康飲食與生活方式對累積風險的影響…………….……………..…212-2-3a,b,c平均體重變化比較……………………………………………....222-2-4減重計畫試驗分組情形………………………………….…………..242-2-5 六個月減重效果比較………………………………………….……242-2-6第一階段減重計畫後30個月減重效果維持情形……………………..252-3-1居家照護介入組與控制組個案在六個月後復原情形比較……………...272-3-2從實證研究得到的心得圖示說明…………………………………….283-1-1營運模式架構…………………………….…………………………323-1-2價值鏈架構…………………………………………………………333-1-3開放創新理念之圖示………………………………………….…….353-2-1研究架構……………………………………………………………363-2-2研究流程…………………………………………………………...374-1-1重新整理飲食趨勢圖示……………………………………………...434-1-2美國有機食品發展………………………………………………….454-1-3 TOP10新食物與飲料………………………………………………..464-1-4英國民眾購買有機食品頻率…………………………………………484-1-5日本健康食品市場成長趨勢…………….............................................494-2-1 Whole Food Market的價值鏈圖示……………………………………554-2-2 Whole Food Market的價值網絡圖示…………………………………574-2-3聖德科斯的價值鏈圖示……………………………………………..594-2-4聖德科斯的價值網絡圖示……………………………….…………..604-2-5永豐餘生技的價值鏈圖示…………………………….……….…….624-2-6永豐餘生技的價值網絡圖示………………………….…….….…….634-2-7個案在價值鏈微笑曲線的表現比較…………………………………. 644-4-1持續性社區式照護服務組織實務架構…………………………….….674-4-2美國居家照護支付來源……………….……………………………..684-4-3美國居家照護人力市場成長趨勢……………….………….…………694-4-4英國居家照護訪視時數公私立變化趨勢……………………….……..704-4-5英國居家照護平均訪視時數趨勢………………………….…………714-4-6英國接受密集居家照護服務的家庭成長趨勢…………………………714-4-7日本在宅照護系統………………….……………………………….724-4-8日本私立經營與醫院經營之在宅護理服務互相合作……….………….734-4-9日本送餐到府服務市場趨勢…………………………………………734-4-10日本送餐到府服務公共財源緊縮…………………………..………..744-5-1飲食模式發展………………………………………………………784-5-2中央廚房操作模式發展………………….…………………………..794-5-3身體活動模式發展…………………….…………………………….804-5-4a,b照護模式發展……………………………………………………814-5-5組合模式發展………………………………………………………824-5-6虛擬平台發展………………………………………..……………..834-6-1價值主張矩陣圖示………………………………………………….854-6-2產品及服務線………………………………………………………864-6-3微笑曲線佈局策略………………………………………………….864-6-4價值鏈圖示…………………………………………………………874-6-5a,b價值網絡圖示…………………………………………………….905-1-1台灣健康概念食品示意圖……………………………………………945-2-1大量客製化創造顧客附加價值………………………………………96application/pdf5236263 bytesapplication/pdfen-US營運模式複合營運模式社區健康餐飲服務人本照護服務價值鏈創新研究Business modelCompound business modelHealthy diet services in communitiesPerson-centered care servicesValue chainInnovation studythesishttp://ntur.lib.ntu.edu.tw/bitstream/246246/180899/1/ntu-98-P96843010-1.pdf