本管理個案主角K 診所陳醫師，屬提供血液透析服務（俗稱洗腎）的基層醫療機構的負責人，主要服務對象係診所所在地周邊的透析患者。透析患者之治療不同於一般病患，一旦病患罹患尿毒症，若未能進行腎臟移植，就須面臨終生洗腎，每次血液透析治療長達4 個小時左右，因此洗腎病患與診所的醫護人員之互動及關係，密切且長久。而健保的改革、血液透析產業之改變、病患就醫意願、醫療服務品質皆攸關診所的經營成敗。
健保署實施「健保總額支付制度」至今，血液透析給付點值逐年下降，診所收入受到直接衝擊，加上診所設置的相關法令及規範日趨嚴謹，基層透析診所的營運成本則逐年上升，若要永續經營勢必要不斷擴展向前跨出一步，負責人陳醫師思考診所未來的發展方向目標，所面臨的挑戰：業績成長率衰退、競爭院所增加、病患忠誠度不足、護理人力短缺，透過案例的探討，可以讓學習者了解，基層診所經營的過程中，被迫不斷增加服務內涵或持續強化軟硬體設備。
本論文包含個案內容和教師手冊兩部分，透過教師的引導式教學，根據個案的實例發展，帶領同學探討個案。診所在經營的過程中，受健保法規制度與政策推動、區域醫療資源密集度、透析產業資源整合程度影響甚大，以商業模式分析、五力分析、SWOT 分析，從中探究個案如何利用本身的優勢及機會，透過服務價值鏈創造利潤，期能提供未來洗腎診所經營策略參考與轉型應對。

The protagonist of this management case, Dr. Chen from K Clinic, is the head of a primary medical institution that provides hemodialysis services (commonly known as dialysis), and his main service targets are dialysis patients around the clinic. The treatment of dialysis patients is different from that of ordinary patients. Once a patient suffers from uremia and fails to receive a kidney transplant, he or she will face lifelong dialysis. Each hemodialysis treatment lasts about 4 hours. The interaction and relationship with the medical staff are close and long-lasting. The reform of health care, the changes in the hemodialysis industry, the willingness of patients to seek medical treatment, and the quality of medical services are all critical to the success or failure of clinics.
Since the National Health Insurance Administration implemented the “Global Budget Payment System”, the value of hemodialysis benefit points has been declining year by year, and the clinic’s income has been directly affected. In addition, the relevant laws and regulations for setting up clinics have become increasingly stringent, and the operating costs of primary dialysis clinics have increased year by year. Continued operation is bound to continue to expand and take a step forward. Dr. Chen, the head of the clinic, thinks about the future development direction of the clinic and the challenges it faces: decline in performance growth rate, increase in competitive institutions, lack of patient loyalty, and shortage of nursing manpower. The discussion of the case can let the learners understand that in the process of the operation of the grassroots clinics, they are forced to continuously increase the service content or continuously strengthen the software and hardware equipment.
This thesis consists of two parts: the case content and the teacher's manual. Through the teacher's guided teaching, according to the development of the case, the students are led to discuss the case. During the operation of the clinic, it is greatly influenced by the promotion of health insurance regulations and policies, the intensity of regional medical resources, and the degree of integration of dialysis industry resources. Through business model analysis, five forces analysis, and SWOT analysis, we explore how individual cases can utilize their own advantages and opportunities to create profits through the service value chain, hoping to provide a reference for future dialysis clinic business strategies and transformation responses.

中文部分
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英文部分
1. Alexander Osterwalder & Yves Pigneur (2010). Business Model Generation.
2. Fitzsimmons, J. A. & Fitzsimmons, M. J. (2013). Service Management: Operations, Strategy, and Information Technology. 8th ed. New York, NY: McGraw-Hill.
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網路部分
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8. 衛生福利部中央健康保險署，重要統計資料，陸、總額支付制度。https://www.nhi.gov.tw/Content_List.aspx?n=D529CAC4D8F8E77B&topn=23C660CAACAA159D