全民健保自民國91年7月起開始實施醫院總額支付制度後，各家醫院因健保收入成長受到限制，自此即進入微利時代，為求永續經營，不得不重新思索經營策略，積極朝開源(拓展自費市場)與節流(降低營運成本)方向而努力。在醫院的成本結構中，以人事比重最高，其次為資材，由於醫護人員配置受法規限制，資材成本已成為節流的重點，因此物流委外成為近年醫院資材管理的重要議題。本研究之目的希望從醫院、物流商、供應商三者的觀點，以供應鏈管理的「協同合作(Collaboration)」理論為基礎，探討醫院推動三方物流(3PL)，參與成員獲得的效益與協同合作各構面之間的關聯性，進而暸解醫院、供應商與三方物流業者之間的協同合作是否可以提升供應鏈整體競爭優勢。本研究以國內某財團法人醫學中心醫材供應採用三方物流的模式為研究個案，重要研究結果如下：
一、 國內醫院物流委外無成功案例的主要原因在於缺少供應鏈協同合作的核心理念「分享」，僅以總成本面評估推動效益，漠視參與三方個別成員的衝擊及利益。
二、 醫材供應鏈三方物流協同合作的四大構面：利益共享、資訊共享、資源互補與共同學習，對醫院、物流商、供應商具有營運面、品質面、成本面的效益關聯。
本研究提供未來醫院三方物流ㄧ個清楚的理論架構與建構模型，醫院在思考物流委外議題時，不應該只侷限於自身成本效益，應該將範圍擴及整醫療產業供應鏈層次，或者至少要能爭取同儕的支持與加入；換言之，「規模經濟」才是三方物流成功與否的最重要關鍵。

Since July 2002, Taiwan’s National Health Insurance began to implement the global budget system, the various hospitals, whose health care revenue growth is limited, and has entered the trend of micro profit. For the sustainable operation, business strategy had to think positive towards taping new resources and reducing expenses. Among the cost structure of hospital, personnel cost is the highest, and the second is materials costs. Therefore, how to reduce the materials cost has become the focus of hospital’s strategy. At the same time, the third party logistic (3PL) has become an important issue. This paper is intended as an investigation of the 3PL participating members gets benefits and the dimensions of Collaboration. The result of this paper was below:
1. The main reason why there is no successful 3PL case for medical industry in Taiwan is that lack of supply chain collaboration’s core idea "sharing". Thus, that is only emphasizing the effectiveness total cost and ignores the impact to the individual members.
2. The main dimensions of Supply Chain Collaboration: benefits-sharing, Information-sharing, Complementary Resource Endowment, Inter-organizational learning, is related to the benefit of 3PL members’ dimension of operation, cost and quality.
This study provides a 3PL model for hospital which wants to carry out in the future, and suggest that hospital thinking about the topic of 3PL should not be limited to its cost-effectiveness, but extended to the entire medical industry supply chain and seek other hospitals’ support and join. In other words, "economies of scale" is the most important key to success of 3PL.

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