近年來，臺灣的醫療環境變化劇烈，由於醫院間的競爭增加，政府介入的加深，使得醫院的經營面臨許多困難。1982年臺灣地區醫院家數為593家，其中114家(19.2%)，到1989年業已歇業，但同一時期，另有346家醫院新設立。本研究以衛生署既有的醫院電腦檔為分析資料，採開放系統中自然模式，來探討醫院組織本身及環境因素對臺灣地區醫院歇業及新設的影響。本研究重要結果有：(1)以地理分布來看，歇業醫院多位於都市化地區，新設醫院則有向鄉村設立的趨勢；(2)病床數少的醫院易歇業也易新設，但新設醫院的平均規模大於歇業醫院；一般看來，存活醫院從1982年到1989年有擴大規模的傾向；(3)影響醫院新設，除病床數以外，還有醫院的服務科別及社區的農業人口百分比。

In face of increasing public intervention and competition, hospitals in Taiwan have been in the difficulty of running since 1980s. In 1982 there were 593 hospitals in Taiwan, of them 114 or 19.2% were closed by 1989. During the same period, however, 346 new hospitals were opened. This study used secondary data to investigate the determinants of hospital closure and opening in Taiwan. The results of this study showed: (1) Most of the closed hospitals were located at municipal cities while most of the new hospitals at suburb and rural areas; (2) Bed size was a major determinant of hospital clousure and opening, but the size of new hospitals' was larger than that of the closed hospitals; from 1982 to 1989, the average size of survived hospitals increased; (3) Besides bed size, type of services as well as proportion of agriculture labor were significantly related to hospital opening.

醫院歇業 ； 醫院新設 ； 開放系統模式

hospital closure, hospital opening, open system model