Background: 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.

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Developing countries often nurture the automotive industry as a path to technological and economic development. Initially, the government often sets up policies to protect the industry, but eventually the industry must face global competition. The process of industrial development for developing countries is complex and dynamic because many roles are involved in the development process. This study analyses the characteristics of the automobile industry in developing countries and the structure of the automotive industry system in Taiwan to explore the system behaviour using system dynamics methodology. The study proposes a four-role model to identify the structure where consumers play an important and subtle role in the development process. The implications for international leading automotive firms, the survival strategies of domestic companies, and the policies for developing country governments are also discussed.

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Objective To investigate the psychometric properties and relationships of perceived service quality, perceived value and overall satisfaction for residents with respect to their long-term care institutions.Design The five-point Likert scale questionnaire administered through facetoface interviews.Setting Fourteen long-term care institutions located in central and southern Taiwan stratified according to services and accommodation population.Participants One hundred and eighty long-term institutional care residents.Main outcome measures Perceived service quality (the SERVPERF model), perceived value and overall satisfaction (models based on the literature on perceived value and satisfaction).Results StudentÕs t-test on institutional location shows a significant difference between overall satisfaction for central and southern institution long-term care recipients. The correlation test revealed that the higher a residentÕs level of education, the higher the scores for perceived value. The factor loading results of confirmation factor analysis show acceptable levels of reliability and index-of-model fits for perceived service, perceived value and overall satisfaction. In addition, the results suggest that an additional construct, a positive attitude (happiness of outlook) towards long-term care institutions, is also an important factor in residentsÕ overall satisfaction. ConclusionThe primary goal of long-term institutional care policy in Taiwan, as in other countries, is to provide residents with practical, cost-effective but high-quality care. On the basis of the results of indepth interviews with long-term institutional care residents, this study suggests long-term care institutions arrange more family visit days to increase the accessibility and interaction of family and residents and thereby increase the happiness of outlook of the residents.