本研究選取國內七間不同層級的公私立醫院，藉由與院方相關決策人員的深度訪談，以個案研究方法，探討各級醫院對於美容雷射儀器與高階影像醫療儀器之採購決策行為，研究中設定「首次採購新型儀器」與「後續購買改良型儀器」的兩種決策情境，以採購意願、採用規格與採用速度等三大決策面向，分析歸納各級醫院對於高階決策的決策行為與考量因素之異同。 本研究結果發現，醫院權屬與層級及採購儀器本身屬性均會影響決策的採購意願、採用速度及採用規格。醫學中心基於學術研究之需，首次購買新型儀器時，偏好採購儀器創新程度高的機種，且其採用速度較地區醫院快。反觀地區醫院較不會追逐儀器的新穎度，對於「儀器是否符合需求及性價比」的重視程度較「儀器先進與否」來得高，不過當地區醫院鎖定特定醫療項目作為策略目標時，會集中資源採購最先進的儀器，並弱化非核心醫療項目之設備的採購意願。 就各層級醫院採購決策的考量因素而言，儀器預期的財務性效益大多是首要考量，私立醫院較公立醫院更注重之，地區醫院則較醫學中心在意儀器的性價比。此外，貴重儀器之醫療必要性的高低亦造成不同層級醫院的決策差異，儀器本身的技術含量與技術創新速度也可能影響醫院採購的意願。 / There are two purposes of this research. The first purpose is to explore how the ownership of hospitals and the features of devices impact on medical procurement decisions. The second purpose is to investigate the factors affecting innovation adoption of medical devices. Based on the case studies of procurement decision experiences made by seven selected hospitals and medical centers in Taiwan, the study focuses on analyzing the willingness of adoption, adoption time, and the favorable standards in procurement decision of aesthetic devices and medical imaging devices. The findings and conclusions drawn from the study show that the academic level and strategy objective of a hospital are associated with the willingness and adoption time of innovation. Academic medical centers are likely to adopt the innovative device earlier for researching purpose, whereas small-to-middle-sized hospitals would be early adopters of innovative products for strategic purpose. In addition, the features of devices also have substantial impacts upon innovative device adoption. Academic medical centers will be early adopters of the medical devices with significant medical necessity. The degree of technology involved and the length of product life cycle of medical devices will affect the medical procurement decision as well. Besides, the priority of distinct factors affecting medical procurement decisions varies from case to case. However, generally speaking, economic benefit will be the most important concern of both private and public hospitals.