The establishment of medical institutions in Kaohsiung municipal is mainly to cooperate with the Kaohsiung City government in promoting health policy, equally allocating medical resources, enhancing the health of the citizens, looking after mid- or low-income citizens, and taking charge of the medical care services of special patients. However, many institutions encounter various internal constraints and environmental challenges, such as bureaucratic personnel management, inflexible accounting system, faulty implementation of national healthy insurance and competition between hospitals, the Taiwanese medical system has become ¡§high competition, low profitability¡¨. More institutions follow the trend to modify their medical care operation. Outsourcing is one of the methods to strength their medical services. The medical industry currently is highly competitive. By increasing awareness of health concern, patients are more cautious in searching for appropriate and reliable medical care. Therefore, the hospital management regards patient satisfaction, confidence, and loyalty as the core values to improve its medical care services. In this research paper, we discuss the relationship between the quality of medical care services in Kaoshiung municipal hospitals and their operating performance. We also compare the operating differences between public hospitals and outsourcing hospitals to provide authoritative reference. In our research, we selected samples of patients from the Kaoshiung Municipal Minsheng Hospital, United Hospital (Kaohsiung Museum of Fine Art Branch), Hsiaokang Hospital, and Cijin Hospital. We sent out 310 surveys and collected 287 responses by Apr 15 2010. Data analysis and hypothesis testing was based on SPSS for Windows12.0. Based on this research, we concluded that: 1.There is a significant correlation between quality of medical care services and hospital operating performance. Also, process of medical care services was highly correlated with operating performance. In addition, hospital operating performance could be effectively evaluated by quality of medical care services. 2.With regards to the evaluation of medical care services and operating performance for the four municipal hospitals, United Hospital received the highest scores, followed by Minsheng Hospital, Hsiaokang Hospital, and Cijin Hospital. However, the performance of these hospitals is average, indicating that their medical care services need improvement. 3.Finally, outsourcing hospitals have a competitive advantage, which could help the improvement of medical care services. Due to the different operating systems for each hospital, the regulatory authority should be cautious in supervising the performance of the hospital.