由於健保費用的負擔與日俱增，健保局為節省健保費用的支出而推行總額支付制度、健保費率提高等措施，致使各醫院之間的競爭日益激烈。醫院經營者為了吸引更多病患來院就診，必須要特別重視醫療服務品質與顧客滿意度，藉此來提昇醫院整體的競爭力。醫療機構的最大資產是「人」，其影響的層面遍及整個組織。一個組織要維持其競爭力，就必須留住所需的「人」。因此，醫院主管們必須找出適當的領導方式，並掌握不同部門間員工的工作特性，還要設法提高員工的組織承諾，降低員工的離職率，以達到降低人力培訓成本的支出，提高醫院營運績效的目標。

　　本研究以一個醫學中心為研究母體，以員工的離職傾向為研究主題，並以影響離職傾向因素中的領導型態、工作特性、組織承諾為三個研究構面，探討彼此之間的相互影響關係，並檢驗組織承諾在領導型態、工作特性與離職傾向間所發揮的中介效果，並根據研究結果提出建議，以作為醫院內部人事管理的參考，進而達到降低醫院員工離職率的目標。

　　為了達到上述目標，本研究共發出600份問卷，有效問卷為246份，經由統計分析結果發現，魅力關懷型領導、工作重要性、組織承諾對離職傾向有顯著的負向影響；魅力關懷型領導、工作重要性對組織承諾有顯著的正向影響。組織承諾在魅力關懷型領導與離職傾向間存在中介效果；組織承諾在工作重要性與離職傾向間也存在中介效果。根據本研究的結果，醫院經營者可藉由改善主管領導方式、加強員工的在職訓練、增進護理人員的福利等方式來降低員工的離職率。

　　Because the burden of National Health Insurance expenses increases with the day, the Bureau of National Health Insurance Authority has promoted Global Budget Payment System and has raised the health insurance fee rate to decrease the expenditure of National Health Insurance expenses, which cause the competition between each hospital to become more vigorous. The hospital executives have to value the quality of medical service and customer satisfaction particularly for attracting more patients to come in. Then, the whole competition ability of the hospital can be enhanced by these ways. The biggest asset of the hospital is “people”, and people’s influence spreads over the whole organization. An organization which wants to maintain its competition ability has to keep “people” needed. Hence, the hospital supervisors must find out fit leadership methods and understand job characteristics of employees who belong to different departments. In addition, they also try to raise the employees’ organizational commitment and reduce their turnover rate for decreasing the expenditure of manpower training cost and enhancing the operation performance of hospital.

　　This study takes a medical center as a research population and takes the employees’ turnover intention as a research topic. Leadership style, job characteristics, organizational commitment are three important factors that influence turnover intention. And this study takes these factors as research factors and wants to understand the relationship between these factors and turnover intention. Besides, this study also wants to investigate the intermediate effect of organizational commitment to leadership style, job characteristics, and turnover intention. According to the research results, this study makes suggestions to the internal personnel management of hospital and hopes to reduce the turnover rate of hospital employees.

　　In order to reach above objectives, this study distributed 600 questionnaires, and 246 replies were valid. According to the results of statistical analysis, charisma-consideration leadership, task significance, and organizational commitment have obviously negative influence on turnover intention; charisma-consideration leadership and task significance have obviously positive influence on organizational commitment. In addition, organizational commitment has an intermediate effect between charisma-consideration leadership and turnover intention; organizational commitment also has an intermediate effect between task significance and turnover intention. According to the research results in this study, the hospital executives can reduce the employees’ turnover rate by improving the leading ways of supervisors, enforcing the employees’ on-the-job training, and promoting the nursing personnel welfare.

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