背景:近年來,我國非營利醫院 (指財團法人醫院)受到健保支付方式的改變以及健保署對於各給付項目審查愈趨嚴格,使醫院主要收入受到嚴重的衝擊,加上各醫院間的競爭日益激烈,更造成醫院醫療收入的減少,單純依靠健保給付,醫院在主要醫務活動上會有財務壓力,而非醫務活動收益能減輕或抵銷醫務活動可能面臨虧損的壓力。 目的:本論文旨在瞭解非營利醫院非醫務活動收益的結構與趨勢,並探討醫院特性、醫務活動損益與非醫務活動收益的關聯。 資料與方法:本研究2006-2011年國內醫療財團法人為研究對象,以人工收集醫療財團法人歷年財務報表相關財務資料進行分析,利用描述性統計進行非醫務活動收益的內容結構及歷年的趨勢分析,並以廻歸分析法模型檢視醫院特性以及醫務活動損益與非醫務活動收益的關聯。 結果:研究結果發現非營利醫院中非醫務活動收益的最大來源為「捐贈收入」,佔非醫務活動收益46.98%及總收入3.53%,其次為「其他營運收入」,佔非醫務活動收益22.88%及總收入1.62%。廻歸分析模型對各項醫院特性變數與整體非醫務活動收益的關聯性分析中,宗教型醫院及醫學中心與非醫務活動收益有顯著的正向關聯;而醫務損益與非醫務活動收益顯著負相關。 結論:整體而言,非醫務活動收益對非營利醫院的財務狀況日益重要,醫院設立屬性與醫院等級是要影響因素,而醫療活動財務壓力愈大(即面臨營運虧損壓力愈大)的醫院有較高的非醫務損益。因此非營利醫院可利用其特性並結合其營運宗旨,發展相關的非醫務活動來面對日益增加的財務壓力以提升醫療品質。
Background: The National Health Insurance (NHI) in Taiwan has changed its method of reimbursement, tending toward more strictly scrutinizing in many items proposed for reimbursement. This has led to fierce competition among nonprofit hospitals (the medical foundations) and many facilities have encountered considerable difficulties in raising patient care revenue and unstable sources of income. Depending solely on reimbursement from the NHI has led to financial difficulties, making it danger the hospital’s going concern. Nonpatient revenues can be used to offset possible losses and decrease the financial stress. Objectives: The aims of this study are (a) to examine the size and sources of nonpatient revenues in nonprofit hospitals, (b) analyzes the impact of nonpatient revenues on nonprofit hospital operating margins and characteristics. Methods: Data for this study came from Ministry of Health and Welfare. The sample consisted of medical foundations for the years 2006-2011. Descriptive statistics were used to hospital nonpatient revenues and characteristics. Regression analysis was used to analyze the impact of nonpatient revenues on nonprofit hospital operating margins and characteristics. Results: During the period 2006-2011, on average, the most is donations accounted for 45.70% of nonpatient revenues and 3.14% of total revenues, second is other operating revenues accounted for 23.71% of nonpatient revenues and 1.63% of total revenues. Nonpatient revenues tended to be more important for among the hospital operating margins. Analytical results based on the regression model show that nonpatient revenues has an obvious positive correlation with religion-funded hospitals and medical centers, and income from patient services is significantly negative correlated with nonpatient revenues. Conclusions: Nonpatient revenues are increasingly important for nonprofit hospitals. The foundations and level advantages of nonprofit hospitals have critical impact on nonpatient revenues, and the less patient care revenue hospitals earn (i.e. the more suffering from operating losses), the more nonpatient revenues managers will make. This in combination with patient-care services can enhance hospitals’ financial performance and the primary line of business as well as promote the quality of medical services.
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