某市立醫院民營規劃之財務影響評估－財務分析之應用

Evaluating the Financial Impact of Privatizing a Municipal Hospital: An Application of Financial Analyses

張睿詒(Ray-E Chang) ； 侯穎蕙(Ying-Hui Hou) ； 董鈺琪(Yu-Chi Tung) ； 楊志良(Chin-Liang Yuang)

《中華公共衛生雜誌》 19卷2期 (2000/04) Pp. 96-108

https://doi.org/10.6288/CJPH2000-19-02-04

摘要

目標：運用財務分析，探討公立醫院不同經營方式之財務影響，提供決策制定所需之財務訊息。方法：結合財務分析中現金流量預估、收入（成本）習性分析、淨現值法以及敏感度分析做為結構式分析程序，估計不同經營方式之營運成果。資料來自同一醫療區六家市立綜合醫院以及六家財團法人綜合醫院。結果：在任何景況下，半開放模式與合作經營模式均提供較佳之淨現值。半開模式可獲得之淨現值介於３億１千４百餘萬元與９億３千２百餘萬元之間；另一方面，合作經營模式淨值介於５億１千７百餘萬元與８億５千２百餘萬元。但醫院實際提供之財務貢獻，若合作經營模式可分享之經營成果不及６１％，則半開放模式將是較佳之經營選擇。結論：半開放模式與合作經營模式均為財務結果較佳之可行方案，但對個案醫院所提供之實質財務貢獻，方為決策者所應考量之攸關資訊。本研究之財務分析，係建立一系統化之分析架構，提供決策制之定財務攸關資訊。然而，準確的財務估計，除了系統化分析方法，尚需藉由過去預估經驗加以持續改善方可獲得。

關鍵字

財務分析 ； 民營化 ； 公立醫院

並列摘要

Objectives: This study intends to investigate the financial impacts of different operation alternatives for a government-owned hospital. Through financial analyses, decision-makers can gain financial insight into different alternatives, Methods: Operation results of different alternatives were obtained based on cash flow analysis, revenue/cost behavior analysis, net present value, and sensitivity analysis. Data were obtained from financial statements of six municipal general hospitals and six private not-far-profit genera1 hospita1s in the same medica1 region. Results: In all cases, the semi-open and joint venture models resulted in higher net present values (NPV) than did the other models. While the semi-open model obtained NT $314-$392 million NPV from its operations, the NPV for the joint venture model was NT $517-$852 million. However, if the hospital's share is less than 61 % of its operating result in the joint venture model, the semi-open model is preferred in terms of providing more actual financial contribution to the hospital. Conclusions: The semi-open and joint venture models are superior to other models in terms of financial results. However, for the decision-maker, the net financial contribution to the hospital should be a relevant issue for consideration. This study establishes a systematic approach to decision making by employing financial analyses. Nevertheless, accurate final1cial estimates depend not only on a systematic approach but also on continuous refinement of the analyses based on past estimating experiences.

並列關鍵字

financial analysis ； privatization ； government-owned hospital