財團法人醫院社會責任支出與財務績效之研究：以不同型態財團法人醫院為例

目的：探討財團法人醫院社會責任支出對健保核減率、自費收入比率與非醫務活動收入比率之影響。方法：利用衛生福利部公布醫療財團法人2016年至2018年財務報表，以多元迴歸模型進行實證分析。結果：財團法人醫院社會責任支出對健保核減率無顯著之影響；對自費收入比率及非醫務活動收入比率呈現顯著負向（正向）影響。進一步區分財團法人醫院型態，宗教與一般財團法人醫院進行社會責任服務行為係出自於「自利」行為及符合「可負擔理論」。結論：可以讓醫院管理當局了解設立宗旨與生存找到平衡點。政府機關應強力監督財團法人醫院從事社會公益之活動，達到社會公平性，此外，輔導醫院適度從事與設立宗旨有關的非醫務活動，提升醫院競爭能力。

關鍵字

財團法人醫院；健保核減率；自費收入比率；社會責任支出；健保總額支付

並列摘要

Objectives: This study was to explore the impact of social responsibility expenditure on the financial performance (health insurance reduction rate, out-of-pocket income ratio and none medical income ratio). Methods: The data source for this study was the annual financial statements for each medical institution released by the Ministry of Health and Welfare. The operation data of the institutional hospitals for the period from 2016 to 2018 used the multiple regression model. Results: It was found in the empirical results that the social responsibility expenditure of institutional hospitals had no significant impact on the health insurance reduction rate. The social responsibility expenditure of institutional hospitals had a significantly negative impact on the out-of-pocket income ratio and positive impact on none medical income ratio. According to managerial guile theory and affordability theory, the corporate social responsibility of an institutional hospital is for its own interest and affordability; further distinguishing the type of institutional hospitals indicated that only corporate institutional hospitals did not affect this association, while religious and general institutional hospitals had the effect of strengthening negative regulations. Conclusions: The contribution in practice of the research findings is to allow hospital management authorities to find a balance between such purpose and survival. Government agencies should strongly supervise institutional hospital and make use of legal power to require them to engage in social welfare activities in order to achieve social equity. In addition, counseling hospitals to moderately engage in non-medical activities related to the purpose of establishment, and enhance the competitiveness of hospitals.

並列關鍵字

institutional hospital ； health insurance reduction rate ； out-of-pocket income ratio ； corporate social responsibility expense percentage (CSRP) ； national health insurance global budgeting

參考文獻

王敏容、王如萱、王佳惠、郭乃文（2005）‧市場競爭程度對醫院開發自費醫療服務之影響。北市醫學雜誌，2(10)，895-906。https://doi.org/10.6200/TCMJ.2005.2.10.03

張力（2012）‧財團法人醫院獲利與醫療救濟服務差異之研究：以不同型態財團法人醫院為例‧當代會計，13(1)，93-116。 https://doi.org/10.6675/JCA.2012.13.1.04

陳敏郎（2005）‧醫療體制與組織的相互再生產—以基督宗教醫院組織行動特質的變與不變為例‧人文及社會科學集刊，17(3)，521-564。https://doi.org/10.6350/JSSP.200509.0521

陳柏瑋、呂昭顯、譚慧芳（2014）‧醫院非醫務活動收益之分析—以台灣非營利醫院為例‧台灣公共衛生雜誌，33(6)，597-608。 https://doi.org/10.6288/TJPH201433103061

梁志民、郭振雄、李怡慧、何怡澄（2018）‧醫療財團法人的租稅優惠與社區公益服務‧臺大管理論叢， 28(2)，1-31。https://doi.org/10.6226/NTUMR.201808_28(2).0001

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財團法人醫院社會責任支出與財務績效之研究：以不同型態財團法人醫院為例

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