醫療費用快速成長,讓醫療產業更趨競爭,且實施總額支付制度後,要求醫院開始控制成本。在成本管控的情況下產生的獲利動機,可能會影響到病患的醫療品質,因此本研究欲探討醫院財務績效與醫療品質的相關性。 本研究以2013-2015於「醫事服務機構財報公開」與2009-2012於「醫療財團法人歷年財務報告公開一覽表」中所能取得完整財報之醫院為研究對象(樣本量為526筆),以及衛生福利部機構公開資訊查詢中的最近一筆評鑑結果(樣本量為113筆),決定出二組樣本,分別為「回推年度」樣本與「適用年度」樣本,並進行敘述性統計、相關係數統計與迴歸分析等統計方法,以驗證研究假設。 本研究之研究結果顯示:(1)在一般情形下,財務績效與醫療品質呈顯著正相關;(2)稅前獲利成長率<3%的潛在獲利動機影響下,財務績效與醫療品質呈顯著負相關。這樣的結果顯示當醫院財務績效表現好、獲得更多的利潤,醫療品質會提高;並提醒評鑑單位,針對資源不足的醫院,需進行更細節的評估,以避免醫院為了達到財務績效而犧牲病患的醫療品質。
As health care costs increase faster and faster, and the government implemented the Global Budget System of the National Health Insurance which required the hospitals to control costs. Hospitals in Taiwan are affected by the finance-driven management culture, and this may also influence the quality of care. This study is aimed to investigate the association between hospital financial performance and quality of care. This is a panel study of hospital care quality and financial condition from 2009 to 2015 for the hospitals in Taiwan. This research found that (1) in general, there is a statistically significant positive association between hospital financial performance and quality of care. (2) Among hospitals with a small increase in the pre-tax income, there is a statistically significant negative association between hospital financial performance and quality of care. The results suggest that a hospital made more profit then its quality of care would generally improve, and the lack of financial strength may result in a lower quality of care.