探討醫院投入企業社會責任與財務績效之關係

研究目的隨著經濟發展的同時，往往伴隨著許多環境汙染、勞工權益等問題不斷爆發，這可能是因為企業在經營時，沒有考量到對社會及環境影響等企業社會責任有關，因此近年來實踐企業社會責任已轉變為國際趨勢，我國政府也希望企業更加重視企業社會責任方面的議題。醫療機構本身是屬於非營利性質且具有社會責任的組織，也就是說，醫院的環境和醫療品質使社會責任的概念有助於改善對大眾提供的基本服務（醫療健康服務，科學研究和教學），並且高於其他營利性企業。雖然就目前研究中，已有許多企業探討企業社會責任議題，卻少有針對醫療機構投入企業社會責任與財務績效關聯之相關研究，因此，本研究為探討醫療機構對企業社會責任的認知、實施策略與企業社會責任投入程度及預期效益之關係，進而探討醫療機構投入企業社會責任的預期效益與財務績效之關聯。研究方法本研究採用問卷調查方法，研究對象包含嘉義以南地區之地區醫院、區域醫院、醫學中心之醫院高階管理者（均為非營利性機構），其中包括院長、副院長、主任、副主任、組長等，探討其對於醫療機構之企業社會責任與財務績效的看法，本研究以描述性分析與偏最小平方法，進行剖析實證研究結果。本研究共發出530份問卷，回收了134份問卷（地區醫院53.0％，區域醫院43.3％，醫學中心3.7％，回收率25％）。研究結果在這項研究中，醫療機構之企業社會責任被定義為維持利潤的持續投入程度，並考量對社會的影響為社會做出貢獻。有四個構面探討與醫療機構企業社會責任與財務績效之關聯，其中包括企業社會責任認知、策略、投入程度、預期效益。本研究之Cronbach’s α係數總體值為0.811，問卷之專家效度值為0.7，表示本研究之問卷通過信效度檢測。本研究進行了PLS路徑分析和模式驗證後的結果顯示，醫療機構對企業社會責任的認知會影響投入程度及預期效益（β= 2.671，P <0.05）。而醫療機構實施企業社會責任策略不會直接影響預期效益（β= 1.845），卻會透過投入程度（β= 4.807，P <0.01）進而影響預期效益（β= 4.727，P <0.01）。因此，企業社會責任的投入程度在本研究中具有中介作用。整體模型的解釋力為37.2％（R2 = 0.372）。在探討醫療機構投入企業社會責任是否有助於提高財務績效，其結果未達顯著差異，表示投入企業社會責任無法提高財務績效（β= 0.08，P> 0.05）。結論與建議本研究結果證實醫療機構管理者對企業社會責任的認知與決策會影響其投入企業社會責任的程度與預期效益，此結果顯示醫療機構對企業社會責任有一定程度的認知，根據先前的文獻，本研究探討醫療機構對於企業社會責任與財務績效之間的看法與文獻有所差異，而本研究調查對象是醫療機構的人員，因為工作性質的關係，他們認為工作的內容本身就是一項企業社會責任，因此認為企業社會責任對醫療機構提升財務績效的影響極小，但根據研究顯示，醫療機構之企業社會責任是落後於其他企業的，加上近年來醫病關係緊張，因此政府與醫療機構還是應多正視相關議題，致力於投入企業社會責任，為社會及環境，還有利害關係人付出一份心力。

關鍵字

醫療機構；企業社會責任；財務績效

並列摘要

Object Economic development is often correlated with environmental pollution and labor rights issues as a company may not consider the issue of corporate social responsibility (CSR) when it operates. From the perspective of globalization, the practice of CSR has evolved into an international trend, where now the Taiwanese government has indicated that enterprises should pay more attention to CSR. The hospital itself is a non-profit and socially responsible organization. That is, the environment and medical quality of the hospital make the concept of social responsibility help to improve the basic services (healthcare delivery, scientific research and teaching) provided to the public and higher than the other for-profits companies. While there has been much research on CSR, few studies focus on the association between social responsibility of hospitals and their financial performance. Therefore, this study explores the relationships between hospitals’ implementation of CSR strategies, the degree of CSR investment against expected benefits and whether this improves financial performance. Method This study adopted a questionnaire survey method. The survey subjects include high-level hospital administrators in regional hospitals, regional hospitals, and medical centers in the south of Taiwan (all not-for-profit), including superintendents, vice superintendent, directors, deputy directors, and team leaders. This study used descriptive analysis, and partial least squares method to verify the results. A total of 500 questionnaires were sent out and 134 questionnaires (district hospital 53.0%, regional hospital 43.3%, medical Center 3.7%) were returned (response rate of 25%) Result In this study, CSR for hospital was defined the degree of continuing commitment to maintain profit and consider the impact on society and contribute to society. There are four constructs to explore the association with hospital performance, which included CSR cognition, strategies, level of commitment, and expected benefits. The overall Cronbach’s α coefficient of the well-defined measurements was 0.811, and the content validity ratio was 0.7 indicating that the questionnaire for this study was reliable and valid. We conducted PLS path analysis and bootstrapping to verify the association within constructs. The results show the perception of CSR by hospitals will affect the level of investment and expected benefits (β = 2.671, P<0.05). The CSR strategy does not directly affect financial performance (β = 1.845), but it will affect the expected benefits of CSR (β = 4.727, P<0.01) through the degree of CSR investment (β = 4.807, P<0.01). Therefore, the degree of CSR investment has a mediating effect in this study. The overall mode interpretation is 37.2% (R2=0.372). The results did not find that hospitals’ investment in CSR contributes to the improvement of financial performance (β = 0.08, P>0.05). Conclusion The results of this study found that the perception and decision-making of hospitals’ top team managers on CSR will affect the degree of social responsibility and the expected benefits of the CSR. This result shows that hospitals have a certain degree of CSR cognition. In contrast, there are different views on CSR and financial performance in the literature compared to this study. The research object of this study is the senior management of hospitals and they believe that the content of the hospital’s work itself is a CSR. Consequently, CSR has little influence on hospitals improving their financial performance. However, according to previous research arguments, the CSR of hospitals lags that of other companies. Additionally, the relations between provider and patients are tense recently. Taiwan’s government and hospitals should pay more attention to relevant issues and commit to investing CSR to maximize benefits for society and the healthcare environment.