- 學位論文
醫院法人化決策因素之個案研究
Case Study on Factors Regarding Corporate Hospital Decisions
摘要
摘 要 依據九十三年四月二十八日公佈，修訂醫療法全文一百二十三條，其立法目的為：「促進醫療事業健全發展，合理分配醫療資源，提高醫療品質，保障病人權益及增進國民健康，特制定本法」，並在其中明定私立醫療機構達中央主管機關公告達200 床規模以上者，在公告後三年內應改以醫療法人型態設立，私立醫院得藉以輔導轉型，改善經營體質，提升醫療服務水準，進而達成永續經營的目的。目前租稅優惠期間已超過，符合醫療法中200 床以上須改制為醫療法人之私立醫療院所仍有46 家。 本論文的研究方法將以質性研究為主，即由相關學術書籍、期刊、論文、網站以及政府之相關官方統計、研究報告、法令規定等，收集多元面向資料，並加以整理、歸納、剖析、比較等，作為研究之基礎，將從法人制度之意義、理由及法人本質等作為公私立醫院在探討新修正醫療法人制度之建議。現今政府財政困難要達成目標更需要透過民間資金之投入才能改善，在目前醫療機構面臨各種衝擊之時，主管機關要有何誘因推動，才能誘使私立醫療機構之業主願意捐贈財產改制為醫療法人，本研究主要利用醫院財務報表等次級資料加以分析私立醫院法人化之優點，並提出合理之建議。 為了解在私立醫療院所法人化後經營績效是否提升或下降故以純益率為應變數，流動比率、負債比率、利息支出比率及所得稅支出比率為自變數，以進一步瞭解其財務體質之資金流動情況，因樣本數較少且個案醫院每季收入及支出穩定情況下，將引用季資料進行分析個案法人化前後差異檢定，本論文實證結果為法人化後，純益率呈現顯著下降的趨勢。
並列摘要
Abstract According to the announcement on April 28th, 2004, the whole content of 123 articles of the Medical Care Act were revised, according to the legislative purpose of: “promoting health development of medical care, reasonably distributing medical resources, enhancing quality of medical care, protecting patients’ rights and improving national health”. The Act further specifies that private medical institutes reaching the scale of 200 beds, as announced by the central authorities, shall convert into corporate medical institutes within three years of such announcement. Through such conversion, private hospitals may improve the operational conditions and enhance the standard of medical services via consultation and transformation, thereby achieving the aim of sustainable operation. At present, the period of discounted rent and tax has expired; and there are still 46 private medical facilities that fit the scale of 200 beds under the Medical Care Act, that have yet to convert into medical corporate. The study used qualitative research, that is, a collection of multi-dimensional data from: relevant academic publications, journals, theses and websites, as well as official statistics, research reports and legal regulations from the government. The data were then organized, compiled, analyzed and compared in order to create the research foundation. Suggestions were provided for public and private hospitals in regard to discussions on the newly set medical corporate system, based on the meanings, reasons and nature of such corporate system. Furthermore, subject to the financial difficulties faced by today’s government, the conditions for reaching these goals can only be improved via continual investment from private capital. Under the various impacts on medical institutes, determining how authorities should provide incentives, so that owners of private medical institutes are willing to donate their properties and convert into medical corporate, has become an issue of concern. This study mainly used secondary data (e.g. financial reports) of hospitals to analyze the strengths and weaknesses of private hospitals, and also proposed rational suggestions. In order to determine whether the operation performance improves or degrades after private medical facilities become corporate, the net profit rate was taken as the dependent variable, while current ratio, liability ratio,interest expense ratio and income tax expenditure ratio were taken as independent variables, in order to further understand the status of capital flow under the respective financial structures. Since there were insufficient samples and the target hospitals showed stable income and expense per quarter, the quarterly data were used to analyze the difference before and after the case subject converted into a corporate. This study found that after converting into a corporate, the net profit rate showed a significant tendency to decrease.