企業治理與會計資訊品質特性對國軍醫院經營關聯性之初步研究

The Preliminary Study on Relationship of Corporate Governance and Qualitative Characterististics of Accounting Information to Operation of Military Hospital

曾明洲(Tzeng Ming-Chou)

指導教授 ： 黃崇謙

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2006年)

摘要

企業治理之課責性原則，是指企業董事及高階主管的權利與責任應該劃分明確，國軍醫院非企業團體，無董事會的組織，希望藉由本研究探討當前國軍醫院高階主管人員之責任歸屬，並從會計報表其會計資訊品質特性之攸關性與可靠性，探討國軍醫院會計報表的解釋力，期更新軍醫政策機關與醫院管理者經營理念，達到永續經營的目標。 國軍醫院因兼具承擔軍事任務之特殊性，除有遂行國防施政計畫之不可取代性外，有關醫療政策制定與執行均有因應戰備的考量，同時顧及病人的醫療照護，其組織型態與使命實有別於一般企業，本研究嘗試藉由企業治理的課責性原則，探討樣本群體對責任追究的認同程度。 美國財務會計準則委員會（FASB）在財務會計觀念公報第2號（SFAC No：2）明白揭示：「欲區別資訊有用及無用端賴攸關性與可靠性兩種。」該會並認為對於決策者有用性其最重要的兩個要素即為攸關性與可靠性；本研究嘗試從國軍醫院醫療作業基金會計月報所提供的醫療服務、資產負債管理、設備投資運用、成本管控與預算執行等主要訊息來分析會計資訊品質特性所具備的程度。 本研究使用的統計方法分別是描述性統計及推論性統計。描述性統計對樣本進行次數分配及百分比之基本特性分析，對各構面問項進行平均數、標準差之統計量分析；推論性統計係以單因子變異數分析之信賴區間估計，預測不同的個人變項，對於企業治理與會計資訊品質兩構面是否存在顯著的差異；利用迴歸分析之線性迴歸，將各類樣本列為自變項，探討其與企業治理及會計資訊品質兩構面之依變項的關係。 因應財團法人醫院評鑑暨醫療品質策進會定頒新制醫院評鑑對醫院財務管理與會計制度的重視，從財務管理理論之財務報表分析常被使用的財務比率做為衡量的工具，以12家國軍醫院92年至94年三年的會計報表資料，做為醫院財務面經營績效的實證分析。 本研究分析結果，提出建議如下： 一、對軍醫政策機關的建議：階級意識與官僚體制觀念猶存，需要耐心持續溝通協調以更新舊思維、革除反對聲浪；政策主管機關宜律定符合本國實況與適合軍醫院體系的財務比率，俾供醫院經營管理之參據。 二、對國軍醫院的建議：強化醫院治理機能落實課責制度，因應「自負盈虧」的要求趨勢，積極推動財務透明化；醫院管理者對會計報表所提供的會計資訊需加以重視，才能健全財務基礎，有效率地經營。 三、對後續研究者的建議：國軍醫院有別於一般企業，非以營利為導向之非營利團體，無董事會組織，又肩負軍事任務之獨特性，本研究屬初探性質，期望能啟發後進者續就企業治理議題再深入探討。

關鍵字

企業治理 ； 課責性 ； 會計資訊品質特性 ； 財務比率 ； 醫院評鑑 ； 官僚體制

並列摘要

The accountability principle of governance corporate means that the rights and responsibilities of directors and top management should be definitely separated. Military hospitals are non-profit organization with no boards of directors. The main purpose of this study is to explore the top management’s accountability and the explanatory potential of accounting statement in military hospitals from such qualitative characteristics of accounting information as relevance and reliability. Further expectation is to renovate the managerial concept of military medical policy making institute and hospital managers so as to reach the goal of sustainable management. It is because of the particularity that military hospitals concurrently shoulder the military assignments. Other than enforce the non-replaceable mission of national offense planning, military hospitals must consider preparedness for war while instituting and implementing medical policy; in the meanwhile, take into account the medical care for patients. Their type of organization differentiates from general enterprises. This study tries to explore the identification extent that sample groups look into responsibility by means of accountability principles in corporate governance. Financial Accounting Standards Board (FASB), U.S.A. states in Concepts Statement 2 : “The qualities that distinguish “better” (more useful) information from “inferior” (less useful) information are primarily the qualities of relevance and reliability”. FASB believes that the primary factors of accounting information that to be useful to policy maker are relevance and reliability. This study tries to analysis the degree that the qualitative characteristics of accounting information posses derived from such main information like medical service, balance management, facilities investment application, cost control and budget implement derived monthly accounting report provided by Foundation For Military Medical Service Operation. The analysis methods used for this study are descriptive statistics and inferential statistics. By descriptive statistics, samples are analyzed using frequency distribution and percentage. Each dimension item is carried out with mean and standard deviation analysis. Inferential statistics refers to the use of ANOVA and confidence interval estimate to infer if there is significant difference between two dimensions- governance and quality of accounting information with different individual variables; use linear regression of regression analysis to list each sample as independent variable to explore its relationship with the dependent variable of two dimensions – governance and quality of accounting information. In response to new regulation on hospital performance accreditation announced by Taiwan Joint Commission on Hospital Accreditation, in which financial management and accounting system are emphasized, in this study the frequently utilized financial ratio in financial management theory is used to empirically analyze the financial performance of hospitals by the 3 year accounting data collected from 12 military hospitals from 2003 to 2005. According to the analysis result, the suggestions are proposed as follow: Suggestion to military medical policy making institute: Class consciousness and bureaucracy concept still exist. It needs continuous communication with patience to renovate old thinking and expel opposition voice; Policy directing institute should regulate financial ratio confirming with current situation and suitable for military hospital system so as to serve as reference for hospital management. Suggestion to military hospitals: Strengthen hospital management function and practice accountability system to response to “financially responsible for profits or losses” trend. Aggressively give impetus to financial transparency. The managers of hospital should value the accounting information derived from accounting statement so as to perfect financial basis and arrive at efficient management. Suggestion to successive researchers: Military hospitals are distinct from general enterprises. They are not profit oriented organizations and do not possess board of directs. Besides, they possess particularity of shouldering military mission. This study is a preliminary exploration. Hope the coming researchers could continue exploring the subject-corporate governance in depth.

並列關鍵字

Corporate Governance ； Accountability ； Qualitative Characteristics of Accounting Information ； Financial Ratio ； Hospital Accreditation ； Bureaucracy

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