地區醫院之財務診斷研究

The Research of Financial Diagnosis for Regional Hospita

章淑華(Changhua Shu-Hua)

指導教授 ： 施能仁

亞洲大學/管理學院/經營管理學系碩士班/碩士(2004年)

摘要

自健保實施後，地區醫院由民國83年的509家萎縮至民國90年底的401家。面臨醫療政策巨大的變化，地區醫院因普遍缺乏管理，應變能力較差，衝擊層面也較大。並且自民國91年7月份醫院總額預算制度開始實施，未來對於地區醫院的經營，可謂雪上加霜。
因此在醫療產業環境丕變，醫療院所管理者在面臨經營困頓的壓力下，更需積極地運用企業管理的精神建全醫院之財務管理。而評估醫院經營績效的重要工具為各類財務報表，不但可看出各類收入情形，更可明瞭一組織的成本費用結構、資金運用效益等。可提供更多樣的管理規劃與控制功能，來協助醫院目標的建立、達成成本的管控，以及資本的有效運用。
本研究採個案研究，以某地區醫院八十七年至九十二年度之財務報表進行分析與研究。依靜態比率分析結果與動態趨勢分析結果以產業標準作評比進行營運績效評估與財務診斷。
緣上述動機，臚列本文之三個研究目的：
一、擬建立一套醫院經營績效指標之分析模式，以提供醫院營運管理決策之參考。
二、擬以個案進行地區醫院財務之診斷的模式，以評估醫院之經營成效與財務績效。
三、藉由財務報表之分析，發現問題，從個案醫院之定位與醫院管理之角度，提出適切可行的建議，做為類似地區醫院經營分析的參考。
依研究結果，對於個案醫院提出四項建議：(一)增加自費項目的收入開發；(二)修正門診發展，擴展住院服務；(三)降低人事費用比率；(四)加強閒置資金的有效運用。對其他地區醫院有五項建議：(一)醫院轉型評估；(二)加強內部控制，提昇外部應變能力；(三)參加聯合採購降低採購成本；(四)稅務申報能力的加強；(五)積沙成塔式之利潤創造。

關鍵字

地區醫院 ； 財務診斷 ； 財務管理 ； 比率分析 ； 趨勢分析

並列摘要

Since the implementation of National Health Insurance, number of regional hospitals shrunk to 401 at the end of 2001 from 509 in 1994. Under the huge changes of medical care policies, it is common that regional hospitals lack of management with poor response capability and experience more impacts. Also, from the implementation of total amount budget system in July 2002, things were going from bad to worse for the operation of regional hospitals.
In the significant changes of medical care industry, hospital management, in the pressure of operation difficulties, is aggressively injecting the business administration to have sound financial management of hospitals. Tools to assess hospital operation performance are various kinds of financial statements from which one can not only have an idea on the income conditions but also further understand the cost structure and use effects of capital of the organization. Furthermore, the statements provide diverse management planning and control functions to help establishment of goals, achievement of cost control and effective use of capital of hospitals.
Case study is used in this study while analysis and research is made on the financial statements of a certain regional hospital between 1998 and 2003. With static ratio analysis results and dynamic trend analysis results, we make operation performance assessment and financial diagnosis on industry standards.
Based on the above motive, we have three research purposes as follows:
1. Establishing a set of analysis model for hospital operation performance index as the reference of decision making for hospital management.
2. Intending to have financial diagnosis of regional hospitals in cases to assess the operation performance and financial results of the hospitals.
3. Discovering problems with financial statement analysis; proposing feasible suggestions from the viewpoint of positioning of case hospital and hospital management as the reference of analysis of similar regional hospital operation.
Four suggestions are made based on the research results: 1) adding the income from own expense items of patients, 2) modifying outpatient development and expanding hospitalization service, 3) reducing ration of personnel expenses, and 4) enhancing use of idled capital. There are five suggestions for other regional hospitals: 1) assessment of hospital transformation, 2) enhancing internal control and improving external response capability, 3) participating in joint purchase to reduce purchase cost, 4) strengthening the tax claim capability and 5) profit making of accumulation.

並列關鍵字

Regional Hospital ； Financial Diagnosis ； Financial Management ； Ratio Analysis ； Trend Analysis

參考文獻

謝琇蓮、江東亮(1994)。台灣地區醫院歇業及新設之決定因素。中華公共衛生雜誌，13(6)，453-458。

William N. Zelman, Michael J. McCue, & Alan R. Millikan(1998). “Financeial Management Of Health Care Organizations：An Introduction To Fundamental Tools, Concepts, And Applications”, Yehyeh Book Gallery All Rights Reserved.

William O. Cleverley(1995).”Understanding your hospital's true financial position and changing it”, Health Care Management Review, 20(2),62-73.

一、中文部分：

吳桂燕(1991)。財務管理，台北市：天一圖書公司。