非營利醫院的負債融資與社區公益活動

Abstract

目標：非營利醫院採用負債融通資金，影響其提供社區公益活動情況，本文採用台灣實證資料。方法：採用35家醫療財團法人2002年的資料為樣本，分析負債額度對醫院提供教育與研究活動、免費醫療活動，以及社區公益活動的影響，並控制醫院特性與市場情況。結果：迥歸分析顯示負債對免費醫療支出有排擠效果。結論：非營利醫院兼具商業與社會角色，當非營利醫院採用負債融通資金時，會排擠社區公益支出且降低其社會公益角色，故研究結果顯示短期的利潤目標與長期社區公益活動目標存在衝突，冉法透過負債解決經理人與社會大眾之期待的問題。

Objective: To examine if debt financing imposes constraints on Taiwan`s private, not-for-profit hospitals` capacity to deliver community benefit services. Method: By using data collected in 2002 through audited financial statements and surveys from 35 private, not-for-profits hospitals in Taiwan, this study investigated whether the extent of debt financing has an impact on education and research expenditures, uncompensated care service expenditures, and community benefit services offered by these hospitals. Result: Regression analysis data suggest that debt financing had a crowding-out effect on uncompensated care service. Conclusion: All private, not-for-profit hospitals have the mission to provide charity services, while making a profit. The results presented herein showed that debt financing of these hospitals decreased expenditures for community benefit services, thereby impairing their social mission. The conflict between the short-term goal of profit maximization and the long-term goal of community benefit services cannot be resolved by debt financing.