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題名 財團法人醫院醫療品質與財務績效及非財務績效之關聯性
The Relationship of Medical Care on Financial Performance and Non-Financial Performance of Non-Profit Proprietary Hospitals作者 葉巾芷
Ye, Jin-Jhih貢獻者 李佳玲
葉巾芷
Ye, Jin-Jhih關鍵詞 醫療品質
財務績效
非財務績效
medical quality
financial performance
non-financial performance日期 2019 上傳時間 7-Aug-2019 15:52:30 (UTC+8) 摘要 在多篇實證研究中，品質與財務績效大多呈顯著正相關，已在諸多產業界得到驗證，但此結論是否能適用於我國的醫療市場，有待探討。因我國醫療市場，在全民健保的制度下，由於政府的高度介入，與自由的資本市場相較，較不具彈性且受管制。本研究樣本期間為民國102年至民國105年共計四個年度，並以財團法人醫院為對象，除了探討醫療品質與財務績效之關聯性，亦探討醫療品質對非財務績效之影響，更進一步探討醫療品質對財務績效中活動損益之影響， 活動損益分成醫務活動損益及非醫務活動損益。實證結果顯示除了結果面醫療品質不具統計顯著性外，醫療品質與財務績效及非財務績效皆呈顯著U型關係；進一步分析中，除了結果面醫療品質與醫療利用面醫療品質外，醫療品質對醫務活動損益呈顯著倒U型關係，但醫療品質對非醫務活動損益的影響，除了結果面醫療品質不具統計顯著性外，皆呈顯著U型關係。
In many empirical studies, quality and financial performance are mostly significantly positively correlated and have been verified in many industries, but whether this conclusion can be applied to Taiwan`s medical market remains to be explored. Because of Taiwan`s medical market, under the system of National Health Insurance, due to the high degree of government involvement, it is less flexible and regulated than the free capital market. The sample period of the study was for the four years from 2013 to 2016. In addition to exploring the relationship between medical quality and financial performance, the impact of medical quality on non-financial performance was discussed. The impact of medical quality on the profit and loss of activities in financial performance, activity profit and loss is divided into profit and loss of medical activities and profit and loss of non-medical activities. The empirical results show that in addition to the statistical quality of the outcome, the medical quality has a significant U-shaped relationship with financial performance and non-financial performance. In further analysis, in addition to the medical quality of outcome and the medical quality of utilization, the relationship of the medical quality and profit and loss of medical activities showed a significant inverted U-shaped relationship, but the impact of medical quality on the profit and loss of non-medical activities, except for the statistical quality of the results, was statistically significant U-shaped relationship.參考文獻 一、中文文獻王媛慧，徐偉初，周麗芳，2005，我國財團法人醫院經營績效之研究，龍華科技大學學報，第19期：133-153。石曜堂，1978，醫療品質評估，醫院雜誌，第11卷第2期：106-109。石曜堂與張政國，2008，醫療品質發展趨勢探討，台灣醫學，第12卷第6期：685-690。江東亮，文羽苹，謝嘉容，2014，全民健康保險制度的發展與問題，台灣醫學，第18卷第1期：33-42。呂執中，曾信超，2015，醫療品質概論，品質月刊，第51卷第7期：28-32。李玉春，黃昱瞳，黃光華，葉玲玲，陳珮青，2014，全民健保支付制度改革之回顧與展望，台灣醫學，第18卷第1期。李志宏與施肇榮，2008，全民健康保險解讀系列9：總額支付制度，臺灣醫界，第51卷第11期：37-43。林宏茂，趙正敏，古雅婷，鄭博文，2013，門診醫療滿意度量表之建構，顧客滿意學刊，第9卷第2期：159-187。林恆慶與陳楚杰，2003，管理式醫療用來控制醫療品質的方法介紹，醫院雜誌，第36卷第1期： 1-10。林欽法與馮茂倉，2002，全民健保醫療審查制度之改善-再議審查制度之模式建構，台灣醫學，第6卷第5期：748-751。林進財，譚醒朝，張曉芬，2013，台灣地區財團法人醫院財務報表之評估，健康管理學刊，第11卷第2期：124-137。邱瓊萱、魏中仁、楊志良與鍾國彪，2000，醫療產業品質保證與品質管理思潮演進--以美國與臺灣為例，醫院雜誌，第33卷第2期：1-12。洪清福，1997，醫療費用主要核減原因及因應之道。醫院雜誌，第30卷第5期：18-20。高資彬，1997，專業審查核減原因及分析，醫院雜誌，第30卷第5期：11-17。張力，2012，財團法人醫院獲利與醫療救濟服務差異之研究：以不同形態財團法人為例，當代會計，第13卷第1期：93-116。張志誠，2016，全民健保制度下醫療費用支付審查機制之檢討—以醫師專業自主為核心，國立政治大學法學院碩士在職專班。章殷超，2003，論述: 全民健康保險醫療服務審查問題之探討，台灣醫學， 第7卷第1期：104-114。陳志豪，張可臻，林忠順，2012，全民健保單一保險制度的優缺點，家庭醫學與基層醫療，第27卷第6期：222-225。陳柏瑋，呂昭顯，譚慧芳，2014，醫院非醫務活動收益之分析-以台灣非營利醫院為例，台灣衛誌，第33卷第6期：597-608。陳盈盈，2002，強調成本意識，節制醫療資源--從全民健保的醫療浪費談起，全民健康保險，第39期：24-28。湯玲郎與黃政豪， 2017，服務品質，認知價值與顧客滿意度對行為意向之關係研究: 以某卓越大學為例，品質學報，第24卷第3期：202-220。黃琡珺與王琪雅，2009，門診醫療服務品質量表之建構，行銷評論，第6卷第2期：221-248。楊秀儀與賴美淑，2003，醫療專業審查和醫療品質之關連性研究:美國經驗比較，台灣醫學，第7卷第5期：726-735。謝溫國，2001，利用品質機能展開法解析醫院的服務品質要素與其系統化之 研究─以中部某區域醫院為個案， 醫務管理期刊，第2卷第4期： 86-107。謝慧敏，林怡潔，邱亨嘉，2014，論質計酬支付制度與慢性疾病照護品質成效，醫療品質雜誌，第8卷第2期：28-31。韓揆，1994，醫院品質管理及門診服務品質定性指標，中華衛誌，第13卷第1期：35-53。蘇勳璧，彭朱如，鄧振華，2001，不同等級醫院其資源優勢，策略優勢與績效之關係。醫務管理期刊，第2卷第1期：93-109。二、英文文獻Alexander, J. 2010. 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國立政治大學
會計學系
105353110資料來源 http://thesis.lib.nccu.edu.tw/record/#G0105353110 資料類型 thesis dc.contributor.advisor 李佳玲 zh_TW dc.contributor.author (Authors) 葉巾芷 zh_TW dc.contributor.author (Authors) Ye, Jin-Jhih en_US dc.creator (作者) 葉巾芷 zh_TW dc.creator (作者) Ye, Jin-Jhih en_US dc.date (日期) 2019 en_US dc.date.accessioned 7-Aug-2019 15:52:30 (UTC+8) - dc.date.available 7-Aug-2019 15:52:30 (UTC+8) - dc.date.issued (上傳時間) 7-Aug-2019 15:52:30 (UTC+8) - dc.identifier (Other Identifiers) G0105353110 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/124652 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 會計學系 zh_TW dc.description (描述) 105353110 zh_TW dc.description.abstract (摘要) 在多篇實證研究中，品質與財務績效大多呈顯著正相關，已在諸多產業界得到驗證，但此結論是否能適用於我國的醫療市場，有待探討。因我國醫療市場，在全民健保的制度下，由於政府的高度介入，與自由的資本市場相較，較不具彈性且受管制。本研究樣本期間為民國102年至民國105年共計四個年度，並以財團法人醫院為對象，除了探討醫療品質與財務績效之關聯性，亦探討醫療品質對非財務績效之影響，更進一步探討醫療品質對財務績效中活動損益之影響， 活動損益分成醫務活動損益及非醫務活動損益。實證結果顯示除了結果面醫療品質不具統計顯著性外，醫療品質與財務績效及非財務績效皆呈顯著U型關係；進一步分析中，除了結果面醫療品質與醫療利用面醫療品質外，醫療品質對醫務活動損益呈顯著倒U型關係，但醫療品質對非醫務活動損益的影響，除了結果面醫療品質不具統計顯著性外，皆呈顯著U型關係。 zh_TW dc.description.abstract (摘要) In many empirical studies, quality and financial performance are mostly significantly positively correlated and have been verified in many industries, but whether this conclusion can be applied to Taiwan`s medical market remains to be explored. Because of Taiwan`s medical market, under the system of National Health Insurance, due to the high degree of government involvement, it is less flexible and regulated than the free capital market. The sample period of the study was for the four years from 2013 to 2016. In addition to exploring the relationship between medical quality and financial performance, the impact of medical quality on non-financial performance was discussed. The impact of medical quality on the profit and loss of activities in financial performance, activity profit and loss is divided into profit and loss of medical activities and profit and loss of non-medical activities. The empirical results show that in addition to the statistical quality of the outcome, the medical quality has a significant U-shaped relationship with financial performance and non-financial performance. In further analysis, in addition to the medical quality of outcome and the medical quality of utilization, the relationship of the medical quality and profit and loss of medical activities showed a significant inverted U-shaped relationship, but the impact of medical quality on the profit and loss of non-medical activities, except for the statistical quality of the results, was statistically significant U-shaped relationship. en_US dc.description.tableofcontents 第 壹 章、 緒論 1一、研究背景和動機 1二、研究目的 3三、研究架構與流程 31.研究架構 32.研究流程 4第 貳 章、 文獻探討與假說發展 5一、醫療品質 51.我國醫療品質發展 52.醫療品質 7二、醫療品質與績效 111.醫療品質與財務績效及假說發展 112.醫療品質與非財務績效及假說發展 12第 參 章、 研究方法 18一、樣本選取與資料蒐集 181.樣本選取 182.資料蒐集 19二、變數之定義與衡量 211.應變數之定義與衡量 212.自變數之定義與衡量 213.控制變數之定義與衡量 234.實證研究模型 26三、實證研究方法 271.敘述性統計 272.相關係數分析 273.迴歸實証結果 27第 肆 章、 實證結果 28一、敘述性統計 28二、相關係數分析 29三、迴歸結果分析 31四、進一步分析 39第 伍 章、 研究結論與研究限制 46一、研究結論 46二、研究限制 47參考文獻 48一、中文文獻 48二、英文文獻 50附錄 55 zh_TW dc.format.extent 1494069 bytes - dc.format.mimetype application/pdf - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0105353110 en_US dc.subject (關鍵詞) 醫療品質 zh_TW dc.subject (關鍵詞) 財務績效 zh_TW dc.subject (關鍵詞) 非財務績效 zh_TW dc.subject (關鍵詞) medical quality en_US dc.subject (關鍵詞) financial performance en_US dc.subject (關鍵詞) non-financial performance en_US dc.title (題名) 財團法人醫院醫療品質與財務績效及非財務績效之關聯性 zh_TW dc.title (題名) The Relationship of Medical Care on Financial Performance and Non-Financial Performance of Non-Profit Proprietary Hospitals en_US dc.type (資料類型) thesis en_US dc.relation.reference (參考文獻) 一、中文文獻王媛慧，徐偉初，周麗芳，2005，我國財團法人醫院經營績效之研究，龍華科技大學學報，第19期：133-153。石曜堂，1978，醫療品質評估，醫院雜誌，第11卷第2期：106-109。石曜堂與張政國，2008，醫療品質發展趨勢探討，台灣醫學，第12卷第6期：685-690。江東亮，文羽苹，謝嘉容，2014，全民健康保險制度的發展與問題，台灣醫學，第18卷第1期：33-42。呂執中，曾信超，2015，醫療品質概論，品質月刊，第51卷第7期：28-32。李玉春，黃昱瞳，黃光華，葉玲玲，陳珮青，2014，全民健保支付制度改革之回顧與展望，台灣醫學，第18卷第1期。李志宏與施肇榮，2008，全民健康保險解讀系列9：總額支付制度，臺灣醫界，第51卷第11期：37-43。林宏茂，趙正敏，古雅婷，鄭博文，2013，門診醫療滿意度量表之建構，顧客滿意學刊，第9卷第2期：159-187。林恆慶與陳楚杰，2003，管理式醫療用來控制醫療品質的方法介紹，醫院雜誌，第36卷第1期： 1-10。林欽法與馮茂倉，2002，全民健保醫療審查制度之改善-再議審查制度之模式建構，台灣醫學，第6卷第5期：748-751。林進財，譚醒朝，張曉芬，2013，台灣地區財團法人醫院財務報表之評估，健康管理學刊，第11卷第2期：124-137。邱瓊萱、魏中仁、楊志良與鍾國彪，2000，醫療產業品質保證與品質管理思潮演進--以美國與臺灣為例，醫院雜誌，第33卷第2期：1-12。洪清福，1997，醫療費用主要核減原因及因應之道。醫院雜誌，第30卷第5期：18-20。高資彬，1997，專業審查核減原因及分析，醫院雜誌，第30卷第5期：11-17。張力，2012，財團法人醫院獲利與醫療救濟服務差異之研究：以不同形態財團法人為例，當代會計，第13卷第1期：93-116。張志誠，2016，全民健保制度下醫療費用支付審查機制之檢討—以醫師專業自主為核心，國立政治大學法學院碩士在職專班。章殷超，2003，論述: 全民健康保險醫療服務審查問題之探討，台灣醫學， 第7卷第1期：104-114。陳志豪，張可臻，林忠順，2012，全民健保單一保險制度的優缺點，家庭醫學與基層醫療，第27卷第6期：222-225。陳柏瑋，呂昭顯，譚慧芳，2014，醫院非醫務活動收益之分析-以台灣非營利醫院為例，台灣衛誌，第33卷第6期：597-608。陳盈盈，2002，強調成本意識，節制醫療資源--從全民健保的醫療浪費談起，全民健康保險，第39期：24-28。湯玲郎與黃政豪， 2017，服務品質，認知價值與顧客滿意度對行為意向之關係研究: 以某卓越大學為例，品質學報，第24卷第3期：202-220。黃琡珺與王琪雅，2009，門診醫療服務品質量表之建構，行銷評論，第6卷第2期：221-248。楊秀儀與賴美淑，2003，醫療專業審查和醫療品質之關連性研究:美國經驗比較，台灣醫學，第7卷第5期：726-735。謝溫國，2001，利用品質機能展開法解析醫院的服務品質要素與其系統化之 研究─以中部某區域醫院為個案， 醫務管理期刊，第2卷第4期： 86-107。謝慧敏，林怡潔，邱亨嘉，2014，論質計酬支付制度與慢性疾病照護品質成效，醫療品質雜誌，第8卷第2期：28-31。韓揆，1994，醫院品質管理及門診服務品質定性指標，中華衛誌，第13卷第1期：35-53。蘇勳璧，彭朱如，鄧振華，2001，不同等級醫院其資源優勢，策略優勢與績效之關係。醫務管理期刊，第2卷第1期：93-109。二、英文文獻Alexander, J. 2010. 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