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總額支付及核減制度下醫院盈餘管理之研究:組織型態之差異
臺大管理論叢, 2022-12, Vol.32 (3), p.187-224
[Peer Reviewed Journal]
ISSN: 1018-1601 ;DOI: 10.6226/NTUMR.202212_32(3).0006
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Title:
總額支付及核減制度下醫院盈餘管理之研究:組織型態之差異
Author:
林嬋娟(Chan-Jane Lin)
;
陳孝宇(Hsiao-Yu Chen)
;
林孝倫(Hsiao-Lun Lin)
Subjects:
earnings management
;
float-point adjustment
;
medical juridical persons
;
NHI deduction
;
private hospitals
;
Scopus
;
TSSCI
;
健保核減
;
盈餘管理
;
私立醫療機構
;
醫療法人
;
點值調整
Is Part Of:
臺大管理論叢, 2022-12, Vol.32 (3), p.187-224
Description:
本研究探討在健保總額支付及核減制度下,醫院組織型態對其盈餘管理行為之影響。本文運用中央健康保險署所公布之2013至2018年私立醫療機構、醫療財團法人、醫療社團法人財務報告,建立模型估計裁決性點值調整數、裁決性健保核減數,用以衡量各醫院之盈餘管理程度。實證結果顯示,當盈餘管理前之盈餘愈高時,私立醫療機構較醫療法人,提列較高之點值調整數及健保核減數,以調降盈餘。此可能係因私立醫療機構盈餘之多寡,直接影響負責醫師或合夥醫師須負擔之稅負,以及私立醫療機構之醫院治理機制較醫療法人較不完備所致。再者,本文亦發現,與醫療社團法人相較,醫療財團法人於盈餘管理前之盈餘愈高時,提列較高之點值調整數及健保核減數,以調降盈餘。此可能係因醫療財團法人為非營利醫院,被賦與的公益性較高,其結餘應提撥較高比例辦理研發、人才培訓、健康教育、醫療救濟與社區服務等事項,且為避免過高盈餘導致更多的監督與管理,而有較強動機調降盈餘。本研究延伸醫療機構盈餘管理的研究範圍,將醫療社團法人與私立醫療機構一併納入分析。本文進一步發現,在全民健保總額支付及核減制度下,國內醫療機構除了運用健保核減應計數外,亦運用裁決性點值調整數進行盈餘管理。最後,本研究結果可提供監管機關作為修正醫療機構治理政策,例如訂定醫療機構提列裁決性應計數之指引
The current study examines earnings management behavior under the Global Budget Payment and Reduction of Medical Expenses System across various types of hospitals in Taiwan. Using 2013-2018 financial data available from the National Health Insurance Administration, this study builds models to estimate the discretionary accruals (e.g., float-point adjustment and allowance for National Health Insurance deduction) as proxies for earnings management behavior of hospitals. O
Publisher:
台灣: 國立臺灣大學管理學院
Language:
Chinese
Identifier:
ISSN: 1018-1601
DOI: 10.6226/NTUMR.202212_32(3).0006
Source:
AUTh Library subscriptions: ProQuest Central
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