資訊揭露透明度與醫院治理效能：一代健保與二代健保比較研究

Transparency of information disclosure and effectiveness of hospital governance: a comparative study of the first and second generations of Nation Health Insurance

目標：資訊揭露透明度為醫院治理能效能否發揮之關鍵要素，本研究試圖比較醫院強制性資訊揭露（二代健保）與自願性資訊揭露（一代健保）對於醫院治理效能之關聯性。方法：本研究採用問卷調查，以全國各醫院高階主管為填卷對象，有效問卷196份，以卡方檢定、T檢定、複迴歸及鄒檢定進行研究分析。結果：資訊揭露透明度會影響醫院治理效能，在目前健保制度下，醫院有關違規資訊愈不揭露，則顧客效能愈好；醫療品質及財務報表揭露度愈高，則醫院之學習成長效能愈好。在差異比較分析結果方面，一代健保醫療品質揭露對社會責任效能達到顯著正向效果；二代健保則醫療處置流程透明度愈低，則財務效能愈好。最後，無論是在一代或二代健保，就醫流程揭露及財務報表揭露，皆能正向影響醫院社會責任效能。結論：醫院治理效能顯示願意傳達揭露資訊給利害關係人，則醫院治理效能會較高。提供消費者醫療揭露資訊時，應提高其應用性，以減少處理相關資訊的負擔。

Objectives: Transparent information disclosure is a key factor affecting the effectiveness of hospital governance. This study compared the association between mandatory disclosure (Second Generation National Health Insurance (NHI)) and voluntary disclosure (First Generation NHI) in relation to the effectiveness of hospital governance. Methods: This research was conducted through the questionnaire survey method and the research subjects included senior executives from hospitals nationwide. A total of 196 valid questionnaires were returned. Data collected from the survey were analyzed by the chi-square test, T-test, multiple regression analysis, and Chow Test. Results: The transparency of information disclosure affected the effectiveness of hospital governance. Lower levels of disclosure regarding hospital violations corresponded to greater effectiveness in terms of the management of customer relationships. Higher levels of disclosure about the quality of medical services and hospital financial reports corresponded to greater effectiveness in hospital learning and development. In First Generation NHI, disclosure of the quality of medical services has a significant positive effect on social responsibility, but in Second Generation NHI, lower transparency about the processes of medical management corresponded to greater financial effectiveness. Finally, in both First and Second Generation NHI, disclosure of medical treatment processes and hospital financial reports had a positive effect on the hospital's effectiveness in terms of social responsibility. Conclusions: Hospitals conveying a willingness to disclose information to stakeholders generally had greater effectiveness in hospital governance. When disclosing medical information to consumers, practicality should be monitored, so that the burden of processing the related information is minimized.