總額預算制度下，醫師專業化程度、管理會計系統與預算控制行為之關聯性

The Relationship among Physicians’ Professionalism, Management Accounting System and Budget Control Behavior under Global Budget System

總額預算制度實施後，成本的控制與資源的分配即成為醫院營運的重要考量。醫院的營運受到醫師高度專業與自主性行為的影響，儘管如此，卻鮮少文獻探討透過管理會計系統使用如何影響醫師預算之控制行為。因此，本研究以角色理論為基礎，針對台灣個案醫院之醫師，進行問卷調查並輔以半結構化的訪談，探討醫師的專業化程度是否透過管理會計系統之使用，進而影響醫師的預算控制行為。本文以部分最小平方法分析92 份有效問卷。實證結果發現，醫師專業化程度與預算控制行為呈現負向關聯性。然而，醫師的專業化程度透過廣範圍的管理會計系統以及互動式的管理會計系統使用之後，會促使醫師從事預算控制，顯示出醫師的專業化程度雖有害於預算控制，但透過管理會計系統的使用，卻進而正向促進其預算控制。實證結果支持本文所提出的論點。

When the global budget system is executed, cost control and resource allocation become important factors for the hospital operation. The operations of hospitals are influenced by physicians’ behavior which are highly professional and autonomous. Whether physicians’ budget control behavior is affected through the use of management accounting systems (MAS) which is seldom addressed despite significant evidence of its importance in hospital operation under global budget system. Based on role theory, this research analyzes the effect of the physicians’ professionalism on their budget control behavior through the use of MAS. Our investigation is conducted using questionnaire survey and semi-structured interview in a regional teaching hospital of Taiwan. Final usable responses from 92 physicians are analyzed via partial least squares. The results indicate that physicians’ professionalism is negatively associated with their budget control behavior. However, the physicians’ professionalism will indirectly enhance budget control behavior via the use of broad-scope and interactive MAS. Although physician professionalism harms budget control, physician’s budget control behavior is improved through the use MAS. The results support the theoretical model taken in the paper.