法令變動對醫療財團法人從事社區公益服務的影響

DO NON-PROFIT HOSPITALS CHANGE THE COMMUNITY BENEFIT SERVICE PROVIDED WHEN FACEDWITH LAWAMENDMENT?

我國在2004 年修改醫療法， 降低醫療財團法人應提供慈善醫療等社區公益服務費用的最低提撥標準， 並將社區公益服務的提撥費基準， 由原先的一項改為分別針對醫療社服活動與教育研究活動兩項提撥。本研究探討此次修法對醫療財團法人從事醫療社服支出比例、教育研究支出比例及社區公益服務支出比例的衝擊。本研究以40間醫療財團法人在2001–2008年度資料，採用最小平方法迴歸進行分析。實證結果顯示， 醫療法降低提撥社區公益服務費用的最低標準， 平均而言， 顯著地降低整體醫療財團法人之醫療社服支出比例、教育研究支出比例及社區公益服務支出比例。此外，相對於低公益支出類型法人， 高公益支出類型醫療財團法人在修法後顯著的減少醫療社服支出比例、教育研究支出比例及社區公益服務支出比例。由本研究實證結果可知， 代理理論比較能解釋臺灣醫療財團法人從事慈善醫療等社區公益服務的行為。

Taiwan’s Medical Care Act was amended in 2004 to lower the minimum appropriate standards for non-profit hospitals in providing community benefit services, and the standard for the total amount of community benefit services wasmodified into two independent criteria of uncompensated care services and educational research activities. This study aimed to investigate the impact of the law amendment on the non-profit hospitals in setting aside funds for uncompensated care services expenditure, educational research expenditure and community benefit services expenditure. The empirical results show that the amendment of the Medical Care Act in modifying the funds set aside for community benefit services has significant impact on the ratio of community benefit services expenditure on average. The amendment of theMedical Care Act in 2004 tomodify the standards for setting aside the funds for community benefit services has significantly reduced the ratio of non-profit hospitals’ expenditure on community benefit services. In addition non-profit hospitals with high community benefit services expenditure significantly reduced the ratio of uncompensated care services expenditure, educational research expenditure and community benefit services expenditure following the lawamendment. The empirical results of this study showthat the agency theory can better explain Taiwan’s non-profit hospitals engaging inmedical community services activities.