醫療財團法人的會計資訊品質特性

Qualitative Characteristics of Accounting Information for Medical Care Corporates

衛生福利部於2006年公告《醫療財團法人財務報告編製準則》供醫療財團法人遵循，本研究因而以申領健保點值超過六億元之大型醫療財團法人為樣本，檢視醫療財團法人於2005至2019年間之會計資訊品質及特性。實證結果發現整體樣本的醫務收入在研究期間呈現成長，且經營獲利穩定；然而在總額支付制度下非醫務利益為多數醫療財團法人餘絀之主要來源。多數樣本由大型會計師事務所查核，整體盈餘持續性佳。本研究進一步比較不同類型醫療財團法人之會計資訊品質特性，發現宗教型醫療財團法人舉債程度最低且短期償債能力最佳；投入在社會福利支出最多，但盈餘持續性較差；在醫療社會服務支出的盈餘管理程度最高，繳稅次數顯著最少。一般型醫療財團法人盈餘平穩化程度較宗教型高，但負債比率最高且短期償債能力較差。而企業型醫療財團法人財務結構、經營與獲利能力皆最佳，但餘絀中營運現金流量組成之盈餘持續性雖優於宗教型，但未優於一般型。整體而言，近年來各醫療財團法人的會計資訊品質在各界關注下已經明顯提升，尤以企業型最為明顯。本研究的結果可供主管機關、利害關係人及其他財務報表使用者參考。

In 2006, the Ministry of Health and Welfare released the ''Regulations Governing Preparation of Financial and Operational Reports by Medical Foundations'' which gives the Medical Care Corporates a guideline to follow. Hence, this study examines the qualitative characteristics of accounting information for medical care corporates from 2005 to 2019. Using the large medical care corporates, which applied over 600 million health care points as a study sample, empirical results show not only medical revenue growth but also that most hospitals were profitable during the study period. However, the primary net income generated from non-medical profit for most medical care corporates due to operating income was restricted by the global budget system. Overall, our samples have good earnings persistence and more than 60% of them were audited by a Big Audit Firm. Furthermore, we separate them by enterprise type, religious type, and normal type by the donors to analyze and compare medical care corporates' qualitative characteristics of accounting information. Our results show that the religious type of medical care corporates have the lowest debt ratio, the highest short-term solvency and medical and social welfare expenditures, but they also show poor earnings persistence, the highest level of earnings management in specific items, and the lowest tax payments. Compared with religious type, the level of earnings smoothing in normal medical care corporates is indeed higher. However, normal medical corporates also have the highest debt ratio and poor short-term solvency. The enterprise type of medical care corporates have the best financial structures, operating performance, and profitability; but the cash flow component of earnings is not persistent than the normal type. Following increased public monitoring and attention in recent years, medical care corporates (especially enterprise corporates) have achieved an overall increase in accounting information quality. Our results provide insights for authorities, stakeholders, involved parties and other financial report users.