政大機構典藏-National Chengchi University Institutional Repository(NCCUR):Item 140.119/124652
English  |  正體中文  |  简体中文  |  Post-Print筆數 : 27 |  全文筆數/總筆數 : 113822/144841 (79%)
造訪人次 : 51783953      線上人數 : 499
RC Version 6.0 © Powered By DSPACE, MIT. Enhanced by NTU Library IR team.
搜尋範圍 查詢小技巧:
  • 您可在西文檢索詞彙前後加上"雙引號",以獲取較精準的檢索結果
  • 若欲以作者姓名搜尋,建議至進階搜尋限定作者欄位,可獲得較完整資料
  • 進階搜尋
    政大機構典藏 > 商學院 > 會計學系 > 學位論文 >  Item 140.119/124652
    請使用永久網址來引用或連結此文件: https://nccur.lib.nccu.edu.tw/handle/140.119/124652


    題名: 財團法人醫院醫療品質與財務績效及非財務績效之關聯性
    The Relationship of Medical Care on Financial Performance and Non-Financial Performance of Non-Profit Proprietary Hospitals
    作者: 葉巾芷
    Ye, Jin-Jhih
    貢獻者: 李佳玲
    葉巾芷
    Ye, Jin-Jhih
    關鍵詞: 醫療品質
    財務績效
    非財務績效
    medical quality
    financial performance
    non-financial performance
    日期: 2019
    上傳時間: 2019-08-07 15:52:30 (UTC+8)
    摘要: 在多篇實證研究中,品質與財務績效大多呈顯著正相關,已在諸多產業界得到驗證,但此結論是否能適用於我國的醫療市場,有待探討。因我國醫療市場,在全民健保的制度下,由於政府的高度介入,與自由的資本市場相較,較不具彈性且受管制。本研究樣本期間為民國102年至民國105年共計四個年度,並以財團法人醫院為對象,除了探討醫療品質與財務績效之關聯性,亦探討醫療品質對非財務績效之影響,更進一步探討醫療品質對財務績效中活動損益之影響, 活動損益分成醫務活動損益及非醫務活動損益。實證結果顯示除了結果面醫療品質不具統計顯著性外,醫療品質與財務績效及非財務績效皆呈顯著U型關係;進一步分析中,除了結果面醫療品質與醫療利用面醫療品質外,醫療品質對醫務活動損益呈顯著倒U型關係,但醫療品質對非醫務活動損益的影響,除了結果面醫療品質不具統計顯著性外,皆呈顯著U型關係。
    In many empirical studies, quality and financial performance are mostly significantly positively correlated and have been verified in many industries, but whether this conclusion can be applied to Taiwan`s medical market remains to be explored. Because of Taiwan`s medical market, under the system of National Health Insurance, due to the high degree of government involvement, it is less flexible and regulated than the free capital market. The sample period of the study was for the four years from 2013 to 2016. In addition to exploring the relationship between medical quality and financial performance, the impact of medical quality on non-financial performance was discussed. The impact of medical quality on the profit and loss of activities in financial performance, activity profit and loss is divided into profit and loss of medical activities and profit and loss of non-medical activities. The empirical results show that in addition to the statistical quality of the outcome, the medical quality has a significant U-shaped relationship with financial performance and non-financial performance. In further analysis, in addition to the medical quality of outcome and the medical quality of utilization, the relationship of the medical quality and profit and loss of medical activities showed a significant inverted U-shaped relationship, but the impact of medical quality on the profit and loss of non-medical activities, except for the statistical quality of the results, was statistically significant U-shaped relationship.
    參考文獻: 一、中文文獻
    王媛慧,徐偉初,周麗芳,2005,我國財團法人醫院經營績效之研究,龍華科技大學學報,第19期:133-153。
    石曜堂,1978,醫療品質評估,醫院雜誌,第11卷第2期:106-109。
    石曜堂與張政國,2008,醫療品質發展趨勢探討,台灣醫學,第12卷第6期:685-690。
    江東亮,文羽苹,謝嘉容,2014,全民健康保險制度的發展與問題,台灣醫學,第18卷第1期:33-42。
    呂執中,曾信超,2015,醫療品質概論,品質月刊,第51卷第7期:28-32。
    李玉春,黃昱瞳,黃光華,葉玲玲,陳珮青,2014,全民健保支付制度改革之回顧與展望,台灣醫學,第18卷第1期。
    李志宏與施肇榮,2008,全民健康保險解讀系列9:總額支付制度,臺灣醫界,第51卷第11期:37-43。
    林宏茂,趙正敏,古雅婷,鄭博文,2013,門診醫療滿意度量表之建構,顧客滿意學刊,第9卷第2期:159-187。
    林恆慶與陳楚杰,2003,管理式醫療用來控制醫療品質的方法介紹,醫院雜誌,第36卷第1期: 1-10。
    林欽法與馮茂倉,2002,全民健保醫療審查制度之改善-再議審查制度之模式建構,台灣醫學,第6卷第5期:748-751。
    林進財,譚醒朝,張曉芬,2013,台灣地區財團法人醫院財務報表之評估,健康管理學刊,第11卷第2期:124-137。
    邱瓊萱、魏中仁、楊志良與鍾國彪,2000,醫療產業品質保證與品質管理思潮演進--以美國與臺灣為例,醫院雜誌,第33卷第2期:1-12。
    洪清福,1997,醫療費用主要核減原因及因應之道。醫院雜誌,第30卷第5期:18-20。
    高資彬,1997,專業審查核減原因及分析,醫院雜誌,第30卷第5期:11-17。
    張力,2012,財團法人醫院獲利與醫療救濟服務差異之研究:以不同形態財團法人為例,當代會計,第13卷第1期:93-116。
    張志誠,2016,全民健保制度下醫療費用支付審查機制之檢討—以醫師專業自主為核心,國立政治大學法學院碩士在職專班。
    章殷超,2003,論述: 全民健康保險醫療服務審查問題之探討,台灣醫學, 第7卷第1期:104-114。
    陳志豪,張可臻,林忠順,2012,全民健保單一保險制度的優缺點,家庭醫學與基層醫療,第27卷第6期:222-225。
    陳柏瑋,呂昭顯,譚慧芳,2014,醫院非醫務活動收益之分析-以台灣非營利醫院為例,台灣衛誌,第33卷第6期:597-608。
    陳盈盈,2002,強調成本意識,節制醫療資源--從全民健保的醫療浪費談起,全民健康保險,第39期:24-28。
    湯玲郎與黃政豪, 2017,服務品質,認知價值與顧客滿意度對行為意向之關係研究: 以某卓越大學為例,品質學報,第24卷第3期:202-220。
    黃琡珺與王琪雅,2009,門診醫療服務品質量表之建構,行銷評論,第6卷第2期:221-248。
    楊秀儀與賴美淑,2003,醫療專業審查和醫療品質之關連性研究:美國經驗比較,台灣醫學,第7卷第5期:726-735。
    謝溫國,2001,利用品質機能展開法解析醫院的服務品質要素與其系統化之 研究─以中部某區域醫院為個案, 醫務管理期刊,第2卷第4期: 86-107。
    謝慧敏,林怡潔,邱亨嘉,2014,論質計酬支付制度與慢性疾病照護品質成效,醫療品質雜誌,第8卷第2期:28-31。
    韓揆,1994,醫院品質管理及門診服務品質定性指標,中華衛誌,第13卷第1期:35-53。
    蘇勳璧,彭朱如,鄧振華,2001,不同等級醫院其資源優勢,策略優勢與績效之關係。醫務管理期刊,第2卷第1期:93-109。
    二、英文文獻
    Alexander, J. 2010. Quality improvement and hospital financial performance. Journal of Organizational Behavior 27(7): 1003-1029.
    Baicker, K., and A. Chandra. 2004. Medicare spending, the physician workforce, and beneficiaries’ quality of care. Health Affairs (Project Hope), Suppl Web Exclusives: W4-184–97.
    Barnes, M., Oner, N., Ray, M. N., and F. D. Zengul. 2018. Exploring the association between quality and financial performance in U.S. hospitals: A systematic review. Journal of Health Care Finance: 1-32.
    Bazzoli, G. J., B. Chan, S. M. Shortell, and T. D’Aunno. 2000. The financial performance of hospitals belonging to health networks and systems. Inquiry 37 (3): 234-252.
    Becker, J. A. 2013. Examining relationships between hospital inpatient expectations and satisfaction for maximum medicare reimbursement. Dissertations & Theses - Gradworks.
    Birkmeyer, J. D., Gust, C., Dimick, J. B., Birkmeyer, N. J. O., and J. S. Skinner. 2012. Hospital quality and the cost of inpatient surgery in the United States. Annals Of Surgery 255(1): 1–5.
    Bridgeland JM, and B. Reed. 2009. The quiet crisis: the impact of the economic downturn on the nonprofit sector. Civic Enterprises: 22.
    Britton, J. R. 2015. Healthcare Reimbursement and Quality Improvement: Integration Using the Electronic Medical Record. International Journal of Health Policy & Management 4(8): 549–551
    Byrd, J. D. J. 2013. Impact of quality performance on financial risk and cost of capital in hospitals. Dissertations & Theses - Gradworks.
    Campbell, SM., Braspenning J., and A. Hutchinson. 2003. Improving the quality of health care:Research methods used in developing and applying quality indicators in primary care. BMJ 326: 816-819.
    Chang, L., and C. P. Hou. 2011. Does a National Health Insurance System Enhance Quality of Care and Contain Cost ? An Empirical Investigation of the National Health Insurance System in Taiwan. Review of Economics & Finance 1: 32-42.
    Chang, L., and J. H. Hung. 2008. The effects of the global budget system on cost containment and the quality of care: experience in taiwan. Health Services Management Research 21(2): 106-116.
    Chang, RE., Lin, SP., and DC. Aron. 2012. A pay-for-performance program in Taiwan improved care for some diabetes patients, but doctors may have excluded sicker ones. Health affairs (Project Hope) 31(1): 93-102.
    Chen, L. M., Jha, A. K., Guterman, S., Ridgway, A. B., Orav, E. J., and A. M. Epstein. 2010. Hospital cost of care, quality of care, and readmission rates: penny wise and pound foolish? Archives Of Internal Medicine 170(4): 340–346.
    Chikoto, G. L., and D. G. Neely. 2014. Building Nonprofit Financial Capacity: The Impact of Revenue Concentration and Overhead Costs. Nonprofit and Voluntary Sector Quarterly 43(3): 570–588.
    Cho, C. C., Liu, S. Z., and J. C. Romeis. 2012. Health service quality and financial performance: findings from renal clinics in taiwan. Journal of Management 29(1): 61-80.
    Choi, M., and K. H. Lee. 2008. A strategy for enhancing financial performance: a study of general acute care hospitals in South Korea. The Health Care Manager 27(4): 288–297.
    Creixans-Tenas, J., and N. Arimany-Serrat. 2018. Influential variables on the profitability of hospital companies. Intangible Capital 14(1): 171–185.
    Cusack, S. 2012. The impact of quality on financial performance of acute care hospitals (Order No. 3515954). Available from ProQuest Dissertations & Theses A&I.
    Dewberry, C. M., and S. Rose. 2010. Hospital Medicare reimbursement: Moving to reimbursement based on quality of care. Washington Healthcare News 5(7): 1-3.
    Donabedian, A. 1980. Methods for Deriving Criteria for Assessing the Quality of Medical Care. Medical Care Review 37(7): 653-698.
    Donabedian, A. 1988. The quality of care:how can it be assessed? JAMA 260(12): 1743-1748.
    Easton, G. S. , and S. L. Jarrell. 1998. The effects of total quality management on corporate performance: an empirical investigation. The Journal of Business 71(2): 253-307.
    Ferrand, Y. B., Siemens, J., Weathers, D., Fredendall, L. D., Yunsik Choi, Pirrallo, R. G., and M. Bitner. 2016. Patient Satisfaction With Healthcare Services: A Critical Review. Quality Management Journal 23(4): 6–22.
    Gapenski, L. C. , Vogel, W. B. , and B. Langlandorban. 1993. The determinants of hospital profitability. Hospital & Health Services Administration 38(1): 63.
    Ge Bai, and G. F. Anderson. 2016. A More Detailed Understanding of Factors Associated With Hospital Profitability. Health Affairs 35(5): 889–897.
    Haydar, Z. , Nicewander, D. , Convery, P. , Black, M. , and D. Ballard. 2010. Clinical quality is independently associated with favorable bond ratings. American Journal of Medical Quality 25(3): 181-185.
    Hegji, C. E. , Self, D. R. , and C. S. Findley. 2007. The link between hospital quality and services profitability. International Journal of Pharmaceutical and Healthcare Marketing 1(4): 290-303.
    Hollingswoth, B. 2008. The meaurement of efficiency and productivity of health care delivery. Health Economics 77(10): 1107-1128.
    Horwitz, J. R. 2005. Making Profits And Providing Care: Comparing Nonprofit, For-Profit, And Government Hospitals. Health Affairs 24(3): 790–801.
    Huerta, T. R. , Ford, E. W. , Peterson, L. T. , and K. H. Brigham. 2008. Testing the hospital value proposition. Health Care Management Review 33(4): 341-349.
    Hussey, P. S. , Wertheimer, S., and A. Mehrotra. 2013. The association between health care quality and cost: a systematic review. Annals of Internal Medicine 158(1): 27-34.
    Janati, A. , Valizadeh, S., and M. A. Jafarabadi. 2014. Development of financial indicators of hospital performance. Journal of Clinical Research & Governance 3.
    Jha, A. K., Orav, E. J., Dobson, A., Book, R. A., and A. M. Epstein. 2009. Measuring efficiency: the association of hospital costs and quality of care. Health Affairs (Project Hope) 28(3): 897–906.
    Kaestner, R., and J. H. Silber. 2010. Evidence on the efficacy of inpatient spending on medicare patients. Milbank Quarterly 88(4): 560-594.
    Karim, S. A., Pink, G. H., Reiter, K. L., Holmes, G. M., Jones, C. B. and E. K. Woodard. 2018. The Effect of the Magnet Recognition Signal on Hospital Financial Performance. Journal of Healthcare Management 63(6): e131–e146.
    Koenig, L., A. Dobson, S. Ho, J. M. Siegel, and D. Blumenthal. 2003. Estimating the related costs of teaching hospitals. Health Affairs 22(6): 112-122.
    Lin, H. C., S. Xirasagar, and C. H. Tang. 2004. Costs per discharge and hospital ownership under prospective payment and cost-based reimbursement systems in Taiwan. Health Policy and Planning 19 (3): 166-176.
    Love, D. , Revere, L., and K. Black. 2008. A current look at the key performance measures considered critical by health care leaders. Journal of Health Care Finance 34(3): 19-33.
    McCue, M. J., and T. H. Kim. 2007. Evaluating the underlying factors behind variable rate debt. Health Care Management Review 32(4): 300-308.
    McCue, M. J., B. A. Mark, and D. W. Harless. 2003. Nurse staffing, quality, and financial performance. Journal of Health Care Finance 29 (4): 54-76.
    McKay, N. L., and M. E. Deily. 2008. Cost inefficiency and hospital health outcomes. Health Economics 17(7): 833–848.
    Mckay, N. L., and L. C. Gapenski. 2009. Nonpatient revenues in hospitals. Health Care Management Review 34(3): 234-241.
    Nadzam, DM. 1991. Development of medication use indicators by the Joint Commission on Accreditation of Healthcare Organization. Am J Hosp Pharm 38: 1925-1928.
    Pink, G. H. , Holmes, G. M. , D`Alpe, C. , Strunk, L. A. , Mcgee, P. , and R. T. Slifkin. 2010. Financial indicators for critical access hospitals. Journal of Rural Health 22(3): 229-236.
    Potter, P. 1991. An assessment tool for developing quality indicators. Journal of Nursing Care Quality 6(1): 30-39.
    Romley, J. A., Jena, A. B., and D. P. Goldman. 2011. Hospital spending and inpatient mortality: evidence from California: an observational study. Annals Of Internal Medicine 154(3): 160–167.
    Rosenthal, M. B., Brantes, F. S. D. , Sinaiko, A. D. , Frankel, M. , Robbins, R. D. , and S. Young. 2008. Bridges to excellence--recognizing high-quality care: analysis of physician quality and resource use. American Journal of Managed Care 14(10): 670-677.
    Singh, S. R., and P. H. Song. 2012. Nonoperating revenue and hospital financial performance: do hospitals rely on income from nonpatient care activities to offset losses on patient care?. Health Care Management Review 38(3): 201-210.
    Suarez, V., Lesneski, C. , and D. Denison. 2011. Making the case for using financial indicators in local public health agencies. American Journal of Public Health 101(3): 419-425.
    Tefera, L., Lehrman, W. G., and P. Conway. 2016. Measurement of the Patient Experience: Clarifying Facts, Myths, and Approaches. JAMA 315(20): 2167–2168.
    U.S. Congress. 1988. Chapter 3 :Evaluating quality from the perspective of individual consumers. U.S. Congress. Officer of Technology Assessment: 51-66.
    Yasaitis, L., Fisher, E. S., Skinner, J. S., and A. Chandra. 2009. Hospital quality and intensity of spending: is there an association? Health Affairs (Project Hope) 28(4): w566–w572.
    Younis M, J. Rice, and J. Barkoulas. 2001. An empirical investigation of hospital profitability in the post PPS era. Journal of Health Care Finance 28(2): 65-73.
    Younis, M. 2002. A comparison study of urban and small rural hospitals financial and economic performance. Journal of Rural Nursing and Health Care 3: 1-20.
    Zeithaml, V. A. 2000. Service quality, profitability, and the economic worth of customers: what we know and what we need to learn. Journal of the Academy of Marketing Science 28(1): 67-85.
    Zeithaml, V. A., Berry, L. L., and A. Parasuraman. 1996. The behavioral consequences of service quality. Journal of Marketing 60(2): 31-46.
    Zeller, T. L., Stanko, B. B., and W. O. Cleverley. 1997. A new perspective on hospital financial ratio analysis. Healthcare Financial Management 51(11): 62-6.
    Zwanziger, J. , Khan, N. , and A. Bamezai. 2010. The relationship between safety net activities and hospital financial performance. BMC Health Services Research 10(1): 15-0.
    描述: 碩士
    國立政治大學
    會計學系
    105353110
    資料來源: http://thesis.lib.nccu.edu.tw/record/#G0105353110
    資料類型: thesis
    DOI: 10.6814/NCCU201900412
    顯示於類別:[會計學系] 學位論文

    文件中的檔案:

    檔案 大小格式瀏覽次數
    311001.pdf1459KbAdobe PDF21檢視/開啟


    在政大典藏中所有的資料項目都受到原著作權保護.


    社群 sharing

    著作權政策宣告 Copyright Announcement
    1.本網站之數位內容為國立政治大學所收錄之機構典藏,無償提供學術研究與公眾教育等公益性使用,惟仍請適度,合理使用本網站之內容,以尊重著作權人之權益。商業上之利用,則請先取得著作權人之授權。
    The digital content of this website is part of National Chengchi University Institutional Repository. It provides free access to academic research and public education for non-commercial use. Please utilize it in a proper and reasonable manner and respect the rights of copyright owners. For commercial use, please obtain authorization from the copyright owner in advance.

    2.本網站之製作,已盡力防止侵害著作權人之權益,如仍發現本網站之數位內容有侵害著作權人權益情事者,請權利人通知本網站維護人員(nccur@nccu.edu.tw),維護人員將立即採取移除該數位著作等補救措施。
    NCCU Institutional Repository is made to protect the interests of copyright owners. If you believe that any material on the website infringes copyright, please contact our staff(nccur@nccu.edu.tw). We will remove the work from the repository and investigate your claim.
    DSpace Software Copyright © 2002-2004  MIT &  Hewlett-Packard  /   Enhanced by   NTU Library IR team Copyright ©   - 回饋