雖然醫療市佔率趨近公立醫院的醫療財團法人(常稱財團法人醫院)為非營利組織，但仍因規避稅負、避免監管機關與媒體關注或維持捐贈收入等目的，而有操縱財務報表動機，進而影響財務資訊品質。本論文將衛福部2015年公布領取健保點值超過6億元之醫療財團法人定義為大型財團法人醫院，以此為樣本檢視其2005年至2014年間財務結構、財報品質和潛在財務操縱行為(以平穩化程度、穩健性、持續性及裁決性應計數衡量)。探討大型財團法人醫院財務資訊品質有助於台灣健保的財政分配效率。 有以下實證發現：首先，大型財團法人醫院醫務收入在研究期間持續成長，平均醫務毛利率超過8.4%，而非醫務利益率超過醫務利益率平均達2倍以上，顯示業外收益為財團法人醫院財報的要項。接著，宗教型財團法人醫院多由四大會計師事務所查核，傾向於向下裁量應計項目數；且其整體平均實質稅率最小(小於千分之一)，有效稅率的分配趨勢向零集中。企業型財團法人醫院之盈餘持續性最低。整體而言，獲利能力較差之醫院傾向於向下裁量教育研究發展支出；負債比較高醫院則傾向於向下裁量醫療社會服務支出。最後，三種類型的財團法人醫院關係人交易主題不同，但僅少數醫院有偏高的比重，且皆已受到媒體關注報導。本論文之研究結果可提供主管機關與財務報表使用者參考。 Medical foundations (often called non-profit hospitals) which medical market share approaching public hospital, are commonly known as a non-profit organization, but it also has the incentive to manipulate financial reports. Hoping to improve efficient allocation of National Health Insurance, this paper investigates the financial structure, financial manipulation behavior, and earnings information quality of different types of large-scale Non-profit hospitals by using financial statements published by the Department of Health from 2005 to 2014 in Taiwan. This research analyzes 250 data of 25 Medical foundations'' 10 years operation. The results indicate that religious type of hospitals are more likely to choose the Big Four Accountants, and tend to conduct financial manipulation via negative discretionary accruals in order to minimize tax burdens. The tax burden of religious type is generally near zero. Hospitals with poor profitability tend to reduce discretionary accruals of the cost of research and education; hospitals with high debt ratios tend to reduce discretionary accruals of the cost of social services. Finally, all types of the hospital conduct different kind of related party transactions, and which is already concern by administration or media. This research could be used by authorities and involved parties.
