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題名 | 我國醫療院所建置責任會計制度之標準推動流程與實務困難因素剖析=Standard Procedures and Practical Difficulties in Implementing the Responsibility Accounting System for Taiwan's Hospitals |
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作者 | 龐玉涓; | 書刊名 | 商管科技季刊 |
卷期 | 5:3 2004.09[民93.09] |
頁次 | 頁321-347 |
分類號 | 419.45 |
關鍵詞 | 責任會計制度; 標準流程; 醫院管理; Responsibility accounting system; Hospital management; Standard implementation procedures; |
語文 | 中文(Chinese) |
中文摘要 | 面對醫療環境競爭的壓力,國民對醫療品質的重視,責任會計制度應用於醫院管理已成為一趨勢。它不僅可以協助醫院企業文化的重整,組織的再造,更可以憑藉著整合的資訊與合理的預算制度,有效地追蹤與控制成本及收益,大幅提昇醫院之經營績效。然而,國內對於醫療院所導入責任會計制度之成效,尤其是自中央健保局於91年7月實施醫院前瞻性支付制度以來,極為缺乏系統性的調查與分析。因此,本研究之目的乃分為三部分:首先,參酌國內外醫療院所成功經驗,建置責任會計制度之標準推動流程;其次,依據此推動流程,設計混和式問卷及訪談調查,以進一步分析我國醫療院所近年來導入責任會計制度之成效及缺失;最後,依據調查結果,確認歸納出我國醫療院所在推動責任會計制度時之實務困難因素,以為今後各界之參考。研究結果顯示目前醫療院所之成效及缺失為:(1)成本考量是醫院推動責任會計之主要動因,(2)醫院規模與醫院型態會影響實施此一制度之決策,(3)制度電腦化所使用之軟體仍以自行開發為主,(4)獎勵制度的實施以北部、成立年數較短及私立醫院較能落實,(5)準備要導入之醫院,最迫切需要管理人才之培訓之軟體之開發,(6)不考慮實施此一制度之醫院,乃因為資金籌措的困難與管理人才培訓不易。而所確認歸納之實務推動困難因素則為:(1)組織文化的重整,(2)分權與授權制度的建立,(3)落實可控制性成本之分攤,(4)制度電腦化之迫切性,(5)獎勵制度之重新建立,以及(6)長期宣導之必要性。 |
英文摘要 | Owing to the competition in the medical environment, people's cautious about the medical quality, and the National Health Bureau's implementation of prospective payment system, the adoption of the responsibility accounting system (RAS) in hospital management has become as a trend. Building up RAS can not only reengineer the business, strengthen the organization function, but also track and control the cost flow. The objective of this paper is threefold: firstly, constructing the standard procedures while implement RAS; secondly, investigating the effectiveness of the responsibility accounting system is hospital management and analyzing the current application achievement in Taiwan's hospitals; lastly, verifying the practical obstacles that holding back the implementation of RAS. In terms of the current status, the research results show that: (1)the cost factor is the main driving factor for all the hospitals to implement RAS, (2)the sizes and types of the hospitals dominates the decision in setting up RAS, (3)most of the related software is developed in house, (4)incentive system is more practicable for private and young hospitals located in Northern Taiwan, (5)training management personnel and software development are the two most important factors for hospitals planning for RAS, and (6)training management personnel and capital raising are the two most difficulties for hospitals not planning for RAS. The practical difficulties while implementing RAS are: (1)organization reengineering, (2)building the authorization system, (3)proportion of the controllable cost, (4)computerization of RAS, (5)rebuilding the incentive system, (6)long-term campaigning of RAS. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。