本研究使用財團法人醫院財務報表之資訊檢視財團法人醫院盈餘之品質，探討各項指標在不同規模、不同型態的財團法人醫院盈餘品質是否具有差異。使用醫院規模與醫院類型進行交互分析，研究結果顯示在大型醫院部分，大型的企業型醫院盈餘平穩化為最高；大型的宗教型醫院，以當期盈餘衡量之盈餘持續性最高；大型的一般型醫院其未估計的裁決性數值為最少且盈餘穩健性最佳。中型醫院部分，中型的企業型醫院，以營運現金流量與應計項目衡量之盈餘持續性為較高；中型的宗教型醫院相互比較並無較佳之盈餘品質特性；中型的一般型醫院其盈餘平穩化程度高。小型醫院部分，小型的企業型醫院無樣本分析；小型的宗教型醫院，以營運現金流量與應計項目衡量之盈餘持續性為較高；小型的一般型醫院相互比較並無較佳之盈餘品質特性。

In this study, we use the information of financial statements in not-for-profit hospitals to view earnings quality and explore the indicators in different sizes, different patterns whether earnings quality of not-for-profit hospitals is different. We use interact analysis earnings quality with using hospital type and hospital size. In large hospitals, large enterprise-type hospitals are the highest earnings smoothness; large religion-type hospitals are the highest earnings persistence which use the measurement of the current earnings; large general-type hospitals are the smallest abnormal accruals which do not estimate and are the highest earnings conservatism. In medium hospital, medium enterprise-type hospitals are the highest earnings persistence which use the measurement of operating cash flow and accruals; there are not a better characteristics of earnings quality when medium religion-type hospitals compared with others; medium general-type hospitals are the highest earnings smoothness. In small hospital, small enterprise-type hospitals are without samples; small religion-type hospitals are the highest earnings persistence which use the measurement of operating cash flow and accruals;there are not a better characteristics of earnings quality when small general-type hospitals compared with others.

目錄
第壹章	緒論 1
第一節	研究背景與動機 1
第二節	研究目的 4
第三節	研究流程 5
第貳章	文獻探討 6
第一節	盈餘品質 6
第二節	財團法人醫院的特性 9
第三節	財團法人醫院的盈餘品質 16
第參章	研究方法 27
第一節	資料來源與樣本選取 27
第二節	實證模型與變數定義 27
第肆章	實證結果 32
第一節	財團法人醫院之財務資料 32
第二節	財團法人醫院之盈餘品質 45
第三節	盈餘分配圖分析 76
第伍章	結論 82
第一節	研究結論 82
第二節	研究貢獻 84
參考文獻 85
附錄 93

表目錄
表2-1我國醫療機構之類型及定義 11
表2-2醫療財團法人財務報表公開之簡要歷史沿革表 17
表2-3財團法人醫院營運之六種類型 21
表2-4財團法人醫院關係人交易之四大爭議類型 22
表3-1財務比率之公式 28
表3-2變數定義表 31
表4-1 2005-2013年度大型醫院財務資料比較 34
表4-2 2005-2013年度中型醫院財務資料比較 39
表4-3 2005-2013年度小型醫院財務資料比較 43
表4-4 2005-2013年度大型醫院盈餘品質比較 48
表4-5 2005-2013年度中型醫院盈餘品質比較 54
表4-6 2005-2013年度小型醫院盈餘品質比較 60
表4-7 2005-2013年度全部醫院盈餘品質比較-大型、中型與小型 65
表4-8 2005-2013年度全部醫院盈餘品質比較-企業型、宗教型與一般型 72
表4-9財團法人醫院盈餘品質彙整表 75

圖目錄
圖1-1研究流程圖 5
圖2-1法人分類圖 10
圖4-1大型醫院醫務利益率 76
圖4-2大型醫院稅前純益率 76 
圖4-3中型醫院醫務利益率 77
圖4-4中型醫院稅前純益率 77
圖4-5小型醫院醫務利益率 78
圖4-6小型醫院稅前純益率 78
圖4-7企業醫院醫務利益率 79
圖4-8企業醫院稅前純益率 79
圖4-9宗教醫院醫務利益率 80
圖4-10宗教醫院稅前純益率 80
圖4-11一般醫院醫務利益率 81
圖4-12一般醫院稅前純益率 81

參考文獻
中文文獻
王媛慧、徐偉初與周麗芳，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。
李佳容、林進財、譚醒朝與張曉芬，2010，臺灣地區財團法人醫院財務績效之評估，健康管理學刊，第8卷第2期：199-208。
林江亮與何永智，2009，資訊透明與財務操縱對非營利組織捐贈收入影響之研究，應用經濟論叢，第86期：139-185。
柯妍嬪，2009，財團法人醫院和金融產業企業社會責任之投入與財務績效的關聯分析，嘉南藥理科技大學醫療資訊管理研究所未出版碩士論文。
洪綾君與林依瑩，2010，台灣醫療財團法人財務資訊公開之研究，公共行政學報，第37期：37-70。
馬銘禪，2011，我國財團法人醫院選任會計師事務所因素之評估，長榮大學經營管理研究所未出版碩士論文。
戚務君與陳宜伶，2008，資本市場對盈餘品質的影響：來自臺灣的證據，管理評論，第27卷第2期：53-69。
許崇源、林宛瑩、游智媛與塗盈媜，2004，複雜交叉持股之典範(III) -和信集團，貨幣觀測與信用評等，第48卷：84-117。
陳櫻琴、黃于玉與顏忠漢，2007，醫療法律，台北市：五南圖書出版。
郭振雄、何怡澄與羅德城，2006，非營利醫院的負債融資與社區公益活動，台灣公共衛生雜誌，第25卷第6期：440-448。
郭振雄與何怡澄，2007，非營利醫院之董事會結構與社區公益活動，台灣衛誌，第26卷第2期：128-139。
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醫院為例，當代會計，第13 卷第1期：93-116。
張雅怡，2012，非營利組織的盈餘管理行為：以醫院為例，成功大學會計系研究所未出版碩士論文。
張樂心、鄭守夏、楊銘欽與江東亮，2004，醫院權屬別與醫療收費，台灣衛誌，第23卷第2期：130-140。
黃德舜、李怡潁與劉振家，2009，績效、審計品質與盈餘管理之關係－以財團法人醫院為例，非營利組織管理學刊，第7期：69-88。
黃經祥，2011/5/23，打開「醫院財報」說亮話 是醫院壓榨醫師，還是健保虧待醫院？醫療改革基金會，網址：htp://www.thrf.org.tw/Page_Show.asp? Page_ID =1381。  
葉銀華、邱顯比與何憲章，1997，利益輸送代理問題和股權結構之理論與實證研究，中國財務學刊，第4卷第4期：47-73。
蔡啟明，2005，以稅捐徵免管理財團法人醫院公益目的之研究，東海大學公共事務碩士在職專班未出版碩士論文。
劉蕙瑩，2012，舉債程度與社區公益支出對財務操縱行為影響之研究：以我國非營利醫院為例，中原大學會計系研究所未出版碩士論文。
醫療改革基金會，2004/09/30，醫院乾坤挪移大法 侵蝕健保財務。醫改會：醫院財報不公開健保漲價怎麼談？網址：http://www.thrf.org.tw/Page_Show.asp? Page_ID=461。 
醫療改革基金會，2014/03/25，關係人交易如「白色蜘蛛網」董事會成「黑色橡皮章」？醫改會呼籲速修遏止「財團法人醫院」淪為「財團」醫院《醫療法》，網址：http://www.thrf.org.tw/Page_Show.asp?Page_ID=1860。
譚慧芳與吳清在，2012，非營利醫院的避稅動機與盈餘管理，會計與公司治理，第8卷第2期：1-25。
英文文獻
Allen, E., C. Larson, and R. Sloan. 2009. Accrual reversals, earnings and stock returns. Working Paper, University of California, Berkeley, Washington University in St. Louis.
Altamuro, J., and A. Beatty. 2010. How does internal control regulation affect financial reporting? Journal of Accounting and Economics 49(1-2): 58-74.
Ashbaugh-Skaife, H., D. Collins, and W. Kinney. 2007. The discovery and reporting of internal control deficiencies prior to SOX-mandated audits. Journal of Accounting and Economics 44(1-2): 166-192.
Ashbaugh-Skaife, H., D. Collins, W. Kinney, and R. LaFond. 2009. The effect of SOX internal control deficiencies on firm risk and cost of equity. Journal of Accounting Research 47(1): 1-43.
Armstrong, C., A. Jagolinzer, and D. Larcker. 2010. Chief executive officer equity incentives and accounting irregularities. Journal of Accounting Research 48(2):  225-271.
Ball, R., S. Kothari, and A. Robin. 2000. The effect of international institutional factors on properties of accounting earnings. Journal of Accounting and Economics 29(1): 1-51.
Ball, R., and L. Shivakumar. 2005. Earnings quality in UK private firms: Comparative loss recognition timeliness. Journal of Accounting and Economics 39(1): 83-128.
Barragato, C. A., and S. Basu. 2007. Properties of accounting earnings in not-for-profit organizations. Unpublished Working Paper, Emory University and Long Island University.
Basu, S. 1997. The conservatism principle and the asymmetric timeliness of earnings. Journal of Accounting and Economics 24(1): 3-37.
Beneish, M. D., and M. E. Vargus. 2002. Insider trading, earnings quality, and accrual mispricing. The Accounting Review 77(4): 755-791.
Beisland, L. A., and R. Mersland. 2014. Earnings quality in nonprofit versus for-profit organizations: Evidence from the microfinance industry. Nonprofit and Voluntary Sector Quarterly 43(4): 652-671.
Bernstein, L. A., and J. J. Wild. 1997. Financial Statement Analysis : Theory, Application and Interpretation. 6th ed. Homewood, ll., Irwin/McGraw Hill.
Bhattacharya, U., H. Daouk, and M. Welker. 2003. The world price of earnings opacity. The Accounting Review 78(3): 641-678.
Bowen, R., S. Rajgopal, and M. Venkatachalam. 2008. Accounting discretion, corporate governance, and firm performance. Contemporary Accounting Research 25(2): 351-405.
Burgstahler, D., and I. Dichev. 1997. Earnings management to avoid earnings decreases and losses. Journal of Accounting and Economics 24(1): 99-126.
Dechow, P., R. Sloan, and A. Sweeney. 1995. Detecting earnings management. The Accounting Review 70(2): 193-225.
Dechow, P., R. Sloan, and A. Sweeney. 1996. Causes and consequences of earnings manipulation: An analysis of firms subject to enforcement actions by the SEC. Contemporary Accounting Research 13(1): 1-36.
Dechow, P., and I. Dichev. 2002. The quality of accruals and earnings: The role of accrual estimation errors. The Accounting Review 77(s-1): 35-59.
Dechow, P., and C. Schrand. 2004. Earnings Quality. The Research Foundation of CFA Institute, United States of America.
Dechow, P., and W. Ge. 2006. The persistence of earnings and cash flows and the role of special items: Implications for the accrual anomaly. Review of Accounting Studies 11(2-3): 253-296.
Dechow, P., W. Ge, and C. Schrand. 2010. Understanding earnings quality: A review of the proxies, their determinants and their consequences. Journal of  Accounting and Economics 50(2-3): 344-401.
Degeorge, F., J. Patel, and R. Zeckhauser. 1999. Earnings management to exceed thresholds. Journal of Business 72(1): 1-33.
Deis, D. R., and G. A. Giroux. 1996. The effect of auditor changes on audit fees, audit hours, and audit quality. Journal of Accounting and Public Policy 15: 55-76.
Demski, J. 1998. Performance measure manipulation. Contemporary Accounting Research 15(3): 261-285.
Desai, H., S. Krishnamurthy, and K. Venkataraman. 2006. Do short sellers target firms with poor earnings quality? Evidence from earnings restatements. Review of Accounting Studies 11(1): 71-90.
Dichev, I., J. Graham, C. R. Harvey, and S. Rajgopal. 2013. Earnings quality: Evidence from the field. Journal of Accounting and Economics 56(2-3): 1-33.
Eldenburg, L. G., K. A. Gunny, K. W. Hee, N. Soderstrom. 2011. Earnings management using real activities: Evidence from nonprofit hospitals. The Accounting Review 86(5): 1605-1630.
Ewert, R., and A. Wagenhofer. 2010. Earnings quality metrics and what they measure. Working Paper, University of Graz.
Fairfield, P., S. Whisenant, and T. Yohn. 2003. Accrued earnings and growth: Implications for future profitability and market mispricing. The Accounting Review 78(1): 353-371.
Farber, D. 2005. Restoring trust after fraud: Does corporate governance matter? The Accounting Review 80(2): 539-561.
Francis, J., R. LaFond, P. Olsson, and K. Schipper. 2004. Costs of equity and earnings attributes. The Accounting Review 79(4): 967-1010.
Francis, J., R. LaFond, P. Olsson, and K. Schipper. 2005. The market pricing of accruals quality. Journal of Accounting and Economics 39(2): 295-327.
Francis, J., and B. Ke. 2006. Disclosure of fees paid to auditors and the market valuation of earnings surprises. Review of Accounting Studies 11(4): 495-523.
Frank, R., D. Salkever, and J. Mitchell. 1990. Market forces and the public good: Competition among hospitals and provision of indigent care. Advances in Health Economics and Health Services Research 11: 159-183.
Ghemawat, P., and T. Khanna. 1998. The nature of diversified business groups: A research design and two cases studies. Journal of Industrial Economics 46(1): 35-61.
Givoly, D., C. Hayn, and A. Natarajan. 2007. Measuring reporting conservatism. The Accounting Review 82(1): 65-106.
Hayn, C. 1995. The information content of losses. Journal of Accounting and Economics 20(2): 125-153.
Hennes, K., A. Leone, and B. Miller. 2008. The importance of distinguishing errors from irregularities in restatement research: The case of restatements and CEO/CFO turnover. The Accounting Review 83(6): 1487-1519.
Holthausen, R., and R. Verrecchia. 1988. The effect of sequential information releases on the variance of price changes in an intertemporal multi-asset market. Journal of Accounting Research 26(1): 82-106.
Joe, J., and S. Vandervelde. 2007. Do auditor-provided nonaudit services improve audit effectiveness? Contemporary Accounting Research 24(2): 467-487.
Jones, J. 1991. Earnings management during import relief investigations. Journal of Accounting Research 29(2): 193-228.
Kanagaretnam, K., G. Lobo, and D. Yang. 2004. Joint tests of signaling and income smoothing through bank loan loss provisions. Contemporary Accounting Research 21(4): 843-884.
Keating, K. E., M. L. Parsons, and A. A. Roberts. 2008. Misreporting fundraising: How do nonprofit organizations account for telemarketing campaigns? The Accounting Review 83(2): 417-446.
Keister, W. 1992. Industrial groups as systems of contractual governance. Oxford Review of Economic Policy 8(3): 24-44.
Kothari, S., A. Leone, and C. Wasley. 2005. Performance matched discretionary accrual measures. Journal of Accounting and Economics 39(1): 163-197.
Krishnan, J. 2005. Audit committee quality and internal control: An empirical analysis. The Accounting Review 80(2): 649-675.
Krishnan, R., M. H. Yetman, and R. J. Yetman. 2006. Expense misreporting in nonprofit organizations. The Accounting Review 81(2): 399-420.
Lev, B., S. Ryan, and M. Wu. 2008. Rewriting earnings history. Review of Accounting Studies 13(4): 419-451.
Leone, A. J., and R. L. Van Horn. 2005. How do non-profit hospitals manage earnings? Journal of Health Economics 24(4): 815-837.
Leuz, C., D. Nanda, and P. Wysocki. 2003. Earnings management and investor protection: An international comparison. Journal of Financial Economics 69(3):  505-527.
Liu, J., and J. Thomas. 2000. Stock returns and accounting earnings. Journal of Accounting Research 38(1): 71-101.
McNichols, M. 2000. Research design issues in earnings management studies. Journal of Accounting and Public Policy 19(4-5): 313-345.
Melumad, N., and D. Nissim. 2008. Line-item analysis of earnings quality. Foundation and Trends in Accounting 3(2-3): 87-221.
Ming, J. J., and T. J. Wong. 2003. Earnings management and tunneling through related party transactions: Evidence from chinese corporate groups. Working Paper, The Hong Kong University of Science and Technology.
Omer, T. C., and R. J. Yetman. 2003. Near zero taxable income reporting by nonprofit organizations. The Journal of the American Taxation Association 25(2): 19-34.
Palmrose, Z., V. Richardson, and S. Scholz. 2004. Determinants of market reactions to restatement announcements. Journal of Accounting and Economics 37(1): 59-89.
Penman, S., and X. Zhang. 2002. Accounting conservatism, the quality of earnings, and stock returns. The Accounting Review 77(2): 237-264.
Pinnuck, M., and B. N. Potter. 2009. The quality and conservatism of the accounting earnings of local governments. Journal of Accounting and Public Policy 28(6): 525-540.
Richardson, S., R. Sloan, M. Soliman, and I. Tuna. 2005. Accrual reliability, earnings persistence and stock prices. Journal of Accounting and Economics 39(3): 437-485.
Ryan, S. 2006. Identifying conditional conservatism. European Accounting Review 15(4): 511-525.
Schipper, K., and L. Vincent. 2003. Earnings quality. Accounting Horizons 17: 97-110.
Sloan, R. 1996. Do stock prices fully reflect information in accruals and cash flows about future earnings? The Accounting Review 71(3): 289-315.
Tan, H. F. 2011. Earning management in non-profit hospitals-evidence from Taiwan. International Journal of Electronic Business Management 9(3): 243-257.
Tate, S. 2007. Auditor change and auditor choice in nonprofit organizations. Auditing: A Journal of Practice and Theory 26(1): 47-70.
Teoh, S., and T. Wong. 1993. Perceived auditor quality and the earnings response coefficient. The Accounting Review 68(2): 346-366.
Tucker, J., and P. Zarowin. 2006. Does income smoothing improve earnings informativeness? The Accounting Review 81(1): 251-270.
Trussel, J. 2003. Assessing potential accounting manipulation: The financial characteristics of charitable organizations with higher than expected program spending ratios. Non-profit Voluntary Sector Quarterly 32(4): 616-634.
Wang, Y. H., L. F. Chou, and W. Tsui. 2005. The efficiency of foundation hospitals in Taiwan. Lunghwa Journal 19: 133-153.
Yetman, R. J. 2001. Tax-motivated expense allocations by nonprofit organizations. The Accounting Review 76(3): 297-311.