內部控制制度之實證研究

An Empirical Study on Internal Control System

10.29916/JMPP.200703.0003

陳碧秀(Pih-Shuw Chen)

內部控制 ； 醫療環境 ； 服務品質 ； Internal Control ； Health Care Environment ； Quality of Service

管理實務與理論研究

1卷1期（2007 / 03 / 01）

40 - 60

繁體中文

鑒於整體醫療環境的快速變遷，醫院服務品質及管理績效之良窳，日益受到重視。睽諸文獻顯示，美國內部控制制度之概念及其整合架構，對台灣內部控制制度發展之影響極其深遠。據此，本研究首在結合國內醫院會計制度與美國COSO內部控制之整合架構，並針對台灣醫院內部控制制度之實施現況，擷取健保局西醫醫院100家爲樣本，進行實地問卷調查、資料彙整及統計分析，期能爲國內醫院設計一套合理、客觀、有效的內部控制評估工具。其次，本研究之結果可協助醫院管理主管確認內部控制制度之優缺點，並擬定合乎成本效益之行動方案。研究顯示：各醫院對內部控制理念之推動，雖咸表認同或抱持高度之需求；然本研究發現受訪醫院中，設有專人負責提昇內部控制事宜之醫院家數，竟未及三成。綜觀現行國內醫院組織對於內部控制制度之重視程度普遍不足，希冀本研究結果能提供政府部門或相關醫療單位，做爲爾後實施或修正內部控制之參考，俾因應醫療環境之銳變及提昇醫院醫職人員及利害關係人之滿意度。

As the health care industry changes rapidly, hospital managerial performance and quality of service are becoming more critical. Recent studies show that the concepts and frameworks of the US internal control systems have greatly influenced on the development of the Taiwan internal control systems. This research surveys 100 Bureau of National Health Insurance certified hospitals to evaluate the implementation of the internal control systems in Taiwan by utilizing the control codes of the Taiwan accounting system as well as the integral framework for internal control of the Committee of Sponsoring Organizations of the Treadway Commission (COSO). By applying the results of this study, hospital administrators can identify the strengths and weaknesses of their internal control systems and set up action plans regarding the cost-benefit analyses. Although most hospitals declare the strong demands for internal controls, less than 30% of hospitals have assigned specialists to supervise and improve the internal controls. The research reveals that current Taiwan hospitals do not place high priority on the internal control systems. In addition, the results of this analysis describe how internal control systems in hospitals are implemented and can offer practical information for hospital administrators. Furthermore, the data reveals to what extent hospital administers understand internal control systems and to what extent they pay attention to the internal control systems. Finally, substantive suggestions have been proposed for government and related administrations of hospital institutions to establish or revise the internal control systems in order to be better confront with the drastically changing health care environment.

1. 楊朝旭(2003)。產品市場競爭可否降低公司內部治理機制不佳所導致的代理成本？。管理學報，21(2)，153-173。
   連結：
2. American Institute of Accountants(1949).Special Report by Committee on Auditing Procedure Internal ControlSpecial Report by Committee on Auditing Procedure Internal Control,未出版
3. American Institute of Certified Public Accountants(1971).Statements on Auditing Procedure No.49 Report on Internal ControlStatements on Auditing Procedure No.49 Report on Internal Control,未出版
4. American Institute of Certified Public Accountants(1974).Statement on Auditing Standards No.3 The effects of EDP on the Auditor's Study and Evaluation of Internal Control.
5. American Institute of Certified Public Accountants(1947).Committee on Auditing Procedure Tentative Statement of Auditing Standards.
6. American Institute of Certified Public Accountants(1988).The National Commission on Fraudulent Financial Reporting [Treadway Commission], Report of National Commission on Fraudulent Financial ReportingThe National Commission on Fraudulent Financial Reporting [Treadway Commission], Report of National Commission on Fraudulent Financial Reporting,未出版
7. American Institute of Certified Public Accountants(1972).Statement on Auditing Procedure No.54(SAS No.1)The Auditor's Study and Evaluation of Internal Control.
8. American Institute of Certified Public Accountants(1995).Statement on Auditing Standards No.78 Consideration of Internal Control in a Financial Statement Audit.
9. American Institute of Certified Public Accountants(1963).Statements on Auditing Procedure No.33 Auditing Standards and Procedure.
10. American Institute of Certified Public Accountants(1958).Statement on Auditing Procedure No.29 Scope of the Independent Auditor's Review of Internal Control.
11. Beumer, H.(2006).A Risk-Oriented Approach.The Internal Auditor,63(1),72-76.
12. Boynton, W.C.,Kell, W. G.(1996).Modern Auditing.John Willey & Sons, Inc.
13. Carter, B. R.,Massa, J. L.,Power, L. M.(1997).An Examination of the Efficiency of Proprietary Hospital versus Non-Proprietary Hospital Ownership Structures.Journal of Accounting and public Policy,16(1),63-87.
14. Committee of Sponsoring Organizations of the Treadway Commission(1994).Internal Control-Integrated Framework (Evaluation Tools).
15. Committee of Sponsoring Organizations of the Treadway Commission(2003).Enterprise Risk Management Framework.
16. Committee of Sponsoring Organizations of the Treadway Commission(1992).Internal Control-Integrated Framework: Executive Summary.
17. Committee of Sponsoring Organizations of the Treadway Commission(1996).Internal Control in Derivatives Usage: An Information Tool for Considering the COSO Internal Control-Integrated Framework in Derivatives Application.
18. Committee of Sponsoring Organizations of the Treadway Commission(1999).Fraudulent Financial Reporting: 1987-1997-An Analysis of U.S. Public Companies.
19. Dillman, D. A.(1978).Mail and Telephone: The Total Design Method.John Wiley.
20. Fiorelli, E. P.,Rooney, J. C.(1997).COSO and the Federal Sentencing Guidelines.Internal Auditor,April,57-60.
21. Kerlinger, F. N.(1986).Foundations of Behavioral Research.Holt, Rinehart, and Winston.
22. Nunnally, J. C.(1978).Psychometric Theory.New York:McGraw-Hall.
23. Ridley, J.(1997).ISO 9000.Internal Auditor,August,44-48.
24. Sarbanes-Oxley(2002).An Act to Protect Investors by Improing the Accuracy and Reliability of Corporate Disclosures made Pursuant to the Securities Law, and for other Purposes.
25. Simmons, R. M.(1997).COSO Based Auditing.Internal Auditor,December,69-73.
26. Tidrick, D. E.(2005).A Conversation with COSO Chairman Larry Rittenberg.The CPA Journal,22-26.
27. 丁克華(2003)。落實推動我國公司治理制度。內部稽核，44，4-8。
28. 參、醫務管理
29. 王怡心(1998)。如何運用內控自我評估觀念提升內稽功能。會計研究月刊，146，75-81。
30. 王義雲(1999)。內部控制原則及方法。台北:五南書局。
31. 行政院衛生署(1991)。醫療院所會計制度。行政院衛生署。
32. 醫療機構現況及醫院醫療服務量統計
33. 林克武、楊聰權(1995)。內控制度制度設計實務。會計研究月刊，120，119-124。
34. 林柄滄(1997)。經營風險之評估與內部控制之檢核。會計研究月刊，143，75-81。
35. 施禔盈(1997)。審查內控，會計師不再難爲。會計研究月刊，138，47-53。
36. 施禔盈(1997)。正視內控的積極意義。會計研究月刊，138，54-57。
37. 范明玲(1997)。產、官、學、稽、會：內部控制實務研討會。會計研究月刊，142，70-80。
38. 韋亭旭(2003)。我國公司治理制度之現況與未來。證券暨期貨管理，21(4)，20-30。
39. 馬秀如(2002)。控制至治理之途－剖析「控制」演化到「治理」的原因期減少推動治理之阻力。主計月刊，562，63-75。
40. 馬秀如(1997)。釐清內部控制制度：作業要點≠實施要點的偏誤。會計研究月刊，141，36-42。
41. 馬秀如(1997)。內部控制的過去與現在。會計研究月刊，138，25-39。
42. 陳明裕(1999)。中小企業內部控制與稽核制度並行規劃之實例說明。會計研究月刊，163，128-137。
43. 陳茵琦(2003)。我國公司治理制度之推動。證券暨期貨管理，21(4)，31-47。
44. 陳禮炫(2001)。內控內稽的實務演變。內部稽核，69-73。
45. 楊德嘉(2002)。全民健保會計工作回顧與問題檢討－強化內部控制健全營運體質，提升健保服務績效。主計月刊，557，85-93。
46. 葉秀惠(1997)。內部控制作業要點Q&A。會計研究月刊，138，58-63。
47. 劉紹樑(2003)。公司治理的理念、現況與改革。證券暨期貨管理，21(4)，1-19。
48. 鄭乃木、謝明娟(1997)。醫務會計及財務管理。
49. 鄭桓圭(2002)。從會計醜聞案探討公司治理與會計控制制度－推動自我控制評估落實內部控制。主計月刊，562，54-62。
50. 鄭桂蕙(1997)。內部控制真諦之剖析。會計研究月刊，138，64-72。
51. 賴森本(2002)。強化內部控制功能提振政府治理績效－落實內部控制之有效執行以提振施政成效。主計月刊，62，28-39。
52. 顏淑涓(1997)。內部稽核在醫院管理控制之角色與功能。醫院，30(3)，14-18。