상급종합병원은 일반종합병원에 비해 회계성과가 우수한가? (Do Tertiary General Hospitals Report Higher Accounting Performance Than The Other General Hospitals?)

서지정보

· 발행기관 : 한국회계학회
· 수록지 정보 : 회계저널 / 31권 / 2호 / 239 ~ 267페이지
· 저자명 : 최승욱

초록

상급종합병원은 “중증질환에 대하여 난이도가 높은 의료행위를 전문적으로 하는 종합병원”으로 일반종합병원에 비해 의료서비스 와 장비 측면에서 우수한 종합병원을 의미한다. 우리나라는 1999년부터 종합전문요양기관을 지정하기 시작하였고, 2011년부터는 상급종 합병원으로 명칭을 변경하여 보건복지부 장관이 3년 주기로 종합병원을 대상으로 평가하여 상급종합병원을 지정한다. 그러나 아직까지 종합병원의 성과를 회계 관점에서 살펴본 연구는 드물며, 상급종합병원과 다른 종합병원의 회계성과에 차이가 있는지 살펴본 연구 역시 거의 없다. 이에 본 연구는 상급종합병원의 회계성과가 다른 종합병원에 비해 우수한지 조사한다. 2016년에서 2019년 사이의 국내 종합병원 재무제표 자료를 이용하여 조사한 결과, 총자산이익률로 대용된 회계성과는 상급종합병원이 일반종합병원에 비해 유의 하게 높았다. 병원의 이익을 의료이익과 의료외이익으로 나눈 조사에서는 상급종합병원의 의료이익률이 일반종합병원보다 높았지만, 의료외이익률은 두 그룹 간 차이가 없었다. 다음으로, 종합병원의 회계성과를 창출하는 요인을 조사하기 위해 DuPont 분석을 활용한 결과, 상급종합병원의 자산회전율과 매출액순이익률이 모두 일반종합병원보다 높았다. 회계성과 요인을 종합병원의 성격에 따라 구분 한 조사에서는 설립형태가 학교법인인 경우 상급종합병원의 회계성과가 증분적으로 높아졌으나, 병상수가 1,000개 이상으로 많은 경우 에는 오히려 회계성과가 감소하였다. 반면, 서울 소재 여부는 상급종합병원의 성과에 유의한 증분효과가 없었다. 마지막으로, 회계성과 의 수준 뿐 아니라 지속성을 살펴보았으며, 상급종합병원의 회계성과는 일반종합병원에 비해 더 지속성이 있었다. 본 연구는 상급종합 병원의 성과를 일반종합병원과 구분하여 회계학 관점에서 조사한 최초의 연구로 DuPont 분석, 회계이익의 지속성 등 회계성과를 포괄적 으로 조사하여 병원의 경영관리를 위한 기초자료를 제시한다. 또한 상급종합병원의 회계성과가 일반종합병원과 체계적으로 다르다는 것을 보여 상급종합병원 지정제도에 제도적 시사점을 제시한다.

영어초록

Tertiary general hospitals are designated by the Minister of Health and Welfare for every three years by evaluating the general hospitals. Tertiary general hospital is specialized in medical services for serious diseases than other general hospitals. Since tertiary general hospital operates for the purpose of treating serious patients, it provides a superior medical services compared to the other general hospitals. However, few studies have been reported the difference in the accounting performance of tertiary general hospitals and other general hospitals. Investigating the accounting performance of tertiary general hospitals has the following importance. If the accounting performance is not well supported, challenging tasks such as research and development activities for the treatment of serious diseases may not be properly carried out. Therefore, this study investigates whether the accounting performance of these tertiary general hospitals is higher than the other general hospitals. By using the financial statement data from 2016 to 2019 of domestic general hospitals, the results of show that accounting performance proxied by the return on assets (ROA) is significantly higher in tertiary general hospital than in other general hospitals. As a result of dividing profits into medical profits and non-medical profits, tertiary general hospitals show a significant positive relationship with medical profits, but are not significantly related to non-medical profits. As medical profits consist of hospitalized income, outpatient income, and other medical income, the results of this study suggest that the high accounting performance of tertiary general hospitals is based on these medical profits. In contrast, non-medical profits include income from funeral, parking lot, cafeteria, interest, dividends, and rental. To summarize, tertiary general hospitals are reporting higher accounting performance than other general hospitals by generating profits from the medical activities. Next, as a result of using DuPont analysis to investigate the factors that create accounting performance of general hospitals, current study documents that both asset turnover and profit margin of tertiary general hospitals are higher than those of other general hospitals. Moreover, current study finds that accounting performance of tertiary general hospitals increases gradually when it is established by an educational foundation (i.e., medical school). In contrast, accounting performance incrementally decreases when the number of beds is more than 1,000 while there is no significant incremental effect of Seoul located on the performance. Finally, the accounting performance of tertiary general hospitals is more persistent than that of other general hospitals. In addition, based on the DuPont analysis, current study finds that the higher persistence is derived from the profit margins rather than the asset turnover. This suggests that the sustainability of the accounting performance of tertiary general hospitals is due to the effectiveness and persistency in their cost structure. This study makes several contributions to the academic, practice, and medical service related regulations. For instance, this is the first study to investigate the performance of tertiary general hospitals from an accounting perspective by separating them from the other general hospitals. In particular, the performance of tertiary general hospitals is investigated through several different measurements to confirm the robustness of the results. In addition, the DuPont analysis provides implications by presenting the factors affecting the accounting performance of tertiary general hospitals. Lastly, by showing that the accounting performance of tertiary general hospitals is systematically different from that of the other general hospitals, the results of this study could be used as an initial outcome for improving the designation system of tertiary general hospitals.

참고자료

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