過去研究盈餘管理的文獻，多以營利組織為主，較少探討非營利組織的盈餘管理行為。本研究探討台灣非營利醫院的盈餘管理行為，並衡量審計品質與盈餘管理間的關聯性，探討四大會計師事務所是否能降低醫院利用裁決性應記項目來操縱盈餘。本研究以台灣2004年到2010年的71家醫院為樣本，並將所有樣本依其設立過程分類，進一步探討不同類型的醫院是否會有不同的盈餘管理可能性。以下為本研究的發現。(1)醫院的盈餘呈現非常態的分布，其大多數的觀察值盈餘都是略高於零；(2) 除了公立醫院以外，其餘類型的醫院皆會利用裁決性應記項目來操縱盈餘，使報導淨利略高於零；(3)實證結果僅得出微弱的證據，四大會計師事務所能降低醫院使用裁決性應記項目來操縱盈餘。

Prior research on earnings management often focuses on for-profit firms. However, research investigating earnings management on the non-profit sector is scant. Therefore, this article will attempt to explore earnings management behavior in Taiwan non-profit hospitals and whether BIG 4 audit firms can reduce earnings-management behavior. Our sample includes 71 hospitals and 311 hospital-years between 2004 and 2010. My findings are as follows: (a) earnings distribution is discontinued and most of observations are slightly above zero, (b) all hospitals except public hospitals engage in earnings management, and (c) there is weak evidence to support the hypotheses that hospitals audited by BIG 4 audit firms are less likely to undertake earnings management.

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