目的：本文探討與比較和立醫療機構與醫療社團法人的財務會計及所得稅制度之差異，作爲和立醫療機構改制醫療社團法人的參考，並對主管機關提出建議，期使醫療法人機構之財務會計制度更加健全。 方法：結合相關醫療法、財務會計及租稅實務，分別就法人資格、資本額、會計基礎、會計制度、財務報表、所得申報、盈餘保留、盈餘分配以及虧損和除等規定，比較和立醫療機構與醫療社團法人的差異。 結果：200床以上的中大型和立醫療機構，若經營階層著眼於第二代永續經營、引進外來資金擴大經營或解決負債難題者，則改制爲醫療社團法人爲最佳途徑；反之，和立醫療院所的財務會計及所得稅規定較爲寬鬆，和立醫院可自行選擇最有利方式爲之，且盈餘可以全數回收、自由動用，但不適用盈虧互抵，適合於無永續經營規劃之財務健全的低調經營階層。 結論：衛生主管機關應修正醫療法人財務報告編製準則，以消除財務會計實務與法令的落差，增訂未依醫療法第53條規定提撥10%研發等服務基金及20%營運基金的罰則，以落實對醫療社團法人財務會計的監督與管理機制。

Objectives: Most private hospital medical administrators are not aware of the impacts caused when changing to a Medical Corporation Aggregate (MCA) organization; for example the impact on reporting earnings and income taxes. Differences in financial accounting and income tax regulations between private hospitals and Medical Corporation Aggregates are examined to provide a useful reference for private hospitals. Suggestions to improve the financial accounting system of MCAs for the government unit in charge are also included. Methods: The study examined a variety of data to determine the impacts of changing to an MCA organization. The authors integrated related medical care law, financial accounting and rental practical affairs data, and compared the differences of legal aggregate requirements, capital, accounting foundation, accounting system, financial statement, income tax reporting, reserve surplus, earnings distribution, and loss deduction between private hospitals and Medical Corporation Aggregates. Results: For owners of medium and large scale private hospitals with more than 200 beds with the external capital investment to expand or pay debt, it is better to change to a Medical Corporation Aggregate organization for sustainable management into the next generation., Due to the more relaxed regulations of financial accounting and income tax, and the ability to retain 100% of profits, it is better to stay as a private hospital for low profile management without a sustainable management plan. Conclusions: The health government unit in charge should modify the financial statement guidelines for Medical Corporation Aggregates to dissolve the gap between financial accounting practical affairs and regulations, and add the penalty provision for those who do not follow the Medical Law (line 53) to withdraw 10% for the research and development foundation and 20% for the operating foundation so that the supervision and management of financial accounting in Medical Corporation Aggregate organizations can be enforced.