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.