종합병원의 이익조정 유인이 원가행태에 미치는 영향

[Purpose] This study aims to empirically examine the impact of earnings management incentives on cost behavior in Korean general hospitals. While prior corporate research has shown that cost behavior varies asymmetrically with profit levels, hospitals as nonprofit organizations may adopt different earnings management strategies due to institutional and political constraints. [Methodology] Building on the model of Anderson et al. (2003), this study classifies hospitals’ earnings management incentives into three categories－high－profit, loss－avoidance, and Big Bath zones－and tests the asymmetry of cost behavior across these profit levels. Cost behavior is then compared between hospitals and firms according to earnings situations. [Findings] The analysis yields three main findings. First, hospitals with high profits exhibit stronger cost stickiness, consistent with results found in firms. Second, unlike firms, hospitals in the loss－avoidance zone do not demonstrate downward cost elasticity, suggesting that hospitals prioritize earnings management toward zero rather than simply avoiding losses. Third, in the Big Bath zone, hospitals show downward cost elasticity, which differs from the corporate sector where costs typically remain sticky. [Implications] This study provides empirical evidence that hospitals adopt different earnings management strategies compared to firms, as reflected in their cost behavior. It highlights that hospital accounting practices are not merely the outcome of cost structures but are closely tied to institutional and political environments.