外文翻譯--醫(yī)療產(chǎn)業(yè)中租賃融資的相關(guān)因素

1、<p>　　2000單詞，3700漢字</p><p>　　出處: Michael J. McCue,2007.“Factors Associated with Lease Financing in the Hospital Industry” . J Health Care Finance.March.pp.72-84.</p><p>　　本科畢業(yè)論文（設(shè)計(jì)）</p&g

2、t;<p>　　外 文 翻 譯</p><p><b>　　原文：</b></p><p>　　Factors Associated with Lease Financing in the Hospital Industry</p><p>　　In contrast to capital leases, which are

3、 reported on the balance sheet as debt, operating leases are a form of off-balance sheet financing only reported in the notes to the financial statement and have limited disclosure requirements. Following the financial c

4、ollapse of Enron and WorldCom, some analysts argue that companies employ operating leases to hide debt off the balance sheet.Guidelines are provided by the General Financial Accounting Standard Board (FASB) to value a ca

5、pital lease;however,</p><p>　　With respect to the hospital industry, little is known empirically about the use of operating lease financing. With only 1 percent growth in hospital capital spending from 1997

6、to 2001, chief financial officers expect capital outlays to increase by 14 percent over the next five years as hospital assets’ age and patients and physicians place greater demand for the latest in medical technology. T

7、o finance these expenditures, analysts expect greater use of lease financing, which is projected to gro</p><p>　　In accordance with FASB numbers 13 and 17, respectively, hospitals are only required to disclo

8、se in the notes of financial statements minimum future operating lease payments for five subsequent fiscal years;however, no researchable databases exist that list detailed footnote analysis of leases. To overcome this w

9、eakness, several studies in corporate finance have developed approaches to create capitalize values of operating leases.</p><p>　　Imhoff, et al.’s approach was to estimate a capitalized lease value by comput

10、ing the present value of the amounts payable for the next five years disclosed in the notes to the financial statement and an assumption of an estimated value for the subsequent five years. Using Imhoff, et al.’s approac

11、h,Graham, et al., define an estimated value for capitalized operating leases as the present value of the current year lease expense plus lease payments over the next five years discounted to the present </p><p

12、>　　Only one study has empirically analyzed leases in the hospital industry ; however, this prior empirical work only focused on capital leases of hospitals within the state of California and was conducted in the late

13、1980s. The aim of this study was to overcome these shortcomings and develop a broader measure of lease financing to include not only capital leases but also operating leases and to expand the analysis nationally. Operati

14、ng leases were measured by utilizing the perpetuity method, which </p><p>　　Overcoming the data requirements of the previous work, Lim, et al., validated the perpetuity method to capitalize an operating leas

15、e value. The perpetuity method computes the average of the current operating lease expense and next year’s minimum operating lease discounted to the present at the cost of debt. Using regression analysis, they found the

16、perpetuity approach a better predictor of future operating lease payments than the approach used by Graham, et al., which they empirically found unde</p><p>　　To assess the credit market’s assessment of oper

17、ating leases to balance sheet debt, Lim, et al., also evaluated these two forms of financing relative to cost of debt. They found off-balance sheet operating lease debt, estimated by the perpetuity method, had the same i

18、nfluence on new debt pricing as debt on the balance sheet, whereas Graham, et al.’s approach understated the market’s estimation of the operating lease debt.</p><p>　　Corporate finance theory claims lease an

19、d debt finance are viewed, to some degree, as substitutes, specifically where increases in lease financing decrease debt financing. More importantly, financial theory claims that it is a one-to-one relationship given tha

20、t cash payments for lease obligations are equivalent to debt cash payments. One study claims, however, that the nature and terms of lease contracts differ from debt and result in a substitute effect of less than one beca

21、use lease financing </p><p>　　Empirically, Ang and Peterson tested the substitution theory and failed to support this relationship, finding instead a complementary relationship between the two forms of finan

22、cing; however, Marston and Harris’s results supported the substitution effect between lease and debt financing and found this relationship to be less than one, although they only included capital leases and not operating

23、 leases.By controlling for debt capacity of lease and nonlease firms, Adedeji and Stapleton also found </p><p>　　Recently, several studies evaluated this substitutability relationship by developing a more co

24、mprehensive and valid measure, which includes both operating and capital leases. Beattie, et al., included operating leases and found that leasing and debt were partial substitutes. They concluded that this partial subst

25、itute effect reflects the risk of the residual value of the operating lease,which is assumed by the lessor.</p><p>　　This study follows the empirical model of Ang and Peterson and Beattie,et al. to evaluate

26、 this lease-to-debt substitutability measured from the debt-to-lease displacement ratio.Ang and Peterson note that one must control for the borrowing capabilities of the firm. To account for these borrowing differences,

27、a set of control variables unique to the hospital are incorporated into the model.</p><p>　　The ratio of long-term debt to total assets was used to measure the debt ratio, DRhit.Analyzing lease financing in

28、California hospitals, McCue found that debt financing was a complement rather than a substitute for lease financing. This outcome implied that lenders and lessors were willing to increase the borrowing capacity of hospit

29、als during the late 1980s, which may stem from the cost-basis reimbursement for capital.</p><p>　　Market factors include a hospital’s market share and its location. Market share was associated with lower bon

30、d ratings,which reflects higher credit risk, for hospitals with smaller market shares. In addition, hospitals located in urban markets may experience higher labors costs and greater competition, which could affect the se

31、rvice mix and demand for equipment and capital. Hospitals located in states with certificate of need regulations face greater scrutiny from regulators, which may control e</p><p>　　Financial factors include

32、long-term debt to total assets, cash flow margin, days cash on hand, and capital expenditures per bed.To examine the debt substitution effect, this study followed Beattie, et al., and utilized long-term debt to total ass

33、et ratio. Because lease financing is a contractual obligation, the ability to meet these payments is measured by the cash flow margin ratio. Hospitals with higher cash flow and liquidity, as measured by the days cash on

34、hand ratio, have a lower credit ri</p><p>　　Prior analysis of lease financing in the hospital industry ignored the obligated value of operating leases and studied only California hospital data. In contrast,

35、this study followed the work of Lim,et al. and applied the perpetuity method to estimate a capitalized operating lease value. The ratio of capitalized operating leases to total assets ranged from.111 in 1999/2000 to .148

36、 in 1998/1999.Accessing 6,800 publicly traded companies from 1980 to 1999, Lim, et al. applied the perpetuity method </p><p>　　In addition, this study tested the corporat finance theory of debt displacement

37、by both capital and operating leases on a national basis for all short-term, acute-care hospitals. The multivariate findings indicated a negative relationship between debt and lease financing, thus supporting the belief

38、that leasing and debt are partial substitutes. The magnitude of the displacement is small, with $1 dollar of leasing displacing $.09 of debt, on average. This outcome suggests that lease financing use</p><p>

39、;　　Operational factors indicate that occupancy rate, bed size, and payor mix relate to the decision to lease. Hospitals with fewer unoccupied beds but a higher proportion of government payors had a greater propensity to

40、lease. Despite a greater demand for their services, hospitals treating a greater number of government payors faced greater risk because of the declines in Medicare payment after the Balanced Budget Act of 1997.As a resul

41、t, this greater uncertainty limited their ability to access the</p><p>　　Because of changing technology, imaging equipment are more conducive to financing by leases. Hospitals with ownership of two “high tec

42、hnology” pieces of imaging equipment were more likely to lease.</p><p>　　Finally, financial factors show that liquidity and the level of capital expenditures are associated with lease financing. During the t

43、ime frame of this study, credit rating agencies placed greater pressure on hospitals to maintain strong liquidity,specifically larger amounts of cash and investments on hand, to achieve a high credit profile. The results

44、 of this analysis reconfirm this outcome and showed weak liquidity hospitals, with fewer dollars to expend on plant and equipment, depended upon l</p><p>　　Finally policymakers, hospital managers,and credit

45、rating analysts should be aware that leases consume some hospital debt capacity, although it is less than a one-to-one basis. More importantly, during the period of this study, it was demonstrated that operating leases a

46、re an important source of hospital financing and accounts for, on average, between 11 percent to 15 percent of a hospital’s total assets.A recent Healthcare Financial Management Association report indicates that lease fi

47、nancing g</p><p><b>　　譯文：</b></p><p>　　醫(yī)療產(chǎn)業(yè)中租賃融資的相關(guān)因素</p><p>　　融資租賃是作為負(fù)債被記錄在資產(chǎn)負(fù)債表上的，相比較而言，經(jīng)營租賃則是被記錄成表外融資的項(xiàng)目，同時(shí)只是被記錄在財(cái)務(wù)報(bào)表附注里并且是被要求有限的披露。隨著安然和世界通信公司的金融崩潰，一些分析師表明公司會(huì)采用經(jīng)營租賃而

48、隱藏其資產(chǎn)負(fù)債表上的負(fù)債數(shù)額。一般財(cái)務(wù)會(huì)計(jì)準(zhǔn)則委員會(huì)（FASB）提供了一些可評(píng)估的方向，以評(píng)估租賃融資價(jià)值；然而，分析師們面臨的難題卻是評(píng)估經(jīng)營租賃的債務(wù)價(jià)值?？傮w上，租賃合同在它們的義務(wù)條款方面沿著一個(gè)連續(xù)變化的方向變化。一方面，承租人在短時(shí)間內(nèi)為使用資產(chǎn)而支付租金。反過來，在一定范圍內(nèi)的另一個(gè)方面，出租人則提供購買資產(chǎn)的資金。然而，由于組織的意愿一般是保持資產(chǎn)負(fù)債表的負(fù)債數(shù)額不變，因此承租人的合約往往趨向上述兩方面的中間情況。<

49、;/p><p>　　對(duì)于醫(yī)療產(chǎn)業(yè)，使用經(jīng)營性租賃融資的方式是很少被大家所知道的。在1997年到2001年間，醫(yī)院的資本支出只增長了百分之一，因此首席財(cái)務(wù)長期望在五年之后，資本支出能夠比原先增長百分之十四，這些支出一般用于延長資產(chǎn)的使用年限，提供病人和醫(yī)生更好且最新的醫(yī)療設(shè)備的需求。為資助這些開支，分析師們預(yù)計(jì)將使用更多方式的融資租賃，預(yù)計(jì)這些融資租賃方式每年能夠帶動(dòng)資本支出百分之八點(diǎn)五的增長，同時(shí)預(yù)期從1997年的4

50、億美元支出增長到2005年的7.4億美元支出。經(jīng)營租賃對(duì)醫(yī)院有吸引力，因?yàn)樗麄兡塬@得最新的醫(yī)療技術(shù)并避免過時(shí)；然而，從義務(wù)的立場(chǎng)上，信用評(píng)級(jí)機(jī)構(gòu)將經(jīng)營租賃業(yè)務(wù)評(píng)估為負(fù)債部分。</p><p>　　根據(jù)FASB編號(hào)13至17日為例，在未來的5個(gè)經(jīng)營租賃會(huì)計(jì)年度里，醫(yī)院只需要支付在附注中披露的財(cái)務(wù)報(bào)表中的最低的經(jīng)營租賃款項(xiàng)。然而，在附注中的租賃分析中并沒有研究數(shù)據(jù)。為克服這個(gè)缺陷，幾項(xiàng)研究對(duì)于公司融資提出了幾條評(píng)估經(jīng)

51、營租賃創(chuàng)造多少價(jià)值的方法。</p><p>　　英霍夫等人估計(jì)租賃價(jià)值的方法是通過在附注中披露的財(cái)務(wù)狀況中的應(yīng)付款項(xiàng)計(jì)算接下來5年的現(xiàn)值。格雷厄姆等人使用英霍夫等人的方法定義一個(gè)估計(jì)值來表示后續(xù)5年內(nèi)的經(jīng)營租賃的現(xiàn)值，這個(gè)估計(jì)值是通過10%的折舊率計(jì)算當(dāng)年租賃費(fèi)用和租賃付款額之和。</p><p>　　目前只有一個(gè)實(shí)證研究分析了醫(yī)療行業(yè)的租賃方面；然而，這之前的實(shí)證研究只著重融資租賃在加利

52、福尼亞州內(nèi)的醫(yī)院，并且是在20世紀(jì)80年代末才開始進(jìn)行的。這個(gè)研究的主旨在于克服之前研究的不足，并且開拓了以租賃作為融資方式下更廣泛的措施，不僅包括融資租賃也包括經(jīng)營租賃，并且在全國展開。經(jīng)營租賃是通過利用永久性測(cè)量方法測(cè)量的，這個(gè)方法是由lim等人開拓的。此外，此項(xiàng)研究調(diào)查可替代應(yīng)用于租賃和負(fù)債融資之間，也可替代應(yīng)用于市場(chǎng)、使命、經(jīng)營和經(jīng)濟(jì)因素之間，并同時(shí)貫穿全美國所有短期、醫(yī)院急診中心的租賃融資。</p><p&

53、gt;　　Lim等人克服了以往工作中的數(shù)據(jù)要求，用永久方法驗(yàn)證了經(jīng)營租賃的可利用價(jià)值。永久方法計(jì)算出了經(jīng)營租賃的平均費(fèi)用，并且計(jì)算出折現(xiàn)到當(dāng)前的債務(wù)成本的最小值。利用回歸分析，對(duì)經(jīng)營租賃用永久方法進(jìn)行估值，這是比格雷厄姆等人發(fā)現(xiàn)的更好的預(yù)測(cè)方法，而格雷厄姆等人的方法則低估了租賃價(jià)值。格雷厄姆等人之所以低估了租賃的價(jià)值，是因?yàn)樗麄冎豢紤]未來五年的經(jīng)營租賃款項(xiàng)，而沒有考慮是否續(xù)租，也沒有考慮到資產(chǎn)是不可替代的。永久方法客服了這些缺點(diǎn)，并表明

54、經(jīng)營租賃是資本結(jié)構(gòu)的一部分，當(dāng)租賃合同期滿，承租人將繼續(xù)使用該資產(chǎn)。</p><p>　　為了計(jì)算經(jīng)營租賃在資產(chǎn)負(fù)債表中的債務(wù)估計(jì)值，lim等人還評(píng)估了兩種方法下的債務(wù)成本。他們發(fā)現(xiàn)經(jīng)營租賃債務(wù)成本，由永久法估算，對(duì)資產(chǎn)負(fù)債表上的債務(wù)費(fèi)用和新債定價(jià)有同樣的影響力，而格雷厄姆等人的做法則低估了市場(chǎng)下經(jīng)營租賃債務(wù)估計(jì)。</p><p>　　在某種程度上，企業(yè)融資理論聲明租賃和負(fù)債融資是被視為互

55、相替代的，尤其在增加租賃融資而減少負(fù)債融資。更重要的是，融資理論聲明，對(duì)于租賃義務(wù)的現(xiàn)金支付相當(dāng)于負(fù)債現(xiàn)金支付時(shí)，兩者是一對(duì)一的相互關(guān)系。一個(gè)研究表明，然而，租賃合同的性質(zhì)和條件的不同于負(fù)債并導(dǎo)致不可替代負(fù)債，這是因?yàn)樽赓U融資消耗更少的負(fù)債能力。另一個(gè)研究爭(zhēng)辯道負(fù)債和租賃時(shí)補(bǔ)充的關(guān)系，因?yàn)樽赓U允許稅盾轉(zhuǎn)讓給組織使其不能給組織使用承租人但能雇傭出租者。</p><p>　　實(shí)際上，安格和彼得森測(cè)試了替代理論，但最后

56、的結(jié)論卻并不支持這層替代關(guān)系，卻發(fā)現(xiàn)兩種融資形式是相輔相成的關(guān)系；但是，馬斯頓和哈里斯的結(jié)論卻又支持了租賃和負(fù)債融資之間的替代影響，并且發(fā)現(xiàn)這種關(guān)系是不止一種的，盡管他們研究時(shí)只包括融資租賃而并不包括經(jīng)營租賃。通過控制租賃和非租賃形式的負(fù)債能力，阿德德吉和斯泰普爾頓也發(fā)現(xiàn)負(fù)債和融資租賃達(dá)不到完全替代的。在醫(yī)院行業(yè)來講，麥丘評(píng)價(jià)了融資租賃和負(fù)債的關(guān)系。他的結(jié)論支持了安格和彼得森的互補(bǔ)的關(guān)系并且發(fā)現(xiàn)醫(yī)院承租人使用更多的債務(wù)。</p&g

57、t;<p>　　近來，一些研究通過開拓更全面和有效的方式的來評(píng)價(jià)租賃和負(fù)債的可替代關(guān)系，這里的租賃融資同時(shí)包括了經(jīng)營租賃和融資租賃。比蒂等人，在包含了經(jīng)營租賃的前提下，發(fā)現(xiàn)租賃和負(fù)債是部分可替代的。他們總結(jié)這些部分可替代性反映了經(jīng)營租賃剩余價(jià)值的風(fēng)險(xiǎn)性，而這些風(fēng)險(xiǎn)是由出租人承擔(dān)的。</p><p>　　此研究按照安格、彼得森和比蒂等人的實(shí)證模型來評(píng)估租賃和負(fù)債可替代比率。安格和彼得森注意到一點(diǎn)，便是

58、控制公司的借貸能力。考慮到一些借款的差異，醫(yī)院中的獨(dú)特的變量設(shè)置納入到模型中。</p><p>　　對(duì)長期債務(wù)與總資產(chǎn)的比率是用來衡量資產(chǎn)負(fù)債率的。通過分析加州醫(yī)院的租賃融資，麥丘發(fā)現(xiàn)，債務(wù)和租賃融資是一對(duì)一的補(bǔ)充，而不是替代的。這一結(jié)果意味著，在80年代末，貸款者和出租者愿意增加在資本成本基礎(chǔ)上的借款金額。</p><p>　　市場(chǎng)因素包括醫(yī)院的市場(chǎng)份額和它的地理位置。市場(chǎng)份額是以較低的

59、比率來反映出較高的信用風(fēng)險(xiǎn)，醫(yī)院則一般是較小的市場(chǎng)份額。此外，醫(yī)院在市場(chǎng)的地理位置可能會(huì)遇到較高的勞動(dòng)力成本和更大的競(jìng)爭(zhēng)，這可能會(huì)影響設(shè)備和資本的服務(wù)組合和需求。為符合規(guī)定而開具證明書，審查監(jiān)管機(jī)構(gòu)需要對(duì)位于美國的醫(yī)院進(jìn)行更嚴(yán)格的審查，因此可控制過剩資本性支出和購買的設(shè)備類型。</p><p>　　經(jīng)濟(jì)因素包括長期債務(wù)與總資產(chǎn)，現(xiàn)金流保證金，手頭現(xiàn)金，資本支出.為檢驗(yàn)債務(wù)的替代效應(yīng)，此研究參照比蒂等人的研究，并利

60、用長期債務(wù)和總資產(chǎn)的比率。由于融資租賃是一項(xiàng)合同義務(wù)，是否有能力滿足這些款項(xiàng)則是根據(jù)現(xiàn)金流量保證金比率。具有較高的現(xiàn)金流動(dòng)性的醫(yī)院，是由每日手頭現(xiàn)金比率來計(jì)算的，由一個(gè)較低的信貸風(fēng)險(xiǎn)和資本成本來獲得更大的資金。因此，較弱的現(xiàn)金流動(dòng)性的醫(yī)院可尋求融資租賃作為一個(gè)資金來源。最后，用租賃的融資方式避免了過時(shí)的風(fēng)險(xiǎn)，在此情況下，有可能在一定的資本開支下使用更大的設(shè)備資源。</p><p>　　在醫(yī)療行業(yè)的事先分析中忽略了

61、經(jīng)營租賃的義務(wù)價(jià)值，并且只研究加利佛尼亞的醫(yī)院數(shù)據(jù)。與此相反，這些研究跟隨Lim等人的工作并且應(yīng)用了永久方法去估計(jì)一個(gè)資本化經(jīng)營租賃的價(jià)值。對(duì)于總資產(chǎn)，資本化經(jīng)營租賃價(jià)值的比率介于1999/2000年的0.111和1998/1999的0.148之間。Lim等人從1980年到1999年間，訪問了6800家上市公司，應(yīng)用了永久性方法并且計(jì)算出經(jīng)營租賃比例平均占到一個(gè)平穩(wěn)的0.167的價(jià)值比率。</p><p>　　此

62、外，在企業(yè)金融理論下，這項(xiàng)研究測(cè)試了融資租賃和經(jīng)營租賃在醫(yī)院所有短期、急性護(hù)理的基礎(chǔ)上的債務(wù)轉(zhuǎn)移。多因素結(jié)果顯示負(fù)債和租賃的融資方法之間的負(fù)相關(guān)關(guān)系，從而支持了租賃和債務(wù)的部分替代性。兩者之間的轉(zhuǎn)移幅度較小，1美元的租賃平均取代債務(wù)的0.09美元。這一結(jié)果表明，租賃的融資方法使用不到類似的債務(wù)的能力。它還意味著出租人承擔(dān)一定的風(fēng)險(xiǎn)，特別是與該資產(chǎn)在經(jīng)營租賃的年底剩余價(jià)值相關(guān)的風(fēng)險(xiǎn)。</p><p>　　經(jīng)營因素表

63、明，入住率、床的大小和付款人本身都會(huì)涉及租賃合約的決定。醫(yī)院會(huì)有較少的空置病床，一般政府付款人會(huì)愿意承擔(dān)較高比例的醫(yī)院租賃額。盡管對(duì)他們的服務(wù)需求較大，醫(yī)院治療費(fèi)用使政府面臨更大的付款額，因?yàn)楦嗟?997年后的平衡預(yù)算法案。因此，這更大的不確定性限制了他們能夠訪問的信貸市場(chǎng)，在醫(yī)療保險(xiǎn)支付風(fēng)險(xiǎn)下降造就了醫(yī)院租賃的融資形式。相反，規(guī)模較大的醫(yī)院和相關(guān)服務(wù)的多樣性可能使他們能夠利用其他融資形式，如內(nèi)部產(chǎn)生的資金或債務(wù)，而依靠租賃融資則較少

64、。</p><p>　　當(dāng)然，由于技術(shù)的發(fā)展變化，更有利于由租賃融資的方式引進(jìn)高科技設(shè)備。醫(yī)院更偏向于用租賃的融資方式引進(jìn)兩個(gè)“高科技”的成像設(shè)備。</p><p>　　最后，經(jīng)濟(jì)因素展示了流動(dòng)性和租賃融資相關(guān)的資本性支出。在這個(gè)研究的時(shí)間框架里，信用評(píng)級(jí)機(jī)構(gòu)置于醫(yī)院更大的壓力以保持強(qiáng)大的流動(dòng)性，尤其是更大數(shù)額的流動(dòng)資金和投資額，以達(dá)到高信用的個(gè)人資料。依賴租賃融資方式，在廠房和設(shè)備方面花

65、費(fèi)更少的美元的基礎(chǔ)上，這次分析的結(jié)果確認(rèn)了支出和顯示了醫(yī)院弱流動(dòng)性。</p><p>　　最后決策者、醫(yī)院的管理者和信用評(píng)級(jí)分析師應(yīng)該要注意租賃會(huì)消耗些醫(yī)院的一部分償債能力。更重要的是，在這個(gè)研究的期間里，它展示了經(jīng)營租賃是醫(yī)院融資里一個(gè)重要的資源，并且經(jīng)營租賃融資獲得的資產(chǎn)總額平均上占到醫(yī)院總資產(chǎn)額度的百分之十一到百分之十五。最近的醫(yī)療財(cái)務(wù)管理協(xié)會(huì)報(bào)告預(yù)示租賃融資額將從1997年的3.7億美元增長到2002年的

66、5.8億美元，原因是其他融資資源的減少，尤其是銀行貸款。由于1997年的平衡預(yù)算法案帶來的不確定性和最大的阿勒格尼衛(wèi)生、教育及研究基金會(huì)的非盈利性醫(yī)院在1998年破產(chǎn)，銀行則限制它們自己接觸到這方面的業(yè)務(wù)。所以人們以為，經(jīng)營租賃在未來的增長仍是可行的資金來源，用來資助廠房和設(shè)備的購買，尤其是弱流動(dòng)性的設(shè)施和較高數(shù)量的床位占用方面。</p><p>　　出處: 邁克爾J.麥丘，《醫(yī)療產(chǎn)業(yè)中租賃融資的相關(guān)因素》.保健