我国公立医院院科两级核算制度的历史与现状分析

History and Status Quo of Accounting Model at Hospital and Department Levels in China's Public Hospital

运用文献检索、专家咨询等方法,分析了我国公立医院院科两级核算制度的历史、成绩、问题以及发展前景。研究结果表明:20世纪80年代以来,公立医院院科两级核算制度主要是以经济效益为导向,极大地推动了公立医院的建设与发展,成绩巨大。但其弊端也十分突出,主要是刺激公立医院逐利,促使医疗费用过快、不合理增长。其解决路径为:分地域、分阶段推进以服务为导向的院科两级核算制度,在技术上还需要研究服务量换算方法等。

The methods of literature review and expert consultation have been employed to analyze the history, achievements, problems and prospects of accounting system at hospital and department levets（ASHDL） in China＇s public hospital. The result shows that, since 1980s, the ASHDL in China＇s public hospital has been mainly oriented by profit, which has greatly promoted the development of hospital. The achievement is enormous while the disadvan- tage is also very prominent, mainly to stimulate public hospital operating for profit, which causes the excessive and unreasonable growth of medical expenditure. The ASHDL in China＇s public hospital should be oriented by service （workload）, The calculation methods of workload conversion should be explored.