公立医院成本核算失真的可能性分析

Probability Analysis on Deviation of Cost Accounting in Public Hospitals

在现行的公立医院管理体制下,试图以公立医院成本核算为抓手推进公立医院补偿机制改革,最终实现公立医院"提高质量、重塑公益、控制费用"的改革目标是一个举步维艰的困局。原因在于,医院成本核算是合理补偿医院的核心,成本核算在现行体制下面临"激励不相容、信息不可靠、结果不适用"三种阻力,目前貌似科学完善的成本核算实际上是形式完整而实质虚无的偏离,公立医院治理制度改革是公立医院改革次序优先的选择。

Under the current management system in public hospitals, the progress in reform goals of ＂quality improvement, public benefits restoration and expense control＂ is stagnant, while the public hospitals attempt to push forward the reform on the compensation mechanism in public hospitals by performing cost accounting. The reason lies in the fact that cost accounting, as the core of reasonable compensation mechanism in hospitals, turns out to be ＂incompatible with incentives, unreliable in terms of information and inapplicable in terms of results＂ under the current system. Although it seems scientific and correct, cost accounting represents deviation with complete form and void essence. The governance reform should be first choice in reform on public hospitals.