我国新公立医院财务制度实践中存在的问题与对策研究——以厦门市为例

Problems and Countermeasures in the Implementation of Financial System of Public Hospital in China:A Case Study of Xiamen

目的:剖析我国新财务制度实践过程中存在的问题并提出改进对策。方法:开展问卷调查以及访谈,利用Spss13.0对收集的数据进行统计分析。结果:1预算管理方面,41.3%的调查对象所在医院没有设立预算管理机构,预算执行情况的考核仅占29.6%;2成本核算方面,73.3%者认为成本归集和分摊存在困难;3内部控制方面,18.8%者认为医院的内部控制体系不健全、42.5%者所在医院未设立资金管理机构;4资产管理方面,19.0%者提到医疗风险基金提取不足。结论:公立医院在实践新财务制度中仍存在预算执行缺乏考核和监督机制,成本核算的归集和分摊存在困难,内部控制体系不健全,坏账准备与医疗风险基金计提不足等问题。针对存在的问题提出多项解决对策,以进一步发挥财务制度对医院经济管理工作的指导作用。

To analyze the existing problems in the implementation process of financial system of public hospital in our country and propose improvement measures. Methods Questionnaire survey and interviews were carried out ,Spss13.0 was used to count and analyze the collection of data. Results 41.3% of the people whose hospital didn＇t set up the specialized organization in the aspect of budget management, and evaluation of the budget implementation accounted for only 29.6%. In the aspect of cost accounting,73. 3% of the surveyed objects thought there were problems in cost collection and distribution. In internal control, 18.8% of the sur- veyed people thought the internal control system was unsound in their hospital, and 42.5 % of the people whose hospital didn＇t build fund management organization,etc. In assets management, 19.0% mentioned that withdrawing medical risk fund was insufficient. Conclusion There were some problems during the process of new system implementation, such as lack of supervision mechanism in budget implementation, problems in cost collection and distribution, unsound internal control system, insufficient provision for bad debt and fund of medical treatment risk. Corresponding measures were proposed to ensure effectiveness in directing and instructing the practice of hospital economic management for the financial system.