吉林大学中日联谊医院内部控制制度研究
摘要
随着我国经济社会的高速发展,卫生事业改革步伐的加快和医院经营模式的改变,国有医院面临的经济环境发生了深刻变化,对内部控制提出了新的要求。
本文以吉林大学中日联谊医院内部会计控制为研究对象,采用传统的规范分析的研究方法,沿着提出问题、分析问题和解决问题的思路进行,首先在医院中对其内部控制情况进行调查和测试,针对重点环节(收支控制、药品及库存物资控制、货币资金控制、固定资产控制)着重调查、研究,对医院内控情况的数据及情况进行归纳总结,分析研究医院内控制度存在的漏洞和问题,针对目前医院内控制度缺陷,研究建立健全中日联谊医院内部控制体系的方法,提出通过预算控制、监督考核相结合的控制方法,堵塞控制漏洞,完善控制体系,把医院各项经济活动全面置于控制之中。
通过强化医院内部控制,使医院适应市场经济的转变,有效地控制与防范医疗经营风险,规范医院经营行为,能使医院走上自我约束、自我发展的良性轨道。因此,对于切实解决吉林大学中日联谊医院面临的问题,具有重要的现实意义。
As China's socialist market economic system, establishment and constant improvement of medical and health system reform and health services continued to deepen the ongoing liberalization of the market, hospitals are facing internal and external environment has undergone tremendous changes in the rules of market economy development and in the hospital management play an increasingly important role. Medical market in the new environments, the hospital management decided to direct the hospital's risk-benefit, which requires hospitals must change their ideas, and foster awareness of market competition, the use of modern management theories and methods to adapt to the new environment.
At present, the hospital managers to the importance of internal control system should be a general lack of awareness, which seriously affects the establishment of sound internal control system and effective implementation. Internal control system and some hospitals are in the embryonic stage; some detail, although the hospital system, and improve, but failed to seriously implement, equivalent to no system, making the internal control system exists in name only, more than the hospital and so many problems caused
Internal control deficiencies in the hospital system to run the hospital also created a great deal of harm:
First, reduce the efficiency of hospital management.
Second, the quality of information reporting.
Third, assets are not guaranteed the safety integrity.
Fourth, development strategies conducive to the implementation of the hospital.
China-Japan Union Hospital is the public nature of the social welfare institutions, followed a long period of time under the planned economic system management mode, in this system, hospitals are not the pressure of survival and development, lack of awareness of market competition and economic efficiency , the concept of social benefits. Hospital medical, light management, resulting in the overall management of the lower level, a serious waste of resources. The concept of economic management in the old hospital on the role of internal control inaccurate understanding of inadequate internal controls; not on internal control the operation and management of the hospital perspective, purely for the purpose to enhance economic efficiency, the importance of internal control system.
Resulting in the internal control system can not function effectively. In addition, the system re-examination of digital indicators to economic profit as the main basis for the completion of the lack of other relevant indicators of the comprehensive survey. Hospital internal control problems exist, mainly for the following areas:
First, the role of internal controls sufficient understanding of
Second, internal control systems
Third, weak enforcement of internal control
Fourth, the functions of management of managers is not high, the quality of mixed
China-Japan Union Friendship Hospital as a major general hospital, with more than ten billion yuan of fixed assets. Hospitals more frequently in economic activity, cash and goods mobility, balance of payments often prone to corruption, waste and theft losses. A number of major investment, the disposal of assets, capital raising and other operational matters of economic policy-making and implementation process is also prone to error and fraud. Therefore, establishing and perfecting the system of internal control hospitals, the hospital property to protect the safety integrity, the prevention of major economic business decision-making and implementation process of error and fraud, to strengthen the hospital's economic management, economic activities regulate hospitals have an important role.
According to the Hospital of the investigation of internal control, understanding and testing, for each link in the system of internal control deficiencies, the hospital should be in the following areas to strengthen internal controls.
First, the hospital managers to improve internal accounting controls to the level of awareness
Business process in the hospital, the hospital managers awareness of internal accounting controls a high degree, then the hospital's internal accounting controls can be better implemented, otherwise the implementation is not ideal. Therefore, hospital managers to improve internal accounting controls to the level of awareness is extremely important. For internal accounting control of the hospital and give full play to the role, first of all, the control of hospital managers must hold a positive attitude, and give strong support, at the same time to carry out such support to the entire hospital; Secondly, managers in the business on the promotion of appropriate ethical conduct will help to control the increased effectiveness. Second, strengthen the organizational structure and responsibilities of the control system, the establishment of internal control evaluation system
Institutions set up in the hospital, consideration should be given for each economic activity must be progressive, after all the relevant departments and to ensure that the business cycle between the relevant departments for examination. The effective implementation of internal control system can not improve the evaluation system, personnel of the relevant results of the work of a certain period of time to carry out periodic assessment, based on the principle of fair and just, their reward or punishment, incentives and constraints to achieve the relevant departments and staff do a good job The purpose of the internal control work.
Powers delegated by the strict control In order to ensure control of the authority to authorize, whether it is "general authorization" or a "specific authorization" must be a clear responsibility to clear the mandate of each of the economic business approval process, establishment of authority to authorize the inspection system. In order to ensure internal controls in accounting and played its due role, for many of the financial revenue and expenditure for approval by the finance department should determine its compliance, legality, by the managers or unit leaders for approval, the unit economic issues related to decision-making in advance, a matter of control, prevent the emergence of "a pen" phenomenon.
Fourth, to strengthen quality control of information
Hospitals to use electronic means of information technology to establish internal accounting control systems, reduce and eliminate manipulation factor, to ensure that the implementation of internal accounting controls; At the same time, strengthen the financial accounting of electronic information systems development and maintenance, data input and output, document storage and custody, and other aspects of network security control. Hospital to establish real-time control system of accounting, accounts payable realize the real-time management of drugs, the number of stores, prices, valid for real-time monitoring. Hospitals to achieve real-time financial control, enhance the management capacity of hospitals and economic benefits to the value of the goal of value-added has an important practical significance, Is also the hospital's internal accounting control system the main tasks and objectives.
Fifth, strengthen the control of the quality of personnel
Raise the level of hospital management, to a large extent depends on the quality of staff and operational levels of their own. First of all, the senior management of the hospital should have a high political and professional qualities, or the development of scientific and rational, rigorous and orderly system of internal accounting has become an empty talk. And the development of an internal accounting system will need to have the appropriate staff to carry out the quality of, or control measures will be ineffective. Second, hospitals should be in accordance with the requirements of different positions in scientific and reasonable arrangements for personnel, so that each staff duties with their own qualities, abilities, maximize their enthusiasm and initiative.
Sixth, improve the financial budget control
Hospital budget is based on the development of the hospital mission and the preparation of plans and annual financial revenue and expenditure plan. Financial sector in accordance with the annual budget to the limit down level by level decomposition, the implementation of quality levels. Control the implementation of financial budget including the preparation of the budget process, the implementation of budgetary control procedures and evaluation system. According to the different internal accounting environment may be the appropriate management of budgetary control.
Seventh, give full play to the supervisory role of internal audit Hospitals should establish an independent internal audit department, through the supervision of the audit, evaluation,functions, regulate the conduct of the hospital. To carry out cost-effective, section head of economic responsibility audit, in order to enhance the effectiveness of internal controls to prevent the control procedures resulting from the passage of time due to the negligence and fraud, but also conducive to the elimination of the control system for an error of systemic risks.
Hospital internal accounting control requirements continue to strengthen self-construction of hospitals, internal control is a complex task, its process of development can not be plain sailing, but also the need for hospital staff to explore a wide range of practice and the need for hospitals to strengthen their self-construction, strengthening of the accounting infrastructure, strengthen of staff training and education and training a large number of accounting and who knows management, knows the accounting business operations, it can help solve practical problems in complex high-level talent.
To sum up, the hospital involved in the medical market as the operation of economic entities in order to ensure the national investment in health resources are limited and reasonable use of the configuration and the need to establish a sound internal control and the development of hospital system of internal accounting control and give full play to the role of system Effective control and prevention of operational risks, the hospital system of internal accounting controls into the scientific, standardized and legalized the development of track, through the practice of continuous exploration and innovation, sustainable development for the hospital to provide reliable protection.
本文以吉林大学中日联谊医院内部会计控制为研究对象,采用传统的规范分析的研究方法,沿着提出问题、分析问题和解决问题的思路进行,首先在医院中对其内部控制情况进行调查和测试,针对重点环节(收支控制、药品及库存物资控制、货币资金控制、固定资产控制)着重调查、研究,对医院内控情况的数据及情况进行归纳总结,分析研究医院内控制度存在的漏洞和问题,针对目前医院内控制度缺陷,研究建立健全中日联谊医院内部控制体系的方法,提出通过预算控制、监督考核相结合的控制方法,堵塞控制漏洞,完善控制体系,把医院各项经济活动全面置于控制之中。
通过强化医院内部控制,使医院适应市场经济的转变,有效地控制与防范医疗经营风险,规范医院经营行为,能使医院走上自我约束、自我发展的良性轨道。因此,对于切实解决吉林大学中日联谊医院面临的问题,具有重要的现实意义。
As China's socialist market economic system, establishment and constant improvement of medical and health system reform and health services continued to deepen the ongoing liberalization of the market, hospitals are facing internal and external environment has undergone tremendous changes in the rules of market economy development and in the hospital management play an increasingly important role. Medical market in the new environments, the hospital management decided to direct the hospital's risk-benefit, which requires hospitals must change their ideas, and foster awareness of market competition, the use of modern management theories and methods to adapt to the new environment.
At present, the hospital managers to the importance of internal control system should be a general lack of awareness, which seriously affects the establishment of sound internal control system and effective implementation. Internal control system and some hospitals are in the embryonic stage; some detail, although the hospital system, and improve, but failed to seriously implement, equivalent to no system, making the internal control system exists in name only, more than the hospital and so many problems caused
Internal control deficiencies in the hospital system to run the hospital also created a great deal of harm:
First, reduce the efficiency of hospital management.
Second, the quality of information reporting.
Third, assets are not guaranteed the safety integrity.
Fourth, development strategies conducive to the implementation of the hospital.
China-Japan Union Hospital is the public nature of the social welfare institutions, followed a long period of time under the planned economic system management mode, in this system, hospitals are not the pressure of survival and development, lack of awareness of market competition and economic efficiency , the concept of social benefits. Hospital medical, light management, resulting in the overall management of the lower level, a serious waste of resources. The concept of economic management in the old hospital on the role of internal control inaccurate understanding of inadequate internal controls; not on internal control the operation and management of the hospital perspective, purely for the purpose to enhance economic efficiency, the importance of internal control system.
Resulting in the internal control system can not function effectively. In addition, the system re-examination of digital indicators to economic profit as the main basis for the completion of the lack of other relevant indicators of the comprehensive survey. Hospital internal control problems exist, mainly for the following areas:
First, the role of internal controls sufficient understanding of
Second, internal control systems
Third, weak enforcement of internal control
Fourth, the functions of management of managers is not high, the quality of mixed
China-Japan Union Friendship Hospital as a major general hospital, with more than ten billion yuan of fixed assets. Hospitals more frequently in economic activity, cash and goods mobility, balance of payments often prone to corruption, waste and theft losses. A number of major investment, the disposal of assets, capital raising and other operational matters of economic policy-making and implementation process is also prone to error and fraud. Therefore, establishing and perfecting the system of internal control hospitals, the hospital property to protect the safety integrity, the prevention of major economic business decision-making and implementation process of error and fraud, to strengthen the hospital's economic management, economic activities regulate hospitals have an important role.
According to the Hospital of the investigation of internal control, understanding and testing, for each link in the system of internal control deficiencies, the hospital should be in the following areas to strengthen internal controls.
First, the hospital managers to improve internal accounting controls to the level of awareness
Business process in the hospital, the hospital managers awareness of internal accounting controls a high degree, then the hospital's internal accounting controls can be better implemented, otherwise the implementation is not ideal. Therefore, hospital managers to improve internal accounting controls to the level of awareness is extremely important. For internal accounting control of the hospital and give full play to the role, first of all, the control of hospital managers must hold a positive attitude, and give strong support, at the same time to carry out such support to the entire hospital; Secondly, managers in the business on the promotion of appropriate ethical conduct will help to control the increased effectiveness. Second, strengthen the organizational structure and responsibilities of the control system, the establishment of internal control evaluation system
Institutions set up in the hospital, consideration should be given for each economic activity must be progressive, after all the relevant departments and to ensure that the business cycle between the relevant departments for examination. The effective implementation of internal control system can not improve the evaluation system, personnel of the relevant results of the work of a certain period of time to carry out periodic assessment, based on the principle of fair and just, their reward or punishment, incentives and constraints to achieve the relevant departments and staff do a good job The purpose of the internal control work.
Powers delegated by the strict control In order to ensure control of the authority to authorize, whether it is "general authorization" or a "specific authorization" must be a clear responsibility to clear the mandate of each of the economic business approval process, establishment of authority to authorize the inspection system. In order to ensure internal controls in accounting and played its due role, for many of the financial revenue and expenditure for approval by the finance department should determine its compliance, legality, by the managers or unit leaders for approval, the unit economic issues related to decision-making in advance, a matter of control, prevent the emergence of "a pen" phenomenon.
Fourth, to strengthen quality control of information
Hospitals to use electronic means of information technology to establish internal accounting control systems, reduce and eliminate manipulation factor, to ensure that the implementation of internal accounting controls; At the same time, strengthen the financial accounting of electronic information systems development and maintenance, data input and output, document storage and custody, and other aspects of network security control. Hospital to establish real-time control system of accounting, accounts payable realize the real-time management of drugs, the number of stores, prices, valid for real-time monitoring. Hospitals to achieve real-time financial control, enhance the management capacity of hospitals and economic benefits to the value of the goal of value-added has an important practical significance, Is also the hospital's internal accounting control system the main tasks and objectives.
Fifth, strengthen the control of the quality of personnel
Raise the level of hospital management, to a large extent depends on the quality of staff and operational levels of their own. First of all, the senior management of the hospital should have a high political and professional qualities, or the development of scientific and rational, rigorous and orderly system of internal accounting has become an empty talk. And the development of an internal accounting system will need to have the appropriate staff to carry out the quality of, or control measures will be ineffective. Second, hospitals should be in accordance with the requirements of different positions in scientific and reasonable arrangements for personnel, so that each staff duties with their own qualities, abilities, maximize their enthusiasm and initiative.
Sixth, improve the financial budget control
Hospital budget is based on the development of the hospital mission and the preparation of plans and annual financial revenue and expenditure plan. Financial sector in accordance with the annual budget to the limit down level by level decomposition, the implementation of quality levels. Control the implementation of financial budget including the preparation of the budget process, the implementation of budgetary control procedures and evaluation system. According to the different internal accounting environment may be the appropriate management of budgetary control.
Seventh, give full play to the supervisory role of internal audit Hospitals should establish an independent internal audit department, through the supervision of the audit, evaluation,functions, regulate the conduct of the hospital. To carry out cost-effective, section head of economic responsibility audit, in order to enhance the effectiveness of internal controls to prevent the control procedures resulting from the passage of time due to the negligence and fraud, but also conducive to the elimination of the control system for an error of systemic risks.
Hospital internal accounting control requirements continue to strengthen self-construction of hospitals, internal control is a complex task, its process of development can not be plain sailing, but also the need for hospital staff to explore a wide range of practice and the need for hospitals to strengthen their self-construction, strengthening of the accounting infrastructure, strengthen of staff training and education and training a large number of accounting and who knows management, knows the accounting business operations, it can help solve practical problems in complex high-level talent.
To sum up, the hospital involved in the medical market as the operation of economic entities in order to ensure the national investment in health resources are limited and reasonable use of the configuration and the need to establish a sound internal control and the development of hospital system of internal accounting control and give full play to the role of system Effective control and prevention of operational risks, the hospital system of internal accounting controls into the scientific, standardized and legalized the development of track, through the practice of continuous exploration and innovation, sustainable development for the hospital to provide reliable protection.
引文
①栾瑞王春鹤,医院货币资金内部控制的问题及解决方法[J].中国卫生经济,2008(6),75-76.
②钟军燕,货币资金内部控制要点及实证分析[J].商丘职业技术学院学报,2006(3),39-40.
③杨慧芳,医院库存物资的管理与核算.中国医药导报[J],1996(10),114-115
④王文育赵乾坤,如何建立医院固定资产的内控制度[J].中国卫生质量管理,2003(10),56-57.
[1]房玲,对医院内部会计控制——预算控制的几点认识[J].医学创新研究,2006,(11):36.
[2]周燕,刍议医院内部会计控制制度[J].会计之友,2008(6),48-49.
[3]关卫勇,公立医院财务会计内控机制建设研究[J].中国总会计师,2008(9),85.
[4]孙蕴君高进明,构建医院信息化会计控制体系实现医院内部会计实时控制[J].军事经济研究,2008(5),58-59.
[5]栾瑞王春鹤,医院货币资金内部控制的问题及解决方法[J].中国卫生经济,2008(6),75-76.
[6]钟军燕,货币资金内部控制要点及实证分析[J].商丘职业技术学院学报,2006(3),39-40.
[7]史秀芳,加强医院药品财务管理的探讨[J].当代经济,2008(9),141-142.
[8]王文育赵乾坤,如何建立医院固定资产的内控制度[J].中国卫生质量管理,2003(10),56-57.
[9]吴淑玲陈财柳,如何健全和落实医院内部控制[J].中山大学学报论丛,2007(5),195-198.
[10]张英,试论医院财务会计内部控制中的问题及对策[J].经济师,2007(8),177.
[11]叶阿琴,医院管理中的成本控制[J].医院管理论坛,2007(7),34-35.
[12]杨慧芳,医院库存物资的管理与核算[J].中国医药导报,1996(10),114-115.
[13]孟冬军,医院收入失控的危害及预防措施[J].会计之友,2008(10),38.
[14]董立友黄龙梅,加强支出控制力度提高医院经营管理水平[J].医院院长论坛,2006(5),20-23.
[15]刘剑蓉郭洪梁,医院药品及物资采购与库存控制[J].四川省卫生管理干部学院学报,2007(12),305-307.
[16]陈天仪,医院预算管理改革的探索[J].中国卫生资源,2004(7),15-156.
[17]段祖福,医院内部控制制度建设之我见[J].中国卫生经济,2007(12),71.
[18]徐迅,医院内部控制执行力研究[J].卫生经济研究,2008(11),47.
[19]曾意情,医院内部控制的思考与启示[J].中外医疗,2008(24),168.
[20]朱立群徐淑丽,医院货币资金的内部会计控制[J],现代医院管理,2007(6),56-57.
[21]白安珍,医院内部控制存在的问题及加强措施[J],中外健康文摘,2007(8),1066.
[22]苏红,浅议医院固定资产的内部控制[J],中国健康环境,2007(1),10.
[23]卢伟良,医疗机构收入内控管理浅析[J],当代经济,2008(5),134-135.
[24]刘凤奎,细化支出预算强化医院财务管理[J],医学信息,2007(9),1710-1711.
[25]吴小红,探讨如何有效控制医院收费环节[J],中国医药指南,2008(9),190-191.
[26]靳萍,强化医院内部会计控制制度[J],内蒙古科技与经济,2007(17),56-57.
[27]朱胤,浅谈医院货币资金控制中的若千风险点及其防范措施[J],中国医疗前沿,2008(1),54-55.
[28]陆玉军,浅谈医院货币资金的控制与管理[J],中国交通医学杂志,2005,(19),187.
[29]陈娟,公立医院规范收支与财务内控管理的研究[J],中国医疗前沿,2008,(8),42-43.
[30]武素英,国有医院实施全面预算管理的思考[J],河南财政税务高等专科学校学报,2007(4),45-46.
[31]李永忠,内控制度在医院管理中的应用[J],现代医院,2006,(11),114-115.
[32]何海燕,公立医院开展财务会计内部控制的研究[J],科技经济市场,2007,(9),12.
[33]中华人民共和国卫生部规划财务司,医疗机构财务会计内部控制规定讲座[M].北京:企业管理出版社,2007
②钟军燕,货币资金内部控制要点及实证分析[J].商丘职业技术学院学报,2006(3),39-40.
③杨慧芳,医院库存物资的管理与核算.中国医药导报[J],1996(10),114-115
④王文育赵乾坤,如何建立医院固定资产的内控制度[J].中国卫生质量管理,2003(10),56-57.
[1]房玲,对医院内部会计控制——预算控制的几点认识[J].医学创新研究,2006,(11):36.
[2]周燕,刍议医院内部会计控制制度[J].会计之友,2008(6),48-49.
[3]关卫勇,公立医院财务会计内控机制建设研究[J].中国总会计师,2008(9),85.
[4]孙蕴君高进明,构建医院信息化会计控制体系实现医院内部会计实时控制[J].军事经济研究,2008(5),58-59.
[5]栾瑞王春鹤,医院货币资金内部控制的问题及解决方法[J].中国卫生经济,2008(6),75-76.
[6]钟军燕,货币资金内部控制要点及实证分析[J].商丘职业技术学院学报,2006(3),39-40.
[7]史秀芳,加强医院药品财务管理的探讨[J].当代经济,2008(9),141-142.
[8]王文育赵乾坤,如何建立医院固定资产的内控制度[J].中国卫生质量管理,2003(10),56-57.
[9]吴淑玲陈财柳,如何健全和落实医院内部控制[J].中山大学学报论丛,2007(5),195-198.
[10]张英,试论医院财务会计内部控制中的问题及对策[J].经济师,2007(8),177.
[11]叶阿琴,医院管理中的成本控制[J].医院管理论坛,2007(7),34-35.
[12]杨慧芳,医院库存物资的管理与核算[J].中国医药导报,1996(10),114-115.
[13]孟冬军,医院收入失控的危害及预防措施[J].会计之友,2008(10),38.
[14]董立友黄龙梅,加强支出控制力度提高医院经营管理水平[J].医院院长论坛,2006(5),20-23.
[15]刘剑蓉郭洪梁,医院药品及物资采购与库存控制[J].四川省卫生管理干部学院学报,2007(12),305-307.
[16]陈天仪,医院预算管理改革的探索[J].中国卫生资源,2004(7),15-156.
[17]段祖福,医院内部控制制度建设之我见[J].中国卫生经济,2007(12),71.
[18]徐迅,医院内部控制执行力研究[J].卫生经济研究,2008(11),47.
[19]曾意情,医院内部控制的思考与启示[J].中外医疗,2008(24),168.
[20]朱立群徐淑丽,医院货币资金的内部会计控制[J],现代医院管理,2007(6),56-57.
[21]白安珍,医院内部控制存在的问题及加强措施[J],中外健康文摘,2007(8),1066.
[22]苏红,浅议医院固定资产的内部控制[J],中国健康环境,2007(1),10.
[23]卢伟良,医疗机构收入内控管理浅析[J],当代经济,2008(5),134-135.
[24]刘凤奎,细化支出预算强化医院财务管理[J],医学信息,2007(9),1710-1711.
[25]吴小红,探讨如何有效控制医院收费环节[J],中国医药指南,2008(9),190-191.
[26]靳萍,强化医院内部会计控制制度[J],内蒙古科技与经济,2007(17),56-57.
[27]朱胤,浅谈医院货币资金控制中的若千风险点及其防范措施[J],中国医疗前沿,2008(1),54-55.
[28]陆玉军,浅谈医院货币资金的控制与管理[J],中国交通医学杂志,2005,(19),187.
[29]陈娟,公立医院规范收支与财务内控管理的研究[J],中国医疗前沿,2008,(8),42-43.
[30]武素英,国有医院实施全面预算管理的思考[J],河南财政税务高等专科学校学报,2007(4),45-46.
[31]李永忠,内控制度在医院管理中的应用[J],现代医院,2006,(11),114-115.
[32]何海燕,公立医院开展财务会计内部控制的研究[J],科技经济市场,2007,(9),12.
[33]中华人民共和国卫生部规划财务司,医疗机构财务会计内部控制规定讲座[M].北京:企业管理出版社,2007
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |