安徽省立醫(yī)院內(nèi)部控制改進研究
本文選題:公立醫(yī)院 + 內(nèi)部控制制度; 參考:《首都經(jīng)濟貿(mào)易大學》2017年碩士論文
【摘要】:在大力推進醫(yī)療制度改革的背景下,醫(yī)療行業(yè)內(nèi)部競爭逐漸趨于白熱化,國內(nèi)各大醫(yī)院都面臨著更嚴峻的挑戰(zhàn)。為尋求更好的生存和發(fā)展空間,提高醫(yī)院的競爭力,一些公立醫(yī)院選擇了多院區(qū)的發(fā)展之路。但醫(yī)院規(guī)模的擴大,往往會因為缺乏有效的內(nèi)部控制系統(tǒng),帶來醫(yī)院內(nèi)部各部門間協(xié)調(diào)、溝通和控制的高成本,出現(xiàn)決策緩慢、執(zhí)行力低下、人力資源政策及實施不合理、內(nèi)部監(jiān)督不到位及審計薄弱等內(nèi)控方面問題。針對這些問題,為了保證公立醫(yī)院在市場競爭中的競爭力,就必須完善公立醫(yī)院的內(nèi)部控制制度,加強管理,建立一套適合公立醫(yī)院的內(nèi)部控制系統(tǒng)。本文基于利益相關者理論與產(chǎn)權理論,采用理論分析與案例分析相結(jié)合的研究方法,對安徽省立醫(yī)院的內(nèi)部控制體系現(xiàn)狀進行調(diào)研與分析,結(jié)果表明:安徽省立醫(yī)院的內(nèi)部控制體系框架不夠完善、存在不恰當?shù)睦嫦嚓P者制度權配置、內(nèi)部控制體系不夠健全等。本文提出要設計利益相關者行使內(nèi)部控制制度權,然后結(jié)合公立醫(yī)院現(xiàn)狀,以企業(yè)內(nèi)部控制五要素(風險評估、控制環(huán)境、信息與溝通、控制活動、監(jiān)督)為參考,構(gòu)建公立醫(yī)院內(nèi)部控制制度要素。以安徽省立醫(yī)院的內(nèi)部控制制度為例進行了分析,提出從五個方面加強內(nèi)部控制體系建設,分別為:成本費用內(nèi)部控制制度、貨幣資金內(nèi)部控制制度、醫(yī)療糾紛內(nèi)部控制制度、采購管理內(nèi)部控制制度、服務質(zhì)量內(nèi)部控制制度。針對安徽省立醫(yī)院在內(nèi)部控制有效性方面存在的突出問題,提出了相應的內(nèi)部控制有效性促進建議,包括:完善問責機制、合理建立健全權力配置、加強醫(yī)院的內(nèi)部監(jiān)督、加強信息的溝通與交流、加強控制活動與內(nèi)部控制環(huán)境建設、提高全員風險控制意識等。
[Abstract]:Under the background of vigorously promoting the reform of medical system, the internal competition in the medical industry is becoming more and more intense, and all the domestic hospitals are facing more severe challenges. In order to seek better survival and development space and improve the competitiveness of hospitals, some public hospitals have chosen the way of multi-hospital development. However, due to the lack of effective internal control system, high cost of coordination, communication and control among various departments in hospitals, slow decision-making, low executive power, unreasonable human resource policies and implementation are often caused by the lack of effective internal control system. Internal control issues such as inadequate internal oversight and weak audit. In order to ensure the competitiveness of public hospitals in the market competition, it is necessary to perfect the internal control system of public hospitals, strengthen management and establish a set of internal control system suitable for public hospitals. Based on stakeholder theory and property right theory, this paper investigates and analyzes the present situation of the internal control system of Anhui provincial hospital by combining theoretical analysis with case analysis. The results show that the framework of the internal control system of Anhui Provincial Hospital is not perfect, there are improper allocation of institutional rights of stakeholders, and the internal control system is not perfect enough. This paper proposes that stakeholders should be designed to exercise the right of internal control system, and then take the five elements of enterprise internal control (risk assessment, control environment, information and communication, control activities, supervision) as the reference, combined with the current situation of public hospitals. Construct the elements of public hospital internal control system. Taking the internal control system of Anhui provincial hospital as an example, the paper puts forward five aspects to strengthen the construction of internal control system, namely: cost and expense internal control system, monetary fund internal control system, medical dispute internal control system. Procurement management internal control system, service quality internal control system. In view of the outstanding problems existing in the effectiveness of internal control in Anhui provincial hospitals, the paper puts forward the corresponding suggestions for promoting the effectiveness of internal control, including: perfecting the accountability mechanism, rationally establishing and perfecting the allocation of power, and strengthening the internal supervision of hospitals. Strengthen the communication and exchange of information, strengthen the construction of control activities and internal control environment, improve the risk control consciousness of all staff.
【學位授予單位】:首都經(jīng)濟貿(mào)易大學
【學位級別】:碩士
【學位授予年份】:2017
【分類號】:R197.322
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