安徽省立医院内部控制改进研究

发布时间：2018-05-30 00:04

本文选题：公立医院 + 内部控制制度　；参考：《首都经济贸易大学》2017年硕士论文

【摘要】：在大力推进医疗制度改革的背景下,医疗行业内部竞争逐渐趋于白热化,国内各大医院都面临着更严峻的挑战。为寻求更好的生存和发展空间,提高医院的竞争力,一些公立医院选择了多院区的发展之路。但医院规模的扩大,往往会因为缺乏有效的内部控制系统,带来医院内部各部门间协调、沟通和控制的高成本,出现决策缓慢、执行力低下、人力资源政策及实施不合理、内部监督不到位及审计薄弱等内控方面问题。针对这些问题,为了保证公立医院在市场竞争中的竞争力,就必须完善公立医院的内部控制制度,加强管理,建立一套适合公立医院的内部控制系统。本文基于利益相关者理论与产权理论,采用理论分析与案例分析相结合的研究方法,对安徽省立医院的内部控制体系现状进行调研与分析,结果表明:安徽省立医院的内部控制体系框架不够完善、存在不恰当的利益相关者制度权配置、内部控制体系不够健全等。本文提出要设计利益相关者行使内部控制制度权,然后结合公立医院现状,以企业内部控制五要素(风险评估、控制环境、信息与沟通、控制活动、监督)为参考,构建公立医院内部控制制度要素。以安徽省立医院的内部控制制度为例进行了分析,提出从五个方面加强内部控制体系建设,分别为:成本费用内部控制制度、货币资金内部控制制度、医疗纠纷内部控制制度、采购管理内部控制制度、服务质量内部控制制度。针对安徽省立医院在内部控制有效性方面存在的突出问题,提出了相应的内部控制有效性促进建议,包括:完善问责机制、合理建立健全权力配置、加强医院的内部监督、加强信息的沟通与交流、加强控制活动与内部控制环境建设、提高全员风险控制意识等。
[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.
【学位授予单位】：首都经济贸易大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.322

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