A公立医院绩效审计案例研究

发布时间：2018-03-18 11:22

本文选题：绩效审计　切入点：公立医院　出处：《中国财政科学研究院》2017年硕士论文　论文类型：学位论文

【摘要】：医改自2009年来一直是我国高度受重视的民生问题,公立医院作为我国医疗卫生系统中的主干,其改革更是重中之重。国务院2016年4月发布了《深化医药卫生体制改革2016年重点工作任务》再次使医改进入高潮期。公立医院改革取得明显效果,但仍存在医疗费用不合理增长、医院人事制度和薪酬制度不完善、药品和医用耗材价格虚高等问题。公立医院由于自身的公益性和广泛性,其运营的终极目的是满足人们对医疗服务的需要,承担着一定的社会责任,因此,政府有必要提高其运营效率和效果来保证服务质量。绩效审计作为政府监管公立医院的有效手段,不仅有助于医疗服务质量的提高,而且帮助核实国家相关政策的有效落实。审计署为配合“十三五”规划在《“十三五”国家审计工作发展规划》中指明要强化对医药卫生领域的审计,进一步支持对公立医院的绩效审计。我国对公立医院绩效审计是随着2009年医改的推进而发展起来,且随着社会的进步在一步步前进,但绩效审计现状仍存在开展的基础薄弱、绩效审计评价指标体系不完善、绩效审计发展程度不一和绩效审计结果公告力度不够的问题。公立医院角色的重要性、新医改的推动性和我国现阶段公立医院绩效审计现状存在的问题,使得对公立医院绩效审计的研究成为热点和难点。我国相关的审计研究不多,联系案例分析解决问题的则更少,公立医院绩效审计仍然处在探索改进阶段。因此,联系案例分析我国公立医院绩效审计的不足,并在总结问题的基础上提出有针对性的审计建议,有利于进一步探索和深化公立医院绩效审计,促进其发展。本文首先介绍了国内外相关文献综述,然后简要介绍了公立医院绩效审计的含义,特点、审计目标、审计内容和程序方法等基本内容,在联系现状分析其存在的问题的基础上,通过案例分析进一步论证和分析公立医院绩效审计存在问题及成因,最后提出几点建议:一是提高绩效审计配备,包括增加外聘专家和引进计算机人才;二是加强后续跟综审计;三是扩展审计内容,包括转向“5E”审计、加强HIS系统审计和政策执行审计;四是增加内部控制审计指标;五是引入数据包络分析法。本文的不足主要表现在:首先,由于自身查阅资料的范围局限性,总结的内容不够完整,会影响本文的研究效果。其次,本文是在现状分析和案例分析问题的基础上提出改进建议,但由于本人对该部分的知识存在很多不足,因此分析仍然很不完善。除此之外,由于资料的局限性,本文的审计对象是一所二甲公立医院,而不同的医院自身的情况不同,提出的改进建议的普遍适用性仍有待检验。
[Abstract]:Since 2009, medical reform has been a highly valued livelihood issue in China. Public hospitals are the backbone of the medical and health system in our country. On April 2016, the State Council issued the key tasks of deepening the reform of the medical and health system on 2016, which once again brought the medical reform into a period of high ebb. The reform of public hospitals has achieved remarkable results. However, there are still some problems such as unreasonable increase of medical expenses, imperfect personnel system and salary system of hospitals, false price of drugs and medical consumables, and so on. The ultimate purpose of its operation is to meet the needs of people for medical services and undertake certain social responsibilities. It is necessary for the government to improve its operational efficiency and effect to ensure the quality of service. As an effective means of government supervision of public hospitals, performance audit is not only helpful to improve the quality of medical services, but also to improve the quality of medical services. Moreover, to help verify the effective implementation of relevant state policies, the Audit Office, in line with the 13th Five-Year Plan, specified in the "13th Five-Year Plan" that it is necessary to strengthen the audit in the field of medicine and health. Further support the performance audit of public hospitals. The performance audit of public hospitals in our country developed with the development of medical reform in 2009, and with the progress of society, the current situation of performance audit is still weak. The evaluation index system of performance audit is not perfect, the degree of development of performance audit is different, and the announcement of performance audit results is not strong enough. The promotion of the new medical reform and the problems existing in the present performance audit of public hospitals in our country make the research on the performance audit of public hospitals become a hot and difficult point. There are fewer cases to solve the problems, and the performance audit of public hospitals is still in the stage of exploration and improvement. On the basis of summing up the problems, this paper puts forward some specific audit suggestions, which is helpful to further explore and deepen the performance audit of public hospitals and promote its development. Firstly, this paper introduces the domestic and foreign literature review. Then it briefly introduces the meaning, characteristics, audit objectives, audit contents and procedural methods of the performance audit of public hospitals, and analyzes the existing problems in connection with the current situation. Through the case analysis to further demonstrate and analyze the problems and causes of public hospital performance audit, finally put forward several suggestions: first, improve the performance audit equipment, including the increase of external experts and the introduction of computer talent; The second is to strengthen the follow-up audit, the third is to expand the audit content, including to turn to "5e" audit, to strengthen the HIS system audit and policy implementation audit; fourth, to increase the internal control audit index; Fifth, the introduction of data envelopment analysis. The main shortcomings of this paper are: first, due to the limitations of the scope of their access to data, the content of the summary is not complete, which will affect the results of this study. This paper is based on the analysis of the current situation and the case study, but because I have many deficiencies in the knowledge of this part, the analysis is still not perfect. In addition, due to the limitations of the data, The audit object of this paper is a No. 2 public hospital, but the situation of different hospital itself is different, the general applicability of the proposed improvement proposal still needs to be tested.
【学位授予单位】：中国财政科学研究院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.322;F239.4

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