卫生事业单位经济合同的监督管理

我们所说的经济合同,主要指卫生事业单位(包括各级医院)以书面形式同其他单位或个人签订的购物合同、劳务合同、工程项目合同等,还包括单位与内部科室及职工个人签订的经济承包协议、医院病人医药费用结算合同等。在经济活动中,由于合同本身内容不细致、不明确、不合法等原因造成合同不能执行或合同无效而引起纠纷并不少见,单位风险损失时有发生。因此,加强对经济合同的监督管理势在必行。     

谈医院经济合同的监督管理

加强经济合同的监督管理,对规范医院经济行为,减少医疗市场风险,提高经济效益,促进医院发展有着十分重要的意义。 1.医院经济合同的种类和形式 医院的经济合同,主要指医院对外签订的购物合同、劳务合同、租赁合同等,合同一经确立,就具有一定的法律效力。 2.医院签订的经济合同的前提条件 (1)医院的一切经济活动必须符合法律法规和上级部门的有关政策、规定。 (2)医院的重大经济活动必须经医院院务委员会研究,并     

刍议医院合同审计

合同审计属于内部审计工作的重要组成部分。随着社会主义市场经济和医疗事业的发展,医院的各种经济活动不断增加,对外签订经济合同的数量也随之增多,合同审计作为内部控制体系的重要手段却仍处在尝试摸索阶段。合同审计就是对合同的真实性、合法性和效益性进行审核检查,     

加强经济合同管理的实践与探索

面对激烈的医疗竞争环境,医院对外业务愈来愈多,经济合同的签订工作大量增加.为保证签订的经济合同既能维护医院合法权益,提升医院信用;又能规避合同风险,防范经济纠纷,就必须加强对经济合同的管理.     

医院在审核、签订和监督经济合同时应注意的问题

随着社会主义市场经济体制的建立和完善,社会各经济主体之间的关系日趋契约化。合同是市场经济中最普遍、基本的契约形式,医院的经济业务活动主要是以签订经济合同的形式实现的。因此,经济合同管理已成为医院经济管理的重要组成部分。     

医院经济合同的内部审计

随着社会发展,人民群众法制意识的增强以及医院经济活动的增多,经济合同的审计也逐渐成为审计部门的一项重要工作,医院加强了合同管理,规范了签订程序.     

内部审计监督在医院经济合同管理中的实践应用

目的:以实践证明内部审计监督在医院经济合同管理中的重要作用。方法:从加强经济合同监督管理入手,介绍芜湖二院在合同管理工作中如何利用审计部门的监督,保障经济活动正常运行。结果:增强了医院各相关部门合同管理和风险意识,促进合同管理规范化、制度化。结论:通过内部审计监督,完善合同管理制度,降低财务风险,提升了财务管理精细化水平。     

公立医院智能化合同管理的研究与思考

公立医院高质量发展背景下,合同管理作为贯穿公立医院各类业务活动的关键,是内部控制和风险防范的重点.本文通过调研,分别针对合同签订前、签订阶段、执行阶段、执行后管理阶段,分析医院智能化合同管理的关键风险点,对拓展智能化技术在公立医院合同管理中的应用提出初步设计.     

探析医院经济合同管理

随着市场经济和医疗事业的发展,经济合同作为医院对外开展各类经济活动的基本载体,其重要性不言而喻。就如何通过制度的完善和机构的健全等措施来加强医院的合同管理进行了探析,提出了实行包括合同签订前、订立时、执行中和终结后的全过程监督管理,以达到规范医院的经营行为,提高经济效益,防范市场风险,维护医院权益的最终目的。     

谈卫生部门内部审计制度的改革

一、卫生部门内部审计制度存在的主要问题近几年来,上级主管部门为了加强内部审计工作,曾先后推出一系列改革措施,如:要求各医院设置科级专职审计员;赋予内部审计人员检查审计各个与财务有关的部门的权力;参与经济合同的签订等等,但效果甚微。     

探讨大型公立医院经济合同审计的风险识别与控制措施

随着近年公立医院规模的不断扩大,其经济活动无论从金额还是种类上都呈上升趋势,对外签订的合同数量及复杂程度也随之加大,因此医院急需完善合同管理流程,并从合同签订前、订立、履行三个阶段加强审计,识别其风险,采取有效控制措施,以规避风险、维护医院合法权益。     

医院经济合同管理策略研究

以上海地区医院为背景,分析公立医院经济合同管理存在的问题,从健全经济合同管理内控机制、完善经济合同管理制度、加大经济合同跟踪监管力度、加强内部审计监督四个方面,探讨经济合同管理策略,为公立医院内部控制工作提供参考。     

Capitation: strategies for success with managed care contracts

With enrollments in HMOs increasing at double digit rates, independent practice associations, integrated medical groups, hospitals and specialty networks are experiencing a substantial increase in the share of their business paid for through capitation. Experience has shown that once one contract is signed, many are sure to follow. Providers must make sure each contract signed is financially sound for the organization. Then they must be able to manage and monitor contracts long after the ink is dry. This column provides a brief overview ad list of pointers for organizations moving into the managed care arena.     

医学科研合同的法律定性及风险防范

医学科研合同因所依托的项目不同,有横向科研合同和纵向科研合同之分,两类合同法律性质如何,直接决定所适用的法律和发生争议时的法律救济途径。医学科研合同的法律定性及签约时的风险防范是本文研究的重点。     

483家职业病危害企业劳动合同和工伤保险现状调查

目的 了解楚雄州483家职业病危害企业劳动合同和工伤保险签订情况,为保障劳动者合法权益提供依据。 方法 根据楚雄州职业病危害调查的方案,对职业病危害企业的劳动合同和工伤保险现状进行调查。 结果 楚雄州共有职业病危害企业483家,签订劳动合同的企业398家,占82.40%;劳动合同签订人数33 227人,签订率为88.68%;合同中有职业病危害内容的企业数占63.82%,合同终止或解除后进行备案的企业数占59.80%,签订集体合同的企业数占39.45%。参加工伤保险的企业391家,占80.95%,实际参保人数34 358人,参保率为96.18%。不同地区、不同企业规模、不同经济类型、不同行业职业病危害企业之间劳动合同签订率比较,差异均有统计学意义(χ2=2 637.07、1 407.15、2 531.07、845.76,P < 0.01);不同地区、不同企业规模、不同经济类型、不同行业职业病危害企业之间工伤保险参保率比较,差异亦均有统计学意义(χ2=2 154.05、334.04、615.87、416.77,P < 0.01)。 结论 楚雄州职业病危害企业劳动合同签订和工伤保险参保状况不容乐观,建议加大对职业病危害企业的监管力度,督促企业为工人签订合法的劳动合同和购买工伤保险。     

The Characteristics of an Effective Physician–Hospital Working Relationship: An Exploratory Study

The working relationship between a private practice physician, whose medical practice was acquired by a health system, and the health system that sponsored the medical practices was studied using a dyadic perspective and drawing from agency theory to identify those characteristics that are present in an effective working relationship. In-depth interviews with currently employed physicians and those whose contracts were terminated within the last 3 years were used to identify why some working relationships failed and others succeeded. Hospital administrators and practice managers that provided the support services to the acquired medical practices were also interviewed for their assessment of the working relationship. As a result of the research, a model for developing an effective working relationship is presented to be considered as a framework for developing future working relationships. Based upon the data, this study posits that the physicians and the hospitals can have a more effective working relationship if specific characteristics are evident before, during, and after the contract is signed. Understanding the factors that contribute to an effective working relationship can help in designing contracts with physicians and better utilize resources at the physician private practice level, as well as at the hospital level.     

A socio-legal and economic analysis of contracting in the NHS internal market using a case study of contracting for district nursing

The introduction of an internal market in the National Health Service (NHS) in the United Kingdom necessitated the use of contracts between purchasers and providers. Little thought was given to the nature of these contracts by policy makers, who appeared to assume that the contracts could conform to the classical, complete model. This paper uses socio-legal and economic theories of contract (which provide an alternative model of relational contracts, in contrast to classical contracts) to explore how realistic that assumption was. An analysis of the institutional context in which the contracts were made is provided, including a legal analysis of the relevant legislation. Contracting by health authorities and GP fundholders is examined, using the results of a recent case study of contracting for district nursing services carried out in a health authority in Greater London. The results show that classical contracting is an inappropriate model for NHS contracts, but that relational contracting is not an entirely appropriate model either. Contracting was found to have increased the accountability of providers in respect of some financial matters, but not in respect of the quality of district nursing services. There are negative implications for the use of contracting in publicly financed health services--hierarchies may be more efficient (as lower transaction costs can be incurred) and possibly more effective in improving quality of care.     

Behavioural contracting as a tool to help patients achieve better health.

Behavioural contracting is an intervention technique in which a client signs an agreement to make certain behaviour changes within a specified time, usually with explicitly defined rewards for adherence or success. Contracting is being increasingly used by health professionals to assist patients in making beneficial life style changes. This paper presents data on the outcome of behavioural contracting interventions to lower serum cholesterol and to increase exercise activity. Of 223 primary care patients enrolled in a health promotion programme, 179 met with the project health educator to improve their cardiovascular risk profile; 144 of these were classified as having 'high cholesterol' and 51 signed contracts to adopt the American Heart Association guidelines diet within a 3-month period. Everyone was encouraged to sign a contract to engage in aerobic exercise three times per week; 96 did so. The results indicate that contractors achieved greater beneficial health changes than non-contractors, and that the group which fully met their contract obligations experienced the greatest health benefit of all (either a lowering of cholesterol or a decreased exercising heart rate).     

Marginal employment and health in Britain and Germany: does unstable employment predict health?

This study examines the possible health impact of marginal employment, including both temporary and part-time employment schemes. It addresses three research questions: (1) Are employed people with a fixed-term contract or no contract more likely to report poor health than those who hold jobs with permanent contracts? (2) Are part-time employed respondents (even when they hold jobs with permanent contracts) more likely to report poor health than full-time workers? (3) Does change in employment stability (i.e., from employment with permanent contract to fixed-term or no contract employment and vice-versa) have an impact on health status? Logistic regression models were used to analyze panel data from Britain and Germany (1991-1993), available in the Household Panel Comparability Project data base. We included 10,104 respondents from Germany and 7988 from Britain. A single measure of perceived health status was used as the dependent variable. Controlling for background characteristics, the health status of part-time workers with permanent contracts is not significantly different from those who are employed full-time. In contrast, fulltime employed people with fixed-term contracts in Germany are about 42 per cent more likely to report poor health than those who have permanent work contracts. In Britain, only part-time work with no contract is associated with poor health, but the difference is not statistically significant. We conclude that monitoring the possible health effects of the increasing number of marginal employment arrangements should be given priority on the social welfare research agenda.