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新《医院财务制度》规定非独立法人运营的医院食堂其财务核算需并入医院大账,基于新制度中对食堂的财务管理、成本控制及相关会计实务处理鲜有论述,笔者从浦东新区人民医院的实际情况出发,从食堂的物资流转、收支核算、经济考核等方面探讨建立完善的食堂财务管理体系及有效的会计实务操作。 相似文献
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目的 探讨福田区某综合医院 1998~ 2 0 0 3年发展过程中 ,医院经营管理情况、存在问题和今后发展的对策。方法 运用收支平衡分析法 ,计算医院工作量平衡点和业务收入平衡点。结果 通过对该医院 6年内的成本 -业务量 -效益分析 ,发现如果不考虑财政补助 ,医院不能实现收支平衡 ,考虑财政补助 ,医院基本实现收支平衡有结余。讨论 目前政府财政补助对非营利性医院的补偿是必要的 ,多数公立医院在成本控制方面较薄弱 ,对该医院实现收支结余 ,提出几点建议。 相似文献
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医院预算管理存在的问题与解决方案 总被引:2,自引:0,他引:2
医院预算是医院对未来经营活动的资金安排,是根据医院事业发展计划和任务编制的年度财务收支计划;是医院未来各项业务活动的财力保证;是医院财务管理的基本依据。在市场经济条件下,做到有计划地聚财、用财,以收定支,是提高医院资金利用效率必不可少的手段。加强预算管理有利于国家方针、政策的贯彻落实,有利于实现收支平衡,有利于提高医院的财务管理水平,有利于医院经营目标的实现。 相似文献
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浅议如何加强医院基础财务管理 总被引:3,自引:0,他引:3
改革开放30年来,医院财务管理逐步从粗放型管理发展到目前的现代化管理,无论是在管理内涵、管理手段,还是在管理效果方面,都有了质的飞跃。但这些管理改革突出体现在为提高职工积极性而进行的内部核算、劳务分配方面,忽视了医院基础财务管理改革,使医院服务成本长期居高不下。要想改变这种状况,只有加强基础财务管理,强化成本控制,建立一套比较完善、严谨、科学、合理的内部控制体系,实现社会效益和经济效益双丰收。 相似文献
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目的:介绍医院在实施全面预算管理中的关键环节及控制措施。方法:以新《医院财务制度》为依据,以《中华人民共和国预算法》为准绳,结合实际工作,总结全面预算管理中所涉及关键环节并提出控制措施。结果:通过实施全面预算管理逐步降低医院成本,合理配置资源,提高资金使用效率,保证医院战略目标的实现。结论:全面预算管理作为一项重要的经济管理手段,对完善医院内部财务控制、提高财务管理水平发挥着重要作用。 相似文献
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我国城镇职工基本医疗保险费用结算办法现状及对策研究 总被引:5,自引:0,他引:5
医保基金收支平衡是基本医保制度建立成功与否的标志,此目标实现的基础是要通过制定科学合理的结算办法,并与医院以签署协议的方式来做为保证,以此形成医院以及参保人员的自我约束和监督机制。在分析我国目前各地医保管理机构现行结算办法利弊的基础上,提出了通过制定完善的结算办法来实现基金收支平衡的一些对策和措施,探讨通过对医院分类管理,有效的信息化支持,完善具体结算办法以及其他配套政策等方面来实现“医、保、患”三赢的对策研究。 相似文献
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This study measures the impact of information technology (IT) use on hospital operating costs during the late 1980s and early 1990s. Using a proprietary eight-year panel dataset (1987–1994) that catalogues application-level automation for the complete census of the 3000 U.S. hospitals with more than 100 beds, this study finds that both financial/administrative and clinical IT systems at the most thoroughly automated hospitals are associated with declining costs three and five years after adoption. At the application level, declining costs are associated with the adoption of some of the newest technologies, including systems designed for cost management, the administration of managed care contracts, and for both financial and clinical decision support. The association of cost declines with lagged IT as well as the cost patterns at the less automated hospitals both provide some evidence of learning effects. 相似文献
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While many hospitals are under pressure to become more cost efficient, new costing systems such as activity-based costing (ABC) may form a solution. However, the factors that may facilitate (or inhibit) cost system changes towards ABC have not yet been disentangled in a specific hospital context. Via a survey study of hospitals, we discovered that cost system development in hospitals could largely be explained by hospital specific factors. Issues such as the support of the medical parties towards cost system use, the awareness of problems with the existing legal cost system, the type of contract for the physician's internal financial agreement, should be considered if hospitals refine their cost system. Conversely, ABC-adoption issues that were found to be crucial in other industries are less important. Apparently, installing a cost system requires a different approach in hospital settings. Especially, results suggest that hospital management should not underestimate the interest of the physician in the process of redesigning cost systems. 相似文献
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Growing evidence has demonstrated that informal fees for health services comprise a large proportion of total health spending in some countries. In 1999, individual out-of-pocket payments for health in Cambodia were estimated at 27 US dollars per person, with a proportion paid as under-the-table fees at public facilities. By formalizing such payments and implementing resource management systems within a comprehensive health financing scheme, Takeo Referral Hospital controlled out-of-pocket patient expenditures, ensured patients of fixed prices, protected patients from the unpredictability of hospital fees and promoted financial sustainability. Utilization levels increased by more than 50% for inpatient and surgical services, and cost recovery from user fees averaged 33%. Furthermore, the hospital phased out external donor support gradually over 4 years and achieved financial sustainability. 相似文献
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徐峥杨中浩张天黄玲萍 《中国卫生质量管理》2023,(1):008-11
目的 从办医主体视角,提出促进公立医院财务管理数字化转型的路径和建议。方法 梳理公立医院财务管理面临问题及原因,以上海市级医院为例,从财务数字化转型切入,总结提升公立医院运营管理效能的举措。结果 集中统一建立会计核算、成本核算和智能分析平台,从而规范医院会计基础核算、规范成本核算路径、强化运营分析评价和加强数据质量控制,强化预算管理、提升成本效率、增强业财融合。结论 办医主体推动公立医院财务管理转型中,需要兼顾不同管理层级和医院业务特点选择系统建设模式,还需从持续加强数据质量控制,构建具有实效的指标评价体系等方面继续努力。 相似文献
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Prospective payment schemes in health care often include supply-side insurance for cost outliers. In hospital reimbursement,
prospective payments for patient discharges, based on their classification into diagnosis related group (DRGs), are complemented
by outlier payments for long stay patients. The outlier scheme fixes the length of stay (LOS) threshold, constraining the
profit risk of the hospitals. In most DRG systems, this threshold increases with the standard deviation of the LOS distribution.
The present paper addresses the adequacy of this DRG outlier threshold rule for risk-averse hospitals with preferences depending
on the expected value and the variance of profits. It first shows that the optimal threshold solves the hospital’s tradeoff
between higher profit risk and lower premium loading payments. It then demonstrates for normally distributed truncated LOS
that the optimal outlier threshold indeed decreases with an increase in the standard deviation.
相似文献
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After undergoing many changes, the financing of health care in countries of the former Soviet Union is now showing signs of maturing. Soon after the political transition in these countries, the development of insurance systems and fee-for-service payment systems dominated the discussions on health reform. At present there is increasing emphasis on case mix adjusted payments in larger hospitals and on global budgets in smaller district hospitals. The problem is that such systems are often mistrusted for not providing sufficient financial control. At the same time, unless further planned restructuring is introduced, payment systems cannot on their own induce the fundamental change required in the health care system. As described in this article, in Tejen etrap (district), Turkmenistan, prospective business plans, which link planned objectives and activities with financial allocations, provide a framework for setting and monitoring budget expenditure. Plans can be linked to the overall objectives of the restructuring system and can be used to ensure sound financial management. The process of business planning, which calls for a major change in the way health facilities examine their activities, can be used as a vehicle to increase awareness of management issues. It also provides a way of satisfying the requirement for a rigorous, bottom-up planning of financial resources. 相似文献
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Boyd H. Gilman PhD 《The Journal of rural health》2008,24(4):400-406
ABSTRACT: Context: While the Medicare Critical Access Hospital (CAH) program has improved the financial viability of small rural hospitals and enhanced access to care in rural communities, the program puts beneficiaries at risk for paying a larger share of the cost of services covered under the Medicare part B benefit. Purpose: This paper examines the impact of hospital conversion to CAH status on beneficiary out‐of‐pocket coinsurance payments for hospital outpatient services. Methods: The study is based on a retrospective observational design using administrative data from Medicare hospital cost reports and fee‐for‐service beneficiary claims from 1999 to 2003. The study compares changes in beneficiary co‐payments before versus after CAH conversion with payment trends among small rural non‐converting hospitals over the same period. Findings: Conversion to CAH status is associated with an increase in beneficiary coinsurance payments per outpatient visit of $17.19, equivalent to 34% of the sample average. However, CAH designation had no significant effect on the share of outpatient costs paid by the beneficiary. Most of the increase in beneficiary liability associated with conversion is attributable to the provision of more services per outpatient visit. Conclusions: While this and other studies show that conversion to CAH status results in more intensive outpatient care, CAH conversion does not appear to inadvertently create financial barriers to accessing ambulatory services in remote rural communities by forcing beneficiaries to pay a higher share of their Medicare part B costs. 相似文献
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新的《医院财务制度》和《医院会计制度》(以下简称“新制度”)的实施为医院的改革与发展提供了新的机遇。医院应以此为契机,认真贯彻落实“新制度”,完善分配方式,增加积累;加强成本核算,制定科学合理的成本标准;严格财产物资管理,确保国有资产安全;减少投资风险,提高投资效益。医院只有解决好这些问题,才能真正实现健康发展。 相似文献