基于因子分析的公立医院债务风险模型构建及实证研究

目的：建立医院债务风险模型,分析公立医院的债务风险现状,为医院防范债务风险提供参考。方法：以广东省600家公立医院为样本,提取25个指标的数据并标化处理,通过因子分析和验证,构建了基于7个公共因子的债务风险模型。结果：模型所计算公立医院的综合得分能符合专业解释,能较好地反映了公立医院债务风险水平的影响因素,包括财政投入水平、医院类型、所属层级等。结论：模型具有较高的有效性;应正确看待医院债务问题,并通过多方协同,把握原则,有效化解公立医院债务风险。     

我国公立医院债务融资的现状、成因和治理策略

公立医院债务融资是当前深化公立医院管理体制改革中一个迫切需要研究的问题.本文根据债务融资理论与原理,分析我国公立医院债务融资的现状,在讨论其产生原因的基础上上,从完善对公立医院的投入和监管机制、控制负债规模、保持合理的负债结构、拓宽公立医院投融资渠道、实施对外业绩信息发布制度、建立明晰的领导任期内经济责任制等方面提出了完善公立医院债务融资的政策建议.     

广东省县级公立医院的负债情况与化解机制

目的:研究分析广东省县级公立医院的债务状况以及地方政府的相对偿债能力,探讨有效的债务化解机制。方法:在可利用的公开统计公报数据基础上,设计县级公立医院债务和地方政府偿债能力的调查问卷,进行实地调查研究,通过SPSS17.0软件对数据进行整合分析。结果:广东省不同县级公立医院负债绝对值差异很大,平均资产负债率较高且占当地财政收入比率较低,大部分医院不能达到经费自给,地方政府对医院的投入占财政收入的比例非常小。结论:县级公立医院负债经营不利于公益性价值的实现,需要建立有效的债务化解机制,其中最为重要的是客观面对地方政府财政能力有限的现实,要通过债务重组、绩效管理和医院改制等方式逐步和妥善化解医院债务。     

对公立医疗机构化债分类指导

正当前,随着取消以药补医改革的深入,医院赢利能力下降,全国公立医院负债的情况是非常严重的,特别是城市医院在前十几年的发展中举债建设情况十分普遍,债务的累计已接近当年卫生总费用35379亿元的6.6%。因此,提出是否需要统一由政府来化解公立医院建设性债务,来保证公立医院在我国     

谈医院债务重组的会计核算

随着社会主义市场经济体制的逐步完善,企业之间竞争更趋激烈,一些企业可能因为经营不善等原因陷入财务困难,难以偿还到期债务,包括拖欠医疗单位的医疗费。随着医疗市场竞争的日益激烈,一些医院也出现了财务困难,到期债务无法偿还,由于存在上述原因,医院也会发生债务重组。 债务重组,是在债务人发生财务困难的情况下,债权人按照其与债务人达成的协议或法院的裁定作出让步的事项。其特点为:(1)是在债务人持续经营条件下进行的;(2)是在债务人发生财务困难情况下进行的;(3)是在债权人作出让步的情况下进行的。其结果是债务人获得债务重组收益,而债权人发生债务重组损失。笔者根据《企业会计准则——债务重组》,结合医院会计制度,仅从现金和非现金资产债务重组两个方面谈谈医院债务重组的会计核算。     

公立医院参与医疗服务领域供给侧结构性改革研究

本文分析了我国医疗服务领域结构性问题在公立医院的主要表现,包括深层次体制机制矛盾和负债扩张后的资源利用低效问题。依据公立医院改革政策文件,提出了公立医院参与医疗服务领域供给侧结构性改革的路径:化解公立医院历史债务,控制财务和财政风险;严格公立医院成本控制,遏制费用不合理增长,提供可负担的服务;改革管理体制和运行机制,补偿监管到位,健全公立医院治理体系;加强公立医院与基层、社会资本的联系,整合医疗产业链,扩大优质医疗资源供给。     

万亿元债务如何化解

正近期,在对外公布的《国务院关于深化医药卫生体制改革工作进展情况的报告》中显示,截至2014年年底,全国8677家政府办公立医院长期负债合计2333亿元,其中地市以上医院占52%、区级医院占9%、县级医院占39%,此报告揭开了公立医院长期债务的面纱。那么,公立医院万亿元债务如何化解?     

各地

重庆公立医院改革年内全覆盖
　　近日召开的重庆市卫生计生工作会透露,今年将把尚未实施改革的12个区的公立医院和市属医院纳入改革范围,实现除重庆医科大学教学医院、部队医院外,公立医院改革全覆盖。该市将进一步完善药品零差率补偿办法,区县医院通过药事服务费（财政、医保分担）、调整部分医疗服务价格的方式予以补偿,市属医院通过调整医疗服务价格、适当财政补助的方式予以补偿,将公立医院历史债务纳入政府管理并逐步予以化解;深化人事薪酬制度改革,在市属医院试点探索编外人员编制备案制,试点探索县级公立医院院长年薪制。     

北京市区县妇幼保健机构偿债能力综合评价

偿债能力是指医院偿还各种到期债务的能力。偿债能力的大小是衡量一个医院财务状况好坏的重要标志，医院只有具备足够偿债能力的前提下，才能保证到期债务的及时偿还并具有持续经营的基础。反映偿债能力的指标按照时间的长短分为两类：一类是反映一年内债务清偿能力的指标，     

湖北省县级公立医院改革试点医院经济运行状况分析

目的:了解湖北省县级公立医院改革试点医院2009—2011年经济运行状况及其中存在的问题。方法:通过定性与定量﹑描述分析与对比分析等方法,研究经济运行现状及其变化发展趋势。结果:湖北省县级公立医院改革试点医院总体经济运行基本平稳,创收能力增强,偿债能力﹑运营能力和经营效率较低。结论:湖北省县级公立医院存在债务负担较重﹑政府投入不足﹑经营效率低下等问题,提出了控制负债规模﹑限制县级医院规模﹑增加政府投入等政策建议。     

公立医院负债经营的风险规制

公立医院处于快速发展的新时期,面对迫切的资金需求,银行贷款等资金的注入突破了医院发展中的资金"瓶颈",但过度负债经营也将带来风险。本文通过了解公立医院负债经营的现状,分析了负债经营的制度、行为等失范的表现,探析了公立医院负债经营需要防范的财务、市场等风险,从构建公立医院负债风险分析指标体系及预警机制、严格控制基础设施建设和大型医用设备配置等视角,探寻其负债经营的风险规制策略,以促进医院协调、健康和可持续发展。     

黑龙江省公立医院运行现状与发展趋势研究

目的了解黑龙江省公立医院的发展现状与未来公立医院的发展趋势。方法根据黑龙江省公立医院的相关数据,利用定性与定量、对比的分析方法,研究2009—2011年黑龙江省公立医院的发展现状与未来发展趋势。结果黑龙江省公立医院的外延在不断扩大;医院门诊及住院的收费水平在不断的提高;药品收入的比值略有降低,但仍然占有很大的比例;医院负债率的增长也非常迅速。结论应该调整政府财政补偿力度与着重点,改变公立医院现有的收入结构,促进公立医院健康稳定的发展。     

Are the nation's hospitals facing a capital crisis?

Are hospitals facing a capital crisis? Wall Street is taking a long, hard look at hospitals' bottom lines--and many analysts don't like what they see. Hospitals' increasing reliance on long-term debt, lower debt-service coverage ratios, and weakening performance indicators all signal a potentially volatile situation for some sectors of the field. Which hospitals are at risk? Experts point to hospitals in Southern California and New York. But others say that hospitals in moderate-size cities with 250 beds and $40 million or more in long-term debt are vulnerable. However, 40 percent of the 600 CEOs who responded to our Hamilton/KSA survey agree that the continued erosion of reimbursement will require a government bailout similar to the savings and loan industry. "A great deal depends on public policy," says Darrel Brownell, executive vice-president and chief financial officer, Memorial Health Services, a two-hospital system based in Long Beach, CA. "The government has the ability to maintain the industry in a stable condition, or it has the ability to force it into a bailout situation."     

IRS is making it easier for hospitals to borrow tax-exempt working capital

Updated regulations recently issued by the Internal Revenue Service spell out how hospitals and other not-for-profit borrowers can issue debt to boost their cash flow. While hospitals probably won't be rushing out to borrow money for working capital, the new rules will provide significant help for facilities. They clarify several issues that had confused hospitals in the past and will give them more latitude in the future.     

Debt Change and Marital Satisfaction Change in Recently Married Couples*

Abstract: Although recently married couples report debt as one of their top concerns, research has not measured how debt changes relate to changes in their marital satisfaction. Further, the mechanisms that link debt and marital satisfaction are unknown. Findings using the National Survey of Families and Households (N= 1,078 couples) demonstrated that consumer debt changes predicted recently married couples’ marital satisfaction changes. Changes in variables associated with couples achieving their marital expectations (e.g., spending time together, arguing about finances) partially explained these findings. Changes in consumer debt negatively predicted couples’ time together and positively predicted arguments over money, which in turn were both associated with declines in marital satisfaction.     

To centralize or not centralize

Not-for-profit systems increasingly are turning to centralized management systems in an effort to reduce duplication of services at local hospitals and to save money. At the same time, some for-profit systems are abandoning their traditional centralized philosophies and are eliminating services provided by the corporate office, often as a result of having to shoulder heavy debt loads.     

基于灰色关联度方法的内蒙古直属公立医院经济运行分析

目的:研究内蒙古自治区直属公立医院经济运行情况,分析存在问题并提出解决对策。方法:利用内蒙古自治区10家直属公立医院卫生财务年报数据,采用灰色关联度方法对其经济运行情况进行分析。结果:内蒙古自治区直属公立医院经济运行状况明显改善,但收支结构不合理,营利能力不强;债务负担较重、财务风险较大;资产运营能力较弱,医院发展后劲不足。结论:调整医疗服务价格,提高运行效率;控制负债规模,减少规模扩张;提高资产运营能力,保持医院良性发展。     

Income levels of bad-debt and free-care patients in Massachusetts hospitals.

This study disputes the common notion that many hospitalized patients whose expenses are written off to bad debt are able to pay their bills. By matching 1996 state tax returns to more than 350,000 bad-debt and free-care claims at seven Massachusetts hospitals, we found that most patients involved had incomes below the federal poverty level and thus were presumably eligible for either public programs or hospital-based free care. This suggests that hospitals and public officials need to investigate further why low-income, uninsured patients are not receiving benefits for which they are eligible. Our results also suggest that measurements of indigent care levels in hospitals for purposes of research or regulation should include some portion of bad debt.