公立医院财政项目支出预算管理探讨

目前,公立医院财政项目支出预算管理存在缺乏科学合理的立项,项目库建设滞后,预算执行与项目进度匹配度不够,绩效管理需要加强等问题。本研究介绍了公立医院财政项目支出预算管理政策,建议:事前进行充分的可行性论证,细化预算编制;事中以绩效监控为手段,严格预算执行管理,增强预算约束力;事后对财政项目执行结果进行追踪问效,与预算安排挂钩。     

医院财务预算管理浅谈

医院预算由收入预算和支出预算组成.收入预算包括:财政补助收入、上级补助收入、医疗收入、药品收入和其他收入.支出预算包括:医疗支出、药品支出、财政专项支出和其他支出.收入预算和支出预算是一个有机的预算整体,互为条件,互相依存,缺一不可,1999年1月1日执行的新的<医院财务制度>规定医院所有收支全部纳入预算管理,有利于医院统筹安排各项资金.     

公立医院财政补助支出预算绩效评价研究

预算绩效评价是新医改方案和新医院财务、会计制度对公立医院提出的要求。本文介绍了公立医院财政补助支出预算绩效评价的经济学和管理学理论基础,指出预算绩效评价公共选择理论、委托代理理论和新公共管理理论在公立医院财政预算管理中的应用。目前,预算绩效评价工作在公立医院处于起步阶段,管理制度体系不健全,需要加强理论研究,包括分项目绩效评价指标体系、评价方法,将评价结果作为以后年度财政预算安排的重要依据。     

浅探卫生监督工作中的项目核算及经费保障

为适应社会主义市场经济发展 ,规范和加强预算管理 ,国务院早在 2 0 0 0年就已批准财政部在中央部门试编部门预算。科学的预算分配制度使财政资金得以统一管理、监督和控制 ,使资源更优化配置 ,在一定程度上防止了预算的不透明性、不科学性和随意性 ;使财政分配与部门职能更好地结合 ,有效发挥财政的宏观调控。为抓住预算管理改革和卫生监督体制改革的有利时机 ,保证卫生监督执法的公正性和队伍的廉洁性 ,在经费方面监督和控制卫生监督执法工作开展 ,项目核算成为财务部门的一项重要工作。卫生监督体制改革后 ,卫生监督执法经费的来源是财政…     

新医院财会制度下的财政补助资金核算与管理

长期以来,一些医院将预算编制作为申请经费的工具,预算编制和执行“两张皮”,财政资金使用效益偏低。新《医院财务制度》强化了预算约束力度,新《医院会计制度》采用了兼顾财务管理与预算管理双目标、双基础的会计模式。医院财政补助资金规模大,拨付、使用、核算和管理有严格要求,应加强财政资金核算和管理,提高预算执行力和整体资金使用效率。     

新医院财务制度下的财政补助资金核算与管理

长期以来,一些医院将预算编制作为申请经费的工具,预算编制和执行“两张皮”,财政资金使用效益偏低。新《医院财务制度》强化了预算约束力度,新《医院会计制度》采用了兼顾财务管理与预算管理双目标、双基础的会计模式。医院财政补助资金规模大,拨付、使用、核算和管理有严格要求,应加强财政资金核算和管理,提高预算执行力和整体资金使用效率。     

浅谈新的《医院财务制度》

为适应社会主义市场经济的需要,规范医院财务行为,加强医院财务管理,促进医疗卫生事业健康发展,财政部、卫生部共同制定了新的《医院财务制度》(以下简称新《制度》),该制度是根据《事业单位财务规则》和国家有关法规,结合医院特点而制定的。新《制度》与旧《制度》相比,主要在以下方面进行了改革:1 预算管理办法的改革 新《制度》明确规定,国家对医院实行“核定收支、定额或定项补助、超支不补、结余留用”的预算管理办法,改变了过去“全额管理、差额补助、超支不补、结余留用”的预算管理办法。 “核定收支”就是医院要将全部收入包括财政补助收入和各项非财政补助收入与支出统一编制预算,报经主管部门和财政部门核定。 “定额或定项补助”就是根据医院收支情况,按照一     

基于HRP一体化管理的全面预算精细化管理研究与设计

目的 随着医院集团化发展,运营成本、资本支出逐渐加大,需要全面落实预算监管和考核力度。方法 结合医院预算管理的要求,进行全面预算编制,并在预算执行过程中引入多维度预算管控、项目预算闭环管理、预算执行路径管控,最后加强预算分析和考核,设计了全面预算精细化管理预算管理系统。结果 新预算系统上线,提高了预算编制的全面性和准确性,规范了医院运营支出、资本支出。结论 全面预算精细化管理,严格管理及控制医院资金支出,提高了资金使用效率,促进了医疗资源的有效配置,促进医院健康、稳步发展。     

论医院预算管理的作用

医院预算贯穿于医院财务活动的全过程，是医院财务管理的重要组成部分。但现在许多医院的预算管理流于形式，财务预算缺乏刚性，其主要原因是没有将预算管理提升为医院全局性管理行为，没有充分认识到预算管理在医院管理中的重要地位和作用。因此，有必要从管理的角度对预算管理的作用加以论述。本文认为预算管理在医院管理中的作用主要表现在以下几个方面：     

医院经济管理 第九讲 医院预算管理

我国国家预算是国家有计划地集中和分配资金的重要工具,是整个国民经济有计划按比例发展的重要保证。卫生事业单价位预算是国家预算的重要组成部分,医院是实行差额预算管理的卫生事业单位。加强医院预算管理,是贯彻执行国家预算的要求,它直接关系到医院建设和医院各项业务计划的完成,是加强医院经济管理的一个重要内容。一、我国的国家预算我国的国家预算,是社会主义国家为实现其职能,有计划地筹集和分配出国家集中掌握的财政资金的一个重要工具。国     

新《医院财务制度》中公立医院预算管理的优化分析

预算管理是医院财务管理的重要内容,但我国公立医院预算管理普遍存在着意识淡薄、体系不健全、预算编制范围不全等问题.为适应预算管理科学化、精细化的要求,新《医院财务制度》于2010年12月31日公布,明确提出医院要建立全面预算管理、建立健全预算管理制度.为配合新《医院财务制度》的有效实施、提高预算管理水平,医院可以采取措施有效地控制预算松弛、成立专门的预算管理组织机构及加强财务人员的培训.     

综合医院继续医学教育项目管理实践探索

继续医学教育项目是卫生技术人员接受继续医学教育的重要途径,随着继教项目数量逐年增加,如何保证继教质量尤为重要。以南京医科大学附属第一医院为研究对象,介绍了综合医院在继续教育项目管理中,如何通过项目申报严格把关、加强过程监管、建立考核指标体系、加强经费管理、实施品牌化策略、进行分类管理等方式加强对项目的管理,并提出了改进管理工作的建议。     

President seeks 4 percent increase in funding for 2000

President Clinton has proposed a 4 percent increase of $162 million in discretionary funding for HIV-specific programs for the fiscal year 2000 budget. The budget calls for a 7 percent increase for the Ryan White CARE Act funds and a similar increase for the Housing Opportunities for People with AIDS program. AIDS drug assistance programs would receive $35 million, or an 8 percent increase in funding. In 4 of the past 5 years, Congress has appropriated more funds to HIV programs than the President requested. A chart shows current funding levels and proposed increases for key HIV/AIDS programs.     

Despite chaos, most AIDS programs are functioning

Despite the 1996 budget crisis, federally-funded AIDS programs have continued to operate. The U.S. Congress and President Clinton have been unable to reach an agreement on the fiscal 1996 budget, but have signed continuing resolutions that keep AIDS research, prevention, and Medicaid programs in place. The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act and the Housing Opportunities for People with AIDS (HOPWA) program have each received stopgap funding. From the perspective of the AIDS community, the absence of a budget agreement is preferable to the budgetary changes proposed by Republicans.     

The cost of quality assurance: an exploratory study.

This paper documents the resource consumption of the quality assurance program at St. Marys Hospital Medical Center, a 357-bed, community, acute care hospital located in Madison, WI. To date, little exists in the literature documenting the financial commitment of an institution to its quality assurance program. Furthermore, no standard with respect to appropriateness has been established, although 1% of the operating budget of an institution has been suggested. In 1986, St. Marys spent 0.6% of its operating budget on its quality assurance function. This calculates out to approximately $20 per admission. In addition, the medical staff and others contributed 1013 hr of time to the quality assurance program. It is important that institutions determine and document their resource commitment to the quality assurance function so that standards can be established and discussion with respect to appropriateness and efficiency can be stimulated. Finally, it is important to document this expenditure so that it can be contemplated in light of fiscal pressure and availability of service.     

House votes to eliminate increased funds for HOPWA

Congress left for the 1998 summer recess without approving a Labor/Health and Human Services appropriations bill for 1999, which is the funding source for most AIDS programs. The Congress is divided on how much to spend on the Housing Opportunities for People with AIDS (HOPWA) program, and in July, the House shifted $21 million from AIDS housing to programs for retired military veterans. This move will keep HOPWA at the same budget as last year, even though the number of jurisdictions eligible for HOPWA funding rose 8 percent this year. Both the White House and the Senate Appropriations Committee favor an increase in HOPWA's budget from $204 to $225 million for fiscal 1999.     

Prioritizing Resource Allocation for Clinical Enhancement: A participative methodology

The allocation of hospital funding for new and expanded clinical programs can be a difficult but most important task to deal with during the development of the operating plan (budget). Like many other hospitals, York Central Hospital has struggled with this task each year. In order to address this challenge, the hospital has successfully designed and implemented a prioritization process that includes a standardized program proposal and peer evaluation. The process is grounded in the hospital's vision and strategic directions and built on a culture of evidence-based practice.     

The societal and organizational contexts of culturally sensitive mental health services: Findings from an evaluation of bilingual/Bicultural psychiatric programs

The Hispanic mental health literature focuses mostly on cultural and clinical issues. This paper argues that researchers and practitioners concerned with mental health services for Hispanics and other minority groups need to pay more attention to the societal and organizational contexts that facilitate or impede the development of effective culturally sensitive psychiatric programs. Utilizing data from an evaluation of three New York psychiatric programs for seriously mentally ill (SMI) Hispanic patients, the paper discusses societal and organizational factors that influenced the programs’ development. Among societal forces were the significance of Hispanics as a voting bloc, the political organization of Hispanic mental health professionals, the philosophy of ethnic assimilation in American society, prevailing views about the place of cultural knowledge in psychiatric treatment, and fiscal crises, and the shortage of Hispanic mental health professionals. Among organizational factors, hospital administrative support and program leadership mediated the effects of societal forces upon the programs, while ethnic competition and lack of coordination between the program and other organizational units acted as barriers to the programs’ development. The findings are relevant to any innovative mental health service in an organizational setting.     

Economic Analysis of Vaccination Programs

This report provides recommendations for budget holders and decision makers in high-, middle, and low-income countries requiring economic analyses of new vaccination programs to allocate scarce resources given budget constraints. ISPOR’s Economic Evaluation of Vaccines Designed to Prevent Infectious Disease: Good Practices Task Force wrote guidelines for three analytic methods and solicited comments on them from external reviewers. Cost-effectiveness analyses use decision-analytic models to estimate cumulative changes in resource use, costs, and changes in quality- or disability-adjusted life-years attributable to changes in disease outcomes. Constrained optimization modeling uses a mathematical objective function to be optimized (e.g. disease cases avoided) for a target population for a set of interventions including vaccination programs within established constraints. Fiscal health modeling estimates changes in net present value of government revenues and expenditures attributable to changes in disease outcomes. The task force recommends that those designing economic analyses for new vaccination programs take into account the decision maker’s policy objectives and country-specific decision context when estimating: uptake rate in the target population; vaccination program’s impact on disease cases in the population over time using a dynamic transmission epidemiologic model; vaccination program implementation and operating costs; and the changes in costs and health outcomes of the target disease(s). The three approaches to economic analysis are complementary and can be used alone or together to estimate a vaccination program’s economic value for national, regional, or subregional decision makers in high-, middle-, and low-income countries.     

构建医院预算信息化管理体系

预算管理作为一种先进的管理方法,在医院长期发展中的战略性、价值导向性作用日益明显。本文从医院实行预算管理的主要内容、预算管理的信息化体系建设和预算控制信息化管理模式等方面进行阐述,为医院实行预算信息化管理提供参考。