基于内部控制框架的公立医院财务风险分析

从经济、政策、医疗技术、行业特殊性等方面对引起公立医院财务风险的原因进行分析与归纳,并根据COSO内部控制框架中5要素分析医院组织结构和责任划分,即分析其管理层哲学、经营模式与风险意识,财务风险的确定、识别以及反应,执行的政策和程序,内部监督等内部控制薄弱环节及医院应对财务风险的能力.提出应培养风险意识,加强医院人员的道德观念和能力,转变医院管理层的管理理念;根据医院自身特点,建立风险预警系统,划分财务风险严重等级,并设计出医院财务风险识别小组控制流程图;根据自身情况建立健全一套适合本医院而又全面的财务内部控制制度;进行相关部门的信息共享,召开座谈会议,对医院重大财务事项共同进行决议;加强内部审计,加强财务控制监督,细化内部控制制度等对策.

Analysis of the Financial Risk of Public Hospitals Based on the COSO Framework

The article first summarized and analyzed the economy, policy, medical technology, industry particularity such aspects as the causes of the financial risk of public hospitals. Analyze of the hospital organizational structure and the responsibility, management philosophy, management pattern and risk awareness, the determination of financial risk, financial risk identification and financial risk response, execution of policies and procedures, internal supervision such as weakness and the hospitals ability to deal with financial risk according to the five elements of the COSO framework. Finally put forward the corresponding countermeasures, such as developing a risk awareness, strengthening the moral and a- bility of the hospital staff, changing the management of the hospital management concept, basing on the characteristics of hospital, establishing the risk early warning system, （tividing into financial risk severity level, and designing of a hospital financial risk identification group control flow chart, According to the hospital＇s circumstance to establish and perfect a set of suitable and comprehensive financial internal control systems; Re- lating departments of information sharing, having a meeting to talk about the significant financial matters for the hospital, strengthening the internal audit and financial supervision, detailing internal control system.