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论文编号：	13767
作者编号：	2120202963
上传时间：	2023/3/9 12:24:50
中文题目：	N县级二甲公立医院成本管理研究
英文题目：	Study on the cost management of N county-level second-class public hospital
指导老师：	李姝
中文关键字：	成本管理；全成本核算；病种成本；标准成本法；公立医院
英文关键字：	cost management；total cost accounting；disease entities cost；standard costing; public hospital
中文摘要：	从1998年颁布的《医院财务制度》，到2011年颁布的新《医院财务制度》，再到2021年颁布的《公立医院成本核算规范》，我国的医药卫生体制改革呈现出越来越重视医院的成本核算与成本管理的特点。究其原因，离不开公立医院的公益性和自负盈亏这两个特点。公立医院受限于自负盈亏的运营模式，不得不为自身的存续和医院的发展追求正盈利。但公立医院为达到公益性的目的，不能盲目扩大收入，增加患者负担，同时，为了保证医疗效果，也不能随意压缩成本。因此，通过合适的成本管理来达到降本增效的目的就成了公立医院的最佳选择。 本文以N县级二甲公立医院为案例，通过实地调研和管理层访谈了解到N医院目前在成本管理方面存在较大问题，直接影响到员工工作积极性和医院的运营。N医院的成本管理问题主要为成本管理目标不明确、缺乏有效的成本分析与管控手段、间接成本分摊基础不合理以及缺乏精细化的病种成本核算内容。针对上述问题，本文根据N医院实际情况，明确了N医院成本管理的目标，完善了成本分析与绩效考核体系，优化了全成本核算中间接成本的分摊基础，并在优化后的科室全成本核算基础上建立了病种成本的核算方式，利用临床路径和标准成本法对病种成本进行管控，以达到精细化成本管理，控制疾病治疗成本的目的。 本文希望通过对N县级二甲公立医院的成本管理进行研究，为中小型公立医院的成本管理提供思路，为中小型公立医院利用现有条件进行成本控制和精细化管理提供一定的启发与指导。
英文摘要：	From the "Hospital Financial System" promulgated in 1998, to the new "Hospital Financial System" promulgated in 2011, and then to the "Cost Accounting Standards for Public Hospitals" promulgated in 2021, China health system reform shows that more and more attention is paid to the hospital cost accounting and hospital cost management. The reason for this phenomenon is that public hospitals are public welfare and responsible for their own profits and losses. Limited by the self-financing operating model, public hospitals have to pursue profits for their own survival and development. However, in order to achieve the purpose of public welfare, public hospitals cannot expand their income without limitation and increase the burden on patients. At the same time, in order to ensure the medical effect, they cannot arbitrarily reduce costs. Therefore, cost management is the best choice for public hospitals to achieve the purpose of reducing costs and increasing efficiency. This paper takes the N county-level second-class hospital as an example. Through field research and management interviews, it is learned that the hospital currently has several problems in cost accounting and cost management, which directly affects the enthusiasm of employees and the operation of the hospital. The main problems of cost management in N Hospital are unclear cost management objectives, lack of effective cost analysis and control system, unreasonable indirect cost allocation basis and lack of refined disease cost accounting content. To solve these problems, this paper proposes the following solutions: Firstly, this paper clarifies the cost management goal of N hospital. Secondly, this paper improves the cost analysis and performance evaluation system. Thirdly, this paper optimizes the allocation basis of indirect costs in hospital full cost accounting. Finally, this paper establishes the accounting method of disease cost based on the optimized department full cost accounting and uses clinical pathway and standard cost method to control the cost of disease. These measures can achieve the goal of refined cost management and control the cost of disease treatment. This paper hopes to provide ideas for the cost management of small and medium-sized public hospitals by studying the cost management of the N county-level second-class public hospital, and to provide guidance for small and medium-sized public hospitals of how to manage and reduce their cost by using available data.
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