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论文编号：	7100
作者编号：	2220100521
上传时间：	2014/12/16 9:30:00
中文题目：	基于风险管理的A医院内部控制体系优化研究
英文题目：	Research on Optimization of the System of The Internal Control in Hospital A Based on Risk Management
指导老师：	程新生
中文关键字：	内部控制；风险管理；内部审计；风险管理组织框架
英文关键字：	Internal Control； Risk management； Internal auditing Risk management organization structure
中文摘要：	公立医院是我国医疗服务体系的主体，肩负着人民群众基本医疗保证的职责。站在新医改的时代背景下，医院更应该构建完善自身的风险管理系统，以期应对未来潜在的风险，实现社会价值最大化的办医目标。但是，现阶段我国对于风险管理的探索还处于起步阶段，研究焦点集中在金融、保险行业和大型国企的风险管理体系构建上，对事业单位特别是公立医院的关注较少。实际上，公立医院基于公益性和经营性的双重属性以及社会价值最大化的办医目标，同样需要展开对风险管理的探索。在此背景下，本文选择了天津市具有代表性的一家大型公立医院——A医院作为案例研究的对象。在文献总结和调研了解的基础上，从外部风险、内部风险、综合风险三个维度分析A医院需要面对的主要风险，继而从风险管理视角审视了A医院当前管理体系应对风险的能力，指出其在风险意识、风险管理组织框架、风险识别、评估、控制、监督环节中不足之处，提出构建基于风险管理的内部控制体系以提升应对风险的能力。方案的设计借鉴了COSO《企业风险管理——整合框架》的三维模型和风险管理八要素，确立了循序渐进、成本效益、合法合规性、全员参与和公益性五点原则，遵循优化原则，从四个方面完成对现有内控体系的优化。第一，优化风险管理内部环境，完善医院目标体系，推动风险文化建设、建立人人参与的风险管理组织框架；第二，优化风险识别和评估机制，通过全院分层识别和矩阵量化评估方法，建立风险事件库，并保持动态管理；第三，优化风险控制活动，以医疗设备PETCT购置活动为例，通过梳理流程对关键环节的控制活动提出具体的优化方案；第四，优化风险监督活动，将内部审计与风险管理相融合，开展全方位的风险管理审计。最后，为风险管理体系设计完成后能够有效运行，对内部实施保障措施和外部推动因素进行了探讨。
英文摘要：	The public hospital has been the main body of healthcare system in China and thus charged with the task of providing the basic medical service for the public. Under the background of new medical reform，the hospital should further improve its own management of risk management so as to handle the potential risk in the future and achieve the goal of maximizing the social value. However，it should be noted that the risk management in China still remains at the early stage. With the focus of research on the risk management system in the field of finance，insurance and large state-owned companies，those institutional organization，especially the public hospital，have not received due attention. As a matter of fact，the public hospital has combined public welfare with business. With the purpose of maximizing social value，the public hospital also demands the further exploration of risk management. Under this background，this paper has chosen A Hospital，which is a large public hospital in Tianjin，as a research subject. On the basis of literature review and case survey，he paper analyses the main risks encountered by A Hospital from three dimensions of external risk, internal risk and integrated risk; then from the perspective of risk management, studies the risk-resistant ability of the current management system of A Hospital; points out its insufficiencies in aspects of risk awareness, risk management organization framework, risk identification, assessment, control and supervision; and puts forward to establish internal control system based on risk management so as to improve the risk-resistant ability. The optimization scheme draws ideas from the three-dimensional models and eight elements of risk management of COSO “enterprise risk management – integrated framework”, and defines five optimization principles including gradual improvement principle, cost-benefit principle, legal compliance principle, full participation principle and public welfare principle. Following the principle of optimization, the paper completes the optimization of current internal control system from four aspects. Firstly, optimize the risk management internal environment, improve the hospital objective system, promote the risk culture construction, and form the risk management organization framework of full participation; Secondly, optimize the risk identification and assessment mechanism, based on the means of hospital level risk identification and quantitative risk matrix, set up hospital risk database and keep dynamic management; Thirdly, optimize the risk control activities, taking the medical equipment PETCT purchase activity as an example, put forward specific optimization scheme by sorting procedures to the control activities in key links; Fourthly, optimize the risk supervision activities, develop an overall risk management audit by combining internal audit with risk management. Finally, in order to ensure the effective operation of the designed risk management system, the paper discusses the implementation of internal guarantee measures and external driving factors.
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