摘要
I
摘要
改革开放四十年以来，工业化、城镇化、农业现代化，人民群众温饱问题
已经解决，生活水平明显提高，中国现已进入了一个新时代，人民群众对健康
需求呈现出多元化、多层次的特点，且对健康需求日益增加，但现阶段我国的
卫生医疗资源地区分布不均衡、结构不合理、供给主体相对单一、基层和中西
部地区医疗服务能力薄弱等约束难以满足人民群众多元化、多层次、不充分的
健康需求。我国优质的医疗卫生资源主要集中在北京、上海、广州等东部沿海
经济发达的大城市，中西部等欠发达地区长期忍受着医疗基础薄弱、医疗资源
匮乏、医疗队伍能力低下之痛，进一步导致了我国普通群众特别是中西部地区
群众陷入看病难，看病贵的窘境。医院托管模式响应了新形势下的国家医药卫
生体制改革，创新人才梯队建设、创新医疗资源合理布局，促进大中城市优质
医疗资源下沉，一定程度上缓解了经济发达地区与贫困地区、特区与老区间医
疗资源分布不均的矛盾
本文以上海市D医院托管的吉安市A医院为案例，分析了一种医院管理新
型模式下的医院财务管理背景、现状以及存在的问题和问题解决路径
首先，对我国现阶段医院总体环境和托管模式下财务管理现状进行分析，
对吉安市A医院的财务现状进行分析主要集中在财务管理制度、固定资产管理
现状、运营管理现状、成本管理以及资金管理的分析，目前医院刚刚处于托管
阶段各方面制度还不够完善，财务状况也不是太理想，特别是固定资产管理存
在一系列的问题，结余还处于负数
其次，分析了A医院在托管模式下财务管理方面存在的问题及原因。医院
领导对财务管理重视不足，缺乏专业背景以及给予的财务管理指导不够；财务
管理基础薄弱，财务管理各个方面虽然有成文的规章和制度，但是仍未有效地
执行；财务制度不完善，制度层面不够细化和深入；财务人员紧张和专业技术
能力不够，难以担当财务管理深层次的管理要求；固定资产价值管理混乱，有
些固定资产仍旧未划入医院统一进行规范化管理；应收医疗款和其他应收款缺
乏有效管理，导致应收款项在流动资产中的占比偏高；医院的绩效管理不健全，
绩效管理制度不够完善和细化
摘要
II
最后，文章提出了改善托管模式下A医院财务管理的建议和对策。完善医
院财务管理基础工作，提高领导的重视程度，完善医院财务工作岗位的人员配
备，明确各个财务人员的岗位职责，提升医院财务人员的综合素质以及专业能
力等；强化成本核算管理，规范医疗收入管理与成本核算，加强对管理费用的
规范化管理；加强固定资产的管理和核算，托管双方尽快移交固定资产，完善
固定资产的账务处理，特别是折旧的管理；加强财务管理的内部和外部的控制，
加强医院内部治理，规范医院运营的同时也要重视外部监督和控制的作用，确
保医院财务健康、可持续运营；增加资本资金，拓宽医院的融资渠道，同时要
防范医院融资的财务风险
关键字：公立医院；财务管理；托管模式；对策
ABSTRACT
III
ABSTRACT
Since China's reform and opening up, industrialization, urbanization and
agricultural modernization as well as the process of population aging is accelerated,
the urban and rural residents of health demand presents the characteristics of
diversified, multi-level, but unreasonable structure of the present stage of health
resources, unbalanced regional distribution, the supply main body is relatively single,
weak basic services such as the constraints, is difficult to meet the health needs of
diversified and multi-level. Medical and health resources are mainly concentrated in
large and medium-sized cities, such as the eastern coastal areas, etc. The
underdeveloped areas such as the central and western regions have long suffered from
weak medical foundation, poor medical resources, and low capacity of medical teams,
which has further led to the difficulties of ordinary people in our country, especially
in the central and western regions, in the difficulty of medical treatment and
expensive medical treatment. In response to the new situation, the hospital has
responded to the reform of the medical and health system under the new situation,
innovative person times of the team, innovative medical resources, and the settlement
of the high-quality medical resources in large and medium-sized cities, which
alleviated the contradiction between the misdistribution of medical resources among
the economically developed areas, the poor areas, the special economic zones and the
old district.
This paper analyzes the background, current situation, existing problems and
solutions of the hospital financial management in A new hospital management mode
based on the case of A hospital in Ji 'an city, which is managed by Shanghai D
hospital.
First of all, this paper analyzes the current situation of financial management in
the general environment and custody mode of hospitals in China, and analyzes the
financial situation of A hospital in Ji 'an city. It mainly focuses on the analysis of
financial management system, asset management status, current situation of liability
management, cost management and earnings management. At present, hospitals are
not perfect in all aspects of the trust stage, and the financial situation is not too ideal,
especially in fixed asset management, there are A series of problems, and the balance。