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MBA毕业论文_WN公立医院全面预算管理的改进研究DOC

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公立医院在我国现阶段医疗卫生管理体系中占有主导地位,为社会承担着主要的医 疗服务工作。随着当前医疗改革的进一步深化,医疗服务机构的逐步多元化,加之公立 医院也逐渐取消了药品加成,等等,使医院间的医疗服务竞争越来越加剧。自 2009 年 颁布了医药卫生体制改革意见及实施方案之后,公立医院开始致力于建设并完善全面预 算管理体系,以便加强内部控制、成本节约及绩效考核等方面的管理。 公立医院要求得生存持续发展,就必须降低各项医疗资源的浪费,才能大比例缩减 医疗服务的成本开支。全面预算及其预算控制是管控各项支出和日常开支的有效方式, 也为医院绩效评估考核提供了数据支持。公立医院科学地、有效地利用全面的预算管理 手段实现内部控制。本文以 WN 公立医院为研究对象,在理论研究的基础之上,从实际 工作出发对该医院的预算管理现状进行分析总结,首先发现存在预算项目设计不合理、 预算编制不统一以及预算考核指标不全面等问题;其次以全面预算管理制度编制流程等 为依据设计一套合适的全面预算管理改进方案,相应遵循平衡记分卡的设计理念;再次 采用 2018 年的各项数据资料进行可行性检验,其分析结果基本满足了成本绩效的考核 要求,当然在动态分析中还存在局限性,可以进一步完善。 全面预算管理是支持该公立医院日常运作流程的有效工具。尽管全面预算能够支持 WN 医院实现战略目标的量化,构建有效的绩效考核指标体系,并可以落实到部门岗位 及人员,从而提升医院的医疗资源管理水平。但是,从目前来看,还需要需要加快信息 化建设,及时收集、整理数据资料,迅速编制成本计划,有效填补医务成本控制的漏洞, 不断推进公立医院的可持续完善的财务管理工作。 关键词,财务管理 全面预算 公立医院 预算指标 研究类型,应用研究III Abstract Public hospitals are dominant in China's health care system and bear the main medical services. At present, the medical reform has been further deepened, and public hospitals have gradually eliminated medicines profits and diversified medical institutions, which has intensified competition in medical services between hospitals. After the promulgation of the medical and health system reform program in 2009, public hospitals began to establish and improve the comprehensive budget management system, thereby strengthening the management of internal control, cost savings and performance appraisal. If public hospitals require sustainable survival, they must reduce the waste of medical resources and reduce the cost of medical services. The comprehensive budget and its budget control are effective ways to control various expenditures and daily expenses, and also provide data support for hospital performance evaluation. Public hospitals use scientific and effective use of comprehensive budget management tools to achieve internal control. Taking WN public hospital as the research sample, this paper analyzes and summarizes the existed budget management system of the WN hospital based on the theoretical research. Firstly, it finds that there are some problems in its budget management, such as, unreasonable budget items, no budget execution and too few assessment indicators. Secondly, this paper designs a comprehensive budget management improvement system for WN hospitals, as well as, uses the method of balanced scorecard. The redesigned budget system is implemented in the hospital for one year, showing the results of data analysis and further proposing problems and solutions. Finally, the feasibility and limitations of the design scheme are discussed. Comprehensive budget management is an effective tool to support the day-to-day operational processes of the public hospital. Applying comprehensive budget management to WN hospitals can quantify the hospital's strategic goals, and clarify management's powers and responsibilities. At present, public hospitals need to speed up the construction of information systems, fill in loopholes in hospital management, truly implement budget management, and promote financial management of public hospitals. Key Words: financial management, comprehensive budget, public hospital, budget indicator Research Type: Applied Research西北大学硕士学位论文 IV 目 录 摘要...................................................................................................................................I ABSTRACT......................................................................................................................III 目 录................................................................................................................................IV 第 1 章 绪论...................................................................................................................... 7 1.1 研究背景及意义...................................................................................................... 7 1.1.1 研究背景........................................................................................................... 7 1.1.2 研究意义........................................................................................................... 8 1.2 研究现状.................................................................................................................. 9 1.2.1 国外文献研究................................................................................................... 9 1.2.2 国内文献研究................................................................................................. 10 1.3 研究对象与方法....................................................................................................12 1.3.1 研究对象........................................................................................................ 12 1.3.2 研究方法........................................................................................................ 13 1.4 研究思路及框架.................................................................................................... 13 1.4.1 研究思路........................................................................................................ 13 1.4.2 研究框架......................................................................................................... 13 第 2 章 基础理论及应用................................................................................................ 15 2.1 有关概念................................................................................................................ 15 2.1.1 财务管理......................................................................................................... 15 2.1.2 全面预算管理................................................................................................. 15 2.1.3 公立医院........................................................................................................ 16 2.1.4 医院全面预算管理......................................................................................... 16 2.2 基础理论................................................................................................................17 2.2.1 消费偏好理论................................................................................................. 17 2.2.2 公共产品理论................................................................................................. 17 2.2.3 内部控制理论................................................................................................ 18 2.3 相关方法................................................................................................................19Abstract V 2.3.1 预算编制方法................................................................................................ 19 2.3.2 预算考评指标设计方法................................................................................ 20 第 3 章 WN 医院全面预算管理现状分析.....................................................................21 3.1WN 医院全面预算管理组织体系..........................................................................21 3.2WN 医院全面预算管理制度..................................................................................21 3.3WN 医院全面预算的编制......................................................................................21 3.3.1 业务预算编制................................................................................................. 21 3.3.2 财务预算编制................................................................................................. 24 3.4WN 医院全面预算管理的考核..............................................................................25 3.5WN 医院全面预算管理存在的问题......................................................................26 3.5.1 预算管理目标的问题..................................................................................... 26 3.5.2 预算管理岗位设置不合理............................................................................ 27 3.5.3 预算编制指标体系不完善............................................................................ 28 3.5.4 预算执行的力度不到位................................................................................. 28 3.5.5 预算考核指标构成不全面............................................................................ 29 第 4 章 WN 医院全面预算管理改进方案的设计.........................................................31 4.1 全面预算管理制度的修定.................................................................................... 31 4.2 全面预算管理岗位的设置.................................................................................... 32 4.3 全面预算管理流程的再造.................................................................................... 32 4.4 全面预算管理指标体系改进的设计.................................................................... 33 4.4.1 基期会计报表分析......................................................................................... 33 4.4.2 预算指标的调整及编制方法......................................................................... 34 4.5 全面预算管理考评办法的修订............................................................................ 39 4.6 全面预算管理的执行控制与调整........................................................................ 42 第 5 章 WN 医院全面预算管理改进方案的施行.........................................................44 5.1 业务收入预算指标执行分析................................................................................ 44 5.2 业务支出预算指标执行分析................................................................................ 45 5.3 采购预算执行分析................................................................................................ 47 5.4 预算改进指标设计仍存在不完善之处及解决措施............................................ 48 5.5 预算指标考评办法的实施.................................................................................... 49西北大学硕士学位论文 VI 第 6 章 结论.................................................................................................................... 52 6.1 总结........................................................................................................................52 6.2 创新与不足............................................................................................................ 52 6.3 展望........................................................................................................................52