The Research On The Establishment And Application Of Index System Of Cost Control Based On Balanced Scorecard In Military Central Hospital

From 2009, along with the reform in medicine system, basic drug system and medical insurance system, hospitals are facing an unprecedented challenge and chance in our country. Health care reform profit mode of hospital challenged.National medical insurance era is coming. Developing of local voluntary and joint venture hospitals, brought more intens competition in the multiple forms of the medical market, not only between the public and voluntary hospital, but also the local and military hospital.Since 1985, military hospital has supplied paid services outside, it not only eased the contradiction between supply and demand of national health resources, but also trained many military professionals, to make up for inadequate funding, achieved both social and economic benefits. But for a long time, military hospital, mainly taking the responsibilities of resident military, was disadvantaged in the market competition with local public hospitals. The new situation indicates that health care reform has entered a new medical institutions of "low-profit era". The military centeral hospital must adjust the 26-year- implementation paid medical services policy, re-examine their own strengths, weaknesses, opportunities and threats focus on the medical market structure, striving for survival and development in the new medical market structure.Cost management based on strategic goals is a new idea created and developed in the last 20 years in West countries. Its core idea is the combination of cost management with strategic goals, while helping the organization to reducing costs and making correct decisions to improve competitiveness. This method is still used for business management more often, and cost control for hospitals in China are still in the theory exploratory stage. Many specific applications also require further study. The basic tools of hospital cost control management, are the same as used in business management, including value chain analysis, strategic positioning analysis, cost driver analysis, cost-effectiveness evaluation. BSC (Balanced Scorecard, BSC) is an effective tool for a strategic management of cost control. It is from a strategic perspective, the cost control management to establish a new evaluation system for hospitals to provide the scientific basis for decision-making, management sector that is currently being practical evaluation tool for cost control.The four dimensions of BSC-based target identification, we can carry out cost control and make related strategies according to the objectives.Military hospitals, entrusted with the special mission, were surppoted by state finance for a long time, so compared with local public hospitals, their cost accounting systems developed slowly. Up to now, most military central hospitals still focused economic accounting on simple method such as“expense substructed from income, surpluses for award”, and didn’t conduct cost control management. The work for medical technology improvement, social and economic benefits is important for military hospital. Balanced scorecard is an efficient tool in manegment. Usage of management tools in hospital cost control has become a hot spot. How to improve their level of medical technology at the same time, create more social and economic benefits, the pursuit of“relative cost minimization,”in Military Hospital is the major issue. Therefore, this study the mission and organizational characteristics of military hospitals ,reviewed the current situations of the military hospital cost control, analyzed the special circumstances of military hospitals and strategic objectives, the implementation of the military central hospital, the cost of BSC-based management theory and models were researched, for the first time established a military center hospital cost control indicator system, and an empirical study.To solve the problem, the project, by reviewing a great amount of literature both in home and abroad, choosing the military hospital cost control management as start point, based on the fundamental principal of BSC, and employing Delphia method and Analytic Hierarchy Process, quantitatively analyzed the data collected and established the index system for cost control assessment. Then by using the CIM (Compositive indexmethod, CIM), we compared one-year data of the military central hospital after cost control method by using BSC , and draw some correlated conclusions, which has put forward a novel method and thought in assessment of cost control in military central hospital. The project falls into the following six parts:In the first part, we summarized the fundamental theory on cost, cost control ,the correlerated theory of hospital cost control and the formation of cost control theory and practice situation.In the second part, in view of the developing feature of military hospital, current situation of hospital cost control in home and abroad were summed up and analyzed, pointed out the focus and direction of military hospital cost control .In the third part, we reviewed the related literatures of hospital management based on BSC, we analyzed the feasibility of hospital cost control method by using BSC. In the fourth part, we analyzed relationship between cost control and strategy of military central hospital, we analyzed the the integration of rational thinking of hospital cost control based on BSC, summarized combination of basic steps.In the fifth part, we analyzed and studied the related factors of military central hospital to establish the index system for cost control, established the index system for cost control assessment based on the four dimensions of BSC including: finace, internal process, learning and growth, patient.In the last part, basing on the above research, we selected the two-year data from cost control method by using BSC of the our hospital according to the index system, and carried out the cost control assessment by using the CIM. At last, we found the cost of control weaknesses and their causes, drew the relevant conclusions, and thus put forward the constructive suggestions of the military center hospital cost control system based on BSC targeted strategy.