Research On Cost Control And Government Management In Public Hospital

BackgroundChina's public hospitals are government-invested non-profit hospitals,with the nature of public welfare, on behalf of the government to play a part of the social welfare functions, mainly for residents to provide basic medical and health services.Public hospitals occupy the leading position in the medical and health service system.However, for a long time,the irrational growth of medical expenses in public hospitals has become a prominent problem. In October 2015, the State Health and Family Planning Commission and other departments issued Some opinions on controlling unreasonable growth of medical wxpenses in public hospitals (National Health Reform [2015] No. 89), and it requires public hospitals to strengthen budget constraints and cost accounting, and carry out cost control. In recent years, the state has encouraged and supported social capital for running hospitals, and the social medical institutions have been developing rapidly, bringing competition pressure to public hospitals. According to the "13th Five-Year" planning requirements, the State Health and Family Planning Commission proposed to carry out a comprehensive reform of public hospitals, comprehensive cancel drug addition in 2017, so public hospitals will face great pressure of the funding gap.Therefore, it is necessary to study the cost control of public hospitals. However,due to the complexity of cost control, higher manpower, material and financial resources are needed, the public hospitals lack motivation for cost control, then, this study attempts to study from the perspective of government management, to promote the implementation and effective implementation of cost control in public hospitals.ObjectiveThrough the empirical study on the current situation and existing problems of cost control in public hospital, this paper analyzes the implementation of cost control measures in public hospital, including cost accounting and budget management, and discusses whether the implementation of cost control measures is in place,the function of accounting and budget has been played effectively, and how about the effect of cost control in public hospitals.Secongdly, this paper attempts to conduct the research from the perspective of government management, analysis of the problems and reasons of the absence of government management, and put forward the corresponding countermeasures and suggestions, hoping to provide reference for the public hospitals to carry out cost management and cost control scientifically and effectively in the future.MethodsThis research is based on the theories of public service management,cost management and budget management, the research contents include the analysis of the current situation of the cost control of public hospitals,the analysis of the reasons for the ineffective internal cost control of public hospitals and the analysis of the government reasons for the ineffective cost control of public hospitals. The current situation of cost control in public hospitals is analyzed by literature; Through inducing related datas of cost control of public hospitals in the statistical yearbook, using quantitative analysis method to analyze the growth trend of medical costs in public hospital, the current situation of cost management and control and the status of cost control of public hospitals in Shandong province; Through searching related literature on the problem of cost accounting and budget management in public hospitals from 2014 to 2016 in CNKI datebase, and obtaining some policy information from website of government, using qualitative analysis methods to analyze the current situation of execution and implementation of cost accounting and budget management in public hospital internal, and the absence problems of government management in the process of cost control in public hospital.Research Results1. The current situation of cost control in China's public hospital is not optimistic: the total health expenses and medical expenses per capita in public hospitals are increasing; the data of the Annul Report of Health Finance in Shandong Province show that the current situation of cost management and control in public hospital in Shandong is worrying, including management costs, medical business costs, medical receivables and bad debt losses, like this is not in a province, which are common in the country's public hospitals.2. Analysis on internal reasons for cost control in public hospitals, the cost control measures in China's public hospitals are not in place, there are many problems in the implementation processes of cost accounting,and their functions have not been played effectively, so the cost control effect in public hospital is not obvious.Analysis on government reasons for cost control in public hospitals, the government lacks the top-level system design and specific operation instruction standards in the cost accounting of public hospitals; the government has not implemented enough in budget management for public hospitals; the government has failed to manage some of the factors that have contributed to the cost increase; the government lacks the examination and evaluation , as well as the rules and regulations of the laws and regulations in the industry management, and these indirectly lead to the implementation of cost control in public hospital to be not in place, the effect of cost control to be poor, so it needs to strengthen and implement the public management responsibility of the government.Suggestions:To carry out the management system reform of the public hospital, implement the board corporate governance mode, built a professional management team of understanding management and having reasonable knowledge structure, develop the modern management of hospital, improve the awareness of cost control, and realize the scientific management and control of cost.To strengthen the cost control measures of the public hospital,design good top-level system, formulate specific operational guidelines, and revise and improve timely according to the problems in the implementation processes, in order to provide scientific guidance for the implementation of cost control in public hospitals, at the same time, the government should provide the specific protection and support for public hospitals,such as professional training and system software.To implement the public management responsiblities of the government, and strengthen the government's external supervision of the cost control in public hospitals: using "Internet + Medical Management" to build a interconnected and unified system monitoring platform between government and hospital, to strengthen the real-time monitoring of cost management in public hospitals; establishing an accessment and evaluation mechanism,which takes medical quality as the core,and scientific control of cost as the guide, and formulating the corresponding measures of rewards and punishments to form incentive and contraint effectively mechanisms;establishing and improving laws and regulations, carrying out industry-wide management and regional supervision, and strengthening the norms and constraints on public hospitals and practitioners of the medical industry, to improve the quality and effect of cost control and promote fine and long-term development of public hospitals.