The Budget Objectives,behavioral Effects And Consequences Of County Public Hospitals In China

At present,domestic and foreign scholars have few research on hospital budget management,most of them stay on the construction of budget management system.With China's medical and health system reform,budget management has received more and more attention.As the starting point of budgeting,the research on the formulation of budget objectives will surely bring new ideas to the promotion of hospital budget management.However,this topic is not well researched now,and hospitals have insufficient experience in budget management.As a result,the problems of budget relaxation are increasingly prominent.Therefore,it is meaningful to discuss in depth about the factors affecting the formulation of budget goals in budgeting process,consequences they will bring,and how to formulate scientific and reasonable budgetary goals.It also can contribute to the realization of the strategic goals of the hospital and the development of China's medical and health services.Based on the background above,this paper attempts to explore the factors that influence the process of making budget targets in the public county hospitals,as well as the behavior and consequences related to these factors.Firstly,this paper introduces the background and significance,and then summarizes five factors that affect the formulation of budget goals(information asymmetry level,budget rewards and penalties mechanism,budget participation level,budget target difficulty and budget target definition).These five factors will be analyzed by agency and incentive theory according to their emphasis.Then,a conceptual framework of influencing factors for setting budget goals in hospital is established based on literature review.Afterwards,X Public Hospital is selected as a typical case for the study of budget management of public county hospitals in China.Based on the conceptual framework,we analyze the status quo of the budget objectives,the performance of all five factors,the behavior and consequences in this hospital.According to this,the existing problems are discovered and relevant suggestions for improvement are proposed.The conclusion is: At present,the hospital has similar methods of setting budget targets as enterprise,meanwhile the influencing factors are similar,but there are different emphasis because the nature of public hospital's welfare.Specifically speaking,the hospital focuses more on solving agency problems rather than incentive problems in the process of setting budget targets.Since most hospitals have no ownership and management rights separation,the president is mainly responsible for budget.As a result,the agency problem is not prominent,in other words,the asymmetric information level is relatively low,and the budget participation level is high.However,due to the nature of public hospital's welfare,the degree of budgetary rewards and penalties is difficult to quantized.At present,a reasonable and effective performance system which is linked to the budget has not been well researched,meanwhile the incentive problem in the formulation of the hospital's budget goals has not been well resolved.Therefore,this study will propose suggestions to improve the formulation of budget goals from the perspective of the public welfare in public hospitals.This paper has innovations in terms of research perspective and content.On one hand,starting from the management behavior,the research focus on the influence of various factors on the behavior of hospital staff;on the other hand,it discusses from the content of the preparation of hospital budget objectives,and provides new ideas for microscopic research of hospital budget management.It succeeds to explore a conceptual framework for the construction of factors affecting the formulation of budget targets,which will help to analyze the systematic research on the current hospital budget objectives.