Research On Internal Control Of Public Hospitals

In recent years,great changes have taken place in the industry internal and external environment of public hospitals in China,which put forward higher requirements for the operation and management of public hospitals and highlight the importance and necessity of internal control construction in public hospitals.From the perspective of external environment,firstly,the government pays more and more attention to the hospital internal control,and has issued the internal control laws and regulations and guidance for administrative institutions and other documents to put forward higher requirements for the hospital internal control.Secondly,with the continuous advancement of health care reform,the government encourages the injection of social capital into the medical field,participation in the restructuring of public hospitals,the cancellation of the addition of drug consumables,and the gradual formation of hierarchical diagnosis and treatment model,which bring unprecedented operational and financial risks to public hospitals and bring new challenges to their operating efficiency.In order to strictly regulate the party and strengthen the restriction and supervision of power operation,the national audit office,local audit office,party committee inspection group and other government departments have increased the audit frequency of public hospitals,which covers financial revenue and expenditure audit,President’s economic responsibility audit,special audit of medical insurance and special audit of poverty alleviation funds.The intervention of government audit reveals a large number of problems in the management of public hospitals,which are often caused by the failure or failure of internal control.From the perspective of internal environment,on the one hand,medical corruption cases occur frequently.On the other hand,the scale of revenue and expenditure of public hospitals is getting larger and larger,and their economic business is getting more and more complex.Diversified development strategies such as the establishment of overseas investment companies,medical cooperation and managed medical consortium operation have increased the difficulty of hospital management,and the original management system can no longer adapt to the new form of economic activities.Under the new situation,only by establishing a complete internal control system and making it operate effectively and continuously,can public hospitals ensure the orderly and standardized operation of various economic and business activities,prevent and reduce the probability of risk occurrence,promote the healthy and long-term development of public hospitals,and achieve the goal of modern hospital management.However,due to the management’s one-sidedness and lack of attention to internal control,China’s public hospitals generally have not established a complete internal control system,which is manifested in weak control environment,imperfect internal control system construction,imperfect information communication mechanism and inadequate supervision.This paper selects public hospital A as an example,and carries on the concrete analysis.Based on the knowledge of business administration and financial management,the paper analyses the current situation and existing problems of internal control in hospital A one by one with five elements: control environment,risk assessment,control activities,information and communication,and supervision,according to the experience of audit department in hospital in recent nine years and the relevant documents of internal control in medical institutions issued by the government.It is found that public hospital A lacks an effective internal control mechanism,which is manifested by the marginalization of the internal audit department,and which makes the supervision function of economic activities not fully reflected.The top-down internal control awareness of the hospital is weak,and the risks it faces are not taken seriously.In addition,the serious lag of information construction leads to the single and backward means and technologies of internal control.From the perspective of the economic operation of public hospital A,the budget of the hospital is poorly implemented,and the financial revenues and expenditures are not strictly implemented according to the internal control system of financial accounting.The informationization degree of high value consumables management is low,relying on manual registration ledger;Hospital A is suspected of evading government procurement;Contract implementation and regulatory process is not standardized.And by referring to the Internal Control Standards of Administrative Units(Trials),this part has proposed the targeted solutions of issues of the internal control of hospital A from the internal control of the hospital,of the business and of the supervision layer,and constructed the internal control system frame of public hospital A.