Research On The Internal Control Evaluation Index System Of Medical Equipment Procurement Management In Public Hospitals

Objective:The purpose of this study is to more objectively evaluate the effectiveness of internal control of medical equipment procurement management in public hospitals,so as to identify the risks existing in the process of medical equipment procurement management.On the basis of following the design concept of importance,effectiveness and operability,and based on the control theory and risk management theory,a set of scientific,reasonable and highly public hospital characteristic management system is constructed The internal control evaluation index system of medical equipment procurement management strengthens the guiding significance to the current reality of public hospitals,so as to promote the positive interaction between theoretical research and practical application.Method:(1)Using the method of literature research,the frequency of "problems or risks"mentioned in the literature of medical equipment procurement management in public hospitals was counted,and the key control points were sorted out through problem orientation;On this basis,based on the perspective of compliance,this paper analyzes the game relationship among stakeholders in the medical equipment procurement supply chain,analyzes the possible loopholes in hospital procurement management from the policy level,deduces the control points based on the control theory and risk management theory,and constructs the index system framework and index alternative Library from the two aspects of internal management demand and external policy background of the hospital.(2)Using Delphi method,through the development of "Research on internal control evaluation index system of medical equipment procurement management in public hospitals-the first round of expert consultation questionnaire",15 relevant experts were consulted for two rounds to screen the evaluation index system.(3)The analytic hierarchy process(AHP)is used to give the index weight.According to the experts' scores on the relative importance of the indicators collected from the questionnaire,the chromatographic analysis method is used to weight the indicators,thus forming the internal control evaluation mathematical model of medical equipment procurement management in public hospitals.(4)Using the method of field investigation,a public hospital in Beijing was selected to test the effectiveness of the index system.Results:The preliminary framework of the internal control evaluation index system of medical equipment procurement management in public hospitals:(1)the frequency of problems mentioned in the literature:the most frequently mentioned procurement management problems in the literature are "the clinical departments deliberately exaggerate or overestimate the effectiveness of the purchased equipment,and the future benefits,and the demand documents tend to be strong,and the centralized procurement management functional departments do not conduct market research" The corresponding three-level index is "market research mechanism for feasibility,economic benefit and social benefit of centralized management department".(2)This paper analyzes the game process between hospitals and suppliers.hospitals and superior administrative departments,and superior administrative departments and suppliers,and discusses the management loopholes of "the selection of procurement methods is based on deviation,the procurement policy does not involve the internal third-party supervision and evaluation system" from the perspective of policy It is the policy basis of index construction.(3)Based on the five elements of COSO,18 secondary indicators and 45 tertiary indicators are determined.2.The evaluation index system of internal control of medical equipment procurement management in public hospitals:before formal expert consultation,through expert group discussion and expert brainstorming,the preliminary indicators were revised.Through merging and deleting indicators,the first round of expert consultation questionnaire was finally determined.The index system includes 5 first level indicators,15 second level indicators and 25 third level indicators In this study,a total of 15 experts in the field of medical equipment procurement management were invited to participate in Delphi consultation,the expert positive coefficient of expert consultation was 100%,the expert authority coefficient was 0.82,the significance test p values of the coordination coefficients of"operability,importance and effectiveness" were less than 0.05;the consistency test ratio of the judgment matrix corrected by the maximum direction improvement method was less than 0.1,because" There are three levels of indicators deleted when the coefficient of variation of operability,importance or effectiveness>0.25,which are respectively "market research mechanism of centralized management department on feasibility,economic benefit and social benefit","rationality of hospital representatives participating in bid evaluation" and "data sharing degree".Finally,15 levels of indicators are constructed,including five elements of COSO as the first level indicators and "management system and process" Among the 22 three-level indicators,the weight of "control environment" is the largest,accounting for 0.2900,and the weight of "information and communication" is the smallest,accounting for 0.1060;among the three-level indicators,the index of internal and external risk concern is the largest,accounting for 0.1196,and the index of "whether the purchase demand application has been reviewed level by level" refers to the highest 0.144.3.According to the evaluation index system,the evaluation results show that the design and operation effect of the internal control system of medical equipment procurement management in A public hospital is good,and the key control points are effectively controlled,which is in line with the current situation of hospital operation and development,but there are some weak links.such as the lack of effective management control in the preparation and review of procurement documents,the lack of effective management control,and the lack of effective management control Procurement project acceptance personnel composition is not standardized.Conclusion:This study combined with a variety of research methods,built the evaluation index system of internal control of medical equipment procurement management in public hospitals,which has certain scientificity and feasibility.At the same time,it is suggested that the quantitative scoring standard should be further defined and the adjustment index system should be further optimized.The evaluation of internal control of medical equipment procurement management in public hospitals is selected as the research perspective,and the evaluation content is more professional,and the research on internal control evaluation of medical equipment procurement management is further improved,which provides reference for the development of the evaluation research on the internal control of medical equipment procurement management in public hospitals.