本文選題：績效審計(jì)　切入點(diǎn)：公立醫(yī)院　出處：《中國財(cái)政科學(xué)研究院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：醫(yī)改自2009年來一直是我國高度受重視的民生問題,公立醫(yī)院作為我國醫(yī)療衛(wèi)生系統(tǒng)中的主干,其改革更是重中之重。國務(wù)院2016年4月發(fā)布了《深化醫(yī)藥衛(wèi)生體制改革2016年重點(diǎn)工作任務(wù)》再次使醫(yī)改進(jìn)入高潮期。公立醫(yī)院改革取得明顯效果,但仍存在醫(yī)療費(fèi)用不合理增長、醫(yī)院人事制度和薪酬制度不完善、藥品和醫(yī)用耗材價(jià)格虛高等問題。公立醫(yī)院由于自身的公益性和廣泛性,其運(yùn)營的終極目的是滿足人們對醫(yī)療服務(wù)的需要,承擔(dān)著一定的社會(huì)責(zé)任,因此,政府有必要提高其運(yùn)營效率和效果來保證服務(wù)質(zhì)量�？冃徲�(jì)作為政府監(jiān)管公立醫(yī)院的有效手段,不僅有助于醫(yī)療服務(wù)質(zhì)量的提高,而且?guī)椭藢?shí)國家相關(guān)政策的有效落實(shí)。審計(jì)署為配合“十三五”規(guī)劃在《“十三五”國家審計(jì)工作發(fā)展規(guī)劃》中指明要強(qiáng)化對醫(yī)藥衛(wèi)生領(lǐng)域的審計(jì),進(jìn)一步支持對公立醫(yī)院的績效審計(jì)。我國對公立醫(yī)院績效審計(jì)是隨著2009年醫(yī)改的推進(jìn)而發(fā)展起來,且隨著社會(huì)的進(jìn)步在一步步前進(jìn),但績效審計(jì)現(xiàn)狀仍存在開展的基礎(chǔ)薄弱、績效審計(jì)評價(jià)指標(biāo)體系不完善、績效審計(jì)發(fā)展程度不一和績效審計(jì)結(jié)果公告力度不夠的問題。公立醫(yī)院角色的重要性、新醫(yī)改的推動(dòng)性和我國現(xiàn)階段公立醫(yī)院績效審計(jì)現(xiàn)狀存在的問題,使得對公立醫(yī)院績效審計(jì)的研究成為熱點(diǎn)和難點(diǎn)。我國相關(guān)的審計(jì)研究不多,聯(lián)系案例分析解決問題的則更少,公立醫(yī)院績效審計(jì)仍然處在探索改進(jìn)階段。因此,聯(lián)系案例分析我國公立醫(yī)院績效審計(jì)的不足,并在總結(jié)問題的基礎(chǔ)上提出有針對性的審計(jì)建議,有利于進(jìn)一步探索和深化公立醫(yī)院績效審計(jì),促進(jìn)其發(fā)展。本文首先介紹了國內(nèi)外相關(guān)文獻(xiàn)綜述,然后簡要介紹了公立醫(yī)院績效審計(jì)的含義,特點(diǎn)、審計(jì)目標(biāo)、審計(jì)內(nèi)容和程序方法等基本內(nèi)容,在聯(lián)系現(xiàn)狀分析其存在的問題的基礎(chǔ)上,通過案例分析進(jìn)一步論證和分析公立醫(yī)院績效審計(jì)存在問題及成因,最后提出幾點(diǎn)建議:一是提高績效審計(jì)配備,包括增加外聘專家和引進(jìn)計(jì)算機(jī)人才;二是加強(qiáng)后續(xù)跟綜審計(jì);三是擴(kuò)展審計(jì)內(nèi)容,包括轉(zhuǎn)向“5E”審計(jì)、加強(qiáng)HIS系統(tǒng)審計(jì)和政策執(zhí)行審計(jì);四是增加內(nèi)部控制審計(jì)指標(biāo);五是引入數(shù)據(jù)包絡(luò)分析法。本文的不足主要表現(xiàn)在:首先,由于自身查閱資料的范圍局限性,總結(jié)的內(nèi)容不夠完整,會(huì)影響本文的研究效果。其次,本文是在現(xiàn)狀分析和案例分析問題的基礎(chǔ)上提出改進(jìn)建議,但由于本人對該部分的知識存在很多不足,因此分析仍然很不完善。除此之外,由于資料的局限性,本文的審計(jì)對象是一所二甲公立醫(yī)院,而不同的醫(yī)院自身的情況不同,提出的改進(jìn)建議的普遍適用性仍有待檢驗(yàn)。
[Abstract]:Since 2009, medical reform has been a highly valued livelihood issue in China. Public hospitals are the backbone of the medical and health system in our country. On April 2016, the State Council issued the key tasks of deepening the reform of the medical and health system on 2016, which once again brought the medical reform into a period of high ebb. The reform of public hospitals has achieved remarkable results. However, there are still some problems such as unreasonable increase of medical expenses, imperfect personnel system and salary system of hospitals, false price of drugs and medical consumables, and so on. The ultimate purpose of its operation is to meet the needs of people for medical services and undertake certain social responsibilities. It is necessary for the government to improve its operational efficiency and effect to ensure the quality of service. As an effective means of government supervision of public hospitals, performance audit is not only helpful to improve the quality of medical services, but also to improve the quality of medical services. Moreover, to help verify the effective implementation of relevant state policies, the Audit Office, in line with the 13th Five-Year Plan, specified in the "13th Five-Year Plan" that it is necessary to strengthen the audit in the field of medicine and health. Further support the performance audit of public hospitals. The performance audit of public hospitals in our country developed with the development of medical reform in 2009, and with the progress of society, the current situation of performance audit is still weak. The evaluation index system of performance audit is not perfect, the degree of development of performance audit is different, and the announcement of performance audit results is not strong enough. The promotion of the new medical reform and the problems existing in the present performance audit of public hospitals in our country make the research on the performance audit of public hospitals become a hot and difficult point. There are fewer cases to solve the problems, and the performance audit of public hospitals is still in the stage of exploration and improvement. On the basis of summing up the problems, this paper puts forward some specific audit suggestions, which is helpful to further explore and deepen the performance audit of public hospitals and promote its development. Firstly, this paper introduces the domestic and foreign literature review. Then it briefly introduces the meaning, characteristics, audit objectives, audit contents and procedural methods of the performance audit of public hospitals, and analyzes the existing problems in connection with the current situation. Through the case analysis to further demonstrate and analyze the problems and causes of public hospital performance audit, finally put forward several suggestions: first, improve the performance audit equipment, including the increase of external experts and the introduction of computer talent; The second is to strengthen the follow-up audit, the third is to expand the audit content, including to turn to "5e" audit, to strengthen the HIS system audit and policy implementation audit; fourth, to increase the internal control audit index; Fifth, the introduction of data envelopment analysis. The main shortcomings of this paper are: first, due to the limitations of the scope of their access to data, the content of the summary is not complete, which will affect the results of this study. This paper is based on the analysis of the current situation and the case study, but because I have many deficiencies in the knowledge of this part, the analysis is still not perfect. In addition, due to the limitations of the data, The audit object of this paper is a No. 2 public hospital, but the situation of different hospital itself is different, the general applicability of the proposed improvement proposal still needs to be tested.
【學(xué)位授予單位】：中國財(cái)政科學(xué)研究院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.322;F239.4

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