【摘要】：隨著我國(guó)近年來(lái)社會(huì)經(jīng)濟(jì)的發(fā)展和社會(huì)保障需求的提高,醫(yī)療保險(xiǎn)作為社會(huì)保障的重要組成部分,其基金的規(guī)模日益龐大,如果缺乏有效監(jiān)督,必將產(chǎn)生極大的隱患。審計(jì)監(jiān)督作為維護(hù)國(guó)民經(jīng)濟(jì)健康、持續(xù)發(fā)展的監(jiān)管手段,對(duì)于確保醫(yī)保基金的安全、完整、有效運(yùn)行責(zé)無(wú)旁貸。審計(jì)機(jī)關(guān)應(yīng)當(dāng)隨著醫(yī)保政策的不斷更新與完善進(jìn)一步加強(qiáng)醫(yī)�；饘徲�(jì)的手段與方法,從而使審計(jì)人員能夠更好的履行相應(yīng)職責(zé),切實(shí)保證醫(yī)療保險(xiǎn)基金都能夠得到合理、合法、有效的運(yùn)用,從而達(dá)到維護(hù)廣大的人民群眾根本權(quán)益的最終目的。因此,對(duì)其進(jìn)行審計(jì)的相關(guān)研究對(duì)于維護(hù)人民的基本權(quán)益、推動(dòng)醫(yī)療保險(xiǎn)制度的建立與完善等方面具有重要的理論與現(xiàn)實(shí)意義。本文在對(duì)前人的相關(guān)研究進(jìn)行歸納總結(jié)的基礎(chǔ)上,對(duì)醫(yī)療保險(xiǎn)基金審計(jì)的相關(guān)概念、主要內(nèi)容與具體目標(biāo)進(jìn)行介紹,闡述了醫(yī)療保險(xiǎn)基金審計(jì)現(xiàn)狀,并結(jié)合A市醫(yī)�；饘徲�(jì)案例,通過(guò)對(duì)A市社保基金審計(jì)概況、醫(yī)保基金審計(jì)案例的審計(jì)內(nèi)容、審計(jì)過(guò)程進(jìn)行介紹,對(duì)其審計(jì)工作取得的主要成效與結(jié)果進(jìn)行論述,以及A市醫(yī)�；饘徲�(jì)中存在問(wèn)題進(jìn)行分析,包括針對(duì)醫(yī)保制度整合的有關(guān)審計(jì)監(jiān)督有待完善,醫(yī)保全國(guó)聯(lián)網(wǎng)異地就醫(yī)審計(jì)技術(shù)有待提升,以及醫(yī)�；饘徲�(jì)人員的知識(shí)與技術(shù)水平有限。在本文的最后,對(duì)完善醫(yī)療保險(xiǎn)基金審計(jì)提出了以下三個(gè)方面的建議:一是強(qiáng)化醫(yī)�；饘徲�(jì)監(jiān)督與預(yù)防職能;二是增強(qiáng)與完善計(jì)算機(jī)聯(lián)網(wǎng)審計(jì)的應(yīng)用;三是建設(shè)高素質(zhì)醫(yī)療保險(xiǎn)基金審計(jì)隊(duì)伍。以推動(dòng)醫(yī)�；饘徲�(jì)的理論與實(shí)踐的進(jìn)一步發(fā)展與完善。
[Abstract]:With the development of social economy and the improvement of social security demand in recent years, medical insurance as an important part of social security, the scale of its fund is increasingly large, if the lack of effective supervision, will produce a great hidden danger. As a means to maintain the health and sustainable development of the national economy, audit supervision is duty-bound to ensure the safety, integrity and effective operation of the medical insurance fund. With the continuous updating and improvement of medical insurance policy, audit institutions should further strengthen the means and methods of medical insurance fund audit, so that auditors can better perform their corresponding duties and ensure that the medical insurance fund can be reasonable. Legal, effective use, thus achieving the ultimate goal of safeguarding the fundamental rights and interests of the broad masses. Therefore, the research on audit has important theoretical and practical significance in safeguarding the basic rights and interests of the people and promoting the establishment and improvement of the medical insurance system. On the basis of summarizing the related research of predecessors, this paper introduces the related concepts, main contents and specific objectives of the medical insurance fund audit, and expounds the current situation of the medical insurance fund audit. Combined with the audit cases of medical insurance fund in A city, this paper introduces the general situation of social security fund audit in A city, the audit content and audit process of the insurance fund audit case, and discusses the main results and results of the audit work. And the problems existing in the audit of medical insurance fund in City A are analyzed, including the related audit supervision on the integration of the medical insurance system to be improved, and the technology of medical audit in different places of the medical insurance network in the whole country to be improved. As well as the medical insurance fund auditor's knowledge and technical level is limited. At the end of this paper, the following three suggestions are put forward to perfect the audit of medical insurance fund: one is to strengthen the function of supervision and prevention of the audit of medical insurance fund, the other is to strengthen and perfect the application of computer network audit; Third, the construction of high-quality medical insurance fund audit team. In order to promote the further development and improvement of the theory and practice of medical insurance fund audit.
【學(xué)位授予單位】：中國(guó)財(cái)政科學(xué)研究院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：F842.684;F239.4

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