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Objective:To construct an evaluation index system for comprehensive budget management at public hospitals and conduct empirical research for reference in evaluation of comprehensive budget management at public hospitals.Methods:From May to June 2022, based on the Implementation Measures for the Comprehensive Budget Management System of Public Hospitals and its interpretations, literature analysis, and expert interviews, a preliminary evaluation index system was developed for comprehensive budget management of public hospitals. Then the Delphi method was applied for two rounds of expert consultation, with experts invited to evaluate the importance of indexes, while the analytic hierarchy process was used to calculate the weight values of indexes. Based on such a comprehensive budget management evaluation index system, a questionnaire was developed, and tertiary public hospitals were selected based on the principle of convenient sampling. Then a questionnaire survey was conducted from June to October 2022. The questionnaire was filled out by hospital level leaders(chief accountants), finance/audit leaders, and directors of finance/audit/operation management departments from the sample hospitals with professional knowledge and rich operational management experience in budget management. The comprehensive budget management level of the sample hospital was thus evaluated based on the survey results. Results:The comprehensive budget management evaluation index system for public hospitals was composed of 2 first-level indexes, 4 second-level indexes, and 20 third-level ones. The weights for the 2 first-level indexes of target building and management orientation were both 0.500, while the weights for the 4 second-level indexes, namely strategic implementation, comprehensive coverage, performance evaluation, and adaptation matching were all 0.250. Among the third-level indexes, the weights of budget execution, system improvement, system establishment, organizational construction, and revenue and expenditure business ranked top five, with weights of 0.070, 0.069, 0.066, 0.066, and 0.064, respectively. A total of 95 hospitals were selected for questionnaire survey, and the evaluation found 46 of them with a comprehensive budget management level of " excellent" and " good" , 27 with a " moderate" level, and 22 with a " poor" and " very poor" level. Scores of the third-level indexes were between 39-94 points, while the score of 6 third-level indexes were below 60 points, namely interconnection, budget analysis, compatibility and adaptation, system improvement, participation level, and assessment application.Conclusions:The evaluation index system for comprehensive budget management at public hospitals in this study proves rational and practical, serving as a reference for the evaluation of comprehensive budget management at public hospitals and related researches.
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Objective:To understand the construction and problems of budget management system in public hospitals, and to provide countermeasures and suggestions for its continuous improvement and construction.Methods:Literature review was used to summarize the national policy requirements for comprehensive budget management system of these hospitals in China. Random sampling was used to select 109 public hospitals as pilots, and a questionnaire was customized from March to April in 2019, to investigate the current budget management and problems, with the data studied by descriptive statistical analysis.Results:Seventy-seven hospitals (70.64%) reported in self-appraisal their budget management as satisfactory and above, 78 hospitals (71.56%) had in place a comprehensive budget management system, 90 hospitals(82.57%) had in place a budget management committee, and 91 hospitals (83.49%) had in place refined budget preparation. The main problems were unclear budgeting requirements and nonstandard process, poor information integration and informationization, inadequate inter-department synergy, and poor alignment between business and finance.Conclusions:The public hospitals are recommended to enhance their comprehensive budget management system and their informationization, for full-process informationized management.
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Cost management is an indispensable part of the economic management of public hospitals,but there are still some problems in the cost control of public hospitals in China.The work of budget management and cost accounting just stays on the surface.Hospitals are running on a large scale and spending too much to make waste.Rules and regulations are incomplete.Staff awareness of cost control is indifferent.The internal audit supervision mechanism is incomplete.Establishing comprehensive budget management is helpful for hospital managers to make decisions,which can effectively improve the cost consciousness of all staff in hospitals,and reduce the management cost of hospital.The goal of cost control should be clearly defined in public hospitals.Hospitals should improve the rules and regulations of cost control.The capital structure of the hospital and the efficiency of fund utilization should be improved.The management of human cost should be taken into account and the idea of cost control should be established.Internal audit supervision should be strengthened.
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Performance budgeting has been the direction of public budget reform in recent years.It is based on the performance,the target responsibility system,comprehensive budget management and performance evaluation of organic integration,broaden the management of new ideas.The application of performance budget in public hospital management has great significance to optimize the allocation of resources and improve management performance.
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Performance budgeting has been the direction of public budget reform in recent years.It is based on the performance,the target responsibility system,comprehensive budget management and performance evaluation of organic integration,broaden the management of new ideas.The application of performance budget in public hospital management has great significance to optimize the allocation of resources and improve management performance.
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In recent years,Shanghai is exploring the implementation ot comprehensive budget management in community nealtn center,but facing some problems in process:the budget management model is still not unified,"separation between revenue and expenditure" policy is not really implemented,the financial subsidies is not combined with performance appraisal.Meanwhile within the center,the personnel funds are approved by public sector,the operation funds are not standardized,and project funds are relatively chaotic.It is recommended to carry out cost accounting of community health center,clarify expenditure,introduce standardized workload in community health center to promote budgeting scientifically,strengthen the information construction to make budget implementation assessment,and establish a performance appraisal linked to the government subsidy mechanism.
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This paper analyzes the concept of hospital financial information management and the current situation.From the perspective of public hospital reform, we proposed the hospital should fulfill the information-based budget management and salary management, construct hospital information-based cost control flowsheet, build message conducting and transferring program, that budget should be achieved as soon as possible, information technology should be applied in hospital management, and build a complex financial information management team as soon as possible.