浅析如何加强医院的财务管理

近几年,国家大力推进医疗改革,各级医院也在适时的不断提高管理水平,而医院财务管理是医院管理水平的重要体现,本文就如何进一步提高医院财务管理水平、深化微观医疗改革提出一些自己的看法。     

Towards A Professional Rationalization

A bstract . The French health care delivery system is characterized, on the one hand, by a centralized and socialized decision making process as far as financing is concerned, yet on the other hand, the regulation of activities is highly decentralized and governed mainly by individual physicians on a private basis.
Today, the health care scene seems to be stuck in a process within which each new reform leads to yet another reform, In this movement, the role played by academic health economists is increasing.
The French health care delivery system and its dynamics are described and two major topics which wilt be at stake in the years to come, the remuneration of physicians and the financing of hospitals are considered. The challenge facing health economists who have to consider the system as a system, is examined. The relationships between the political arena and the researcher's ivory tower appears to be is one of the keys for the future of the health care system. It is demonstrated that, in this area too, few barriers have fallen.     

A case history: forging a "reusable" alliance

This article presents the focus of partnerships in the future of health care providers. It discusses the necessity for partnerships as well as the mutual benefits that must be a vital part of the relationship. The article also shows specific information about and outlines the value of a specific partnership between the Medical Center of Central Georgia and Medline Industries. The future of health care delivery and reform will depend on different types of partnerships and that all the providers of services and products, as well as health care delivery, must be willing to aggressively align with partners.     

Making tough decisions about telemetry monitoring

Telemetry monitoring, when used effectively and appropriately, is beneficial and plays an important role in enabling primary caregivers to provide optimum care for their patients. However, it is frequently used ineffectively and inappropriately, which can be extremely costly for hospitals. In this era of health care reform, careful review of this technology and analysis of telemetry utilization can avoid unnecessary expenditures or abuse.     

A JIT-type stocking system for hospital pharmacies: the stockless method

During the past few years, hospitals have been actively evaluating the use of newer-type stocking systems for their pharmacies. While "stockless," a just-in-time (JIT) variation, appears to be emerging as perhaps the most promising method, it is far from being accepted as the industry standard. Because of growing concern for health care reform, with its cost containment component, it may well be anticipated that both the pace and profoundness of these efforts will continue to intensify.     

Health care reform and the hospital supply chain

With health care reform, hospitals will be differentiated in the marketplace by how well they manage the costs of services. Because products will be market priced, hospital materiel managers will have to minimize all other related acquisition costs. The key opportunities will be in changing processes to eliminate non-value added administrative, supply chain, and process activities and their attendant costs.     

基于DEA-Tobit模型的上海医疗资源整合效率分析

本文以2007年至2010年上海市39家二级医院为样本,利用数据包络分析(DEA)和Tobit回归模型分析参与整合对医院效率变化的影响及其主导因素。结果发现在2010年整合组医院和非整合组医院的纯效率值产生显著差异。从投入要素的作用机制角度考虑,以2010年各医院效率值为因变量,高级职称医师比例、10万元以上设备比例以及是否整合为虚拟变量作为自变量,通过Tobit回归模型认定高级职称医生的比例提高是其效率提升的关键因素。     

Public-private partnerships in health care services: Do they outperform public hospitals regarding quality and access? Evidence from Portugal

Public-private partnerships (PPPs) are widely spread long-term arrangements between governments and strategic private partner(s). One of their objectives is to reduce the financial pressure on the public treasury with regard to new investments. PPPs have been employed within the health care sector which, in turn, carries a huge social burden. In Portugal, for instance, PPPs in health care concern bundling hospital infrastructure and clinical services management. Notwithstanding the need to ensure sustainability and efficient use of hospital resources, it is clearly compulsory to guarantee that patients receive appropriate and timely care, with maximum security, and equitable manner. Still, little or even no attention has been paid in the literature to the clinical response capacity of PPP hospitals and to the populism arguing that these entities have a lower social performance than typical public hospitals. This study uses robust benchmarking methodologies alongside recent data about Portuguese hospitals (FY2012-FY2017) to demystify this idea and to demonstrate that, actually, PPP hospitals can deliver health care services with social performance levels at least as good as public hospitals.     

Factors to consider in the delivery of quality services by hospitals

The focus of any health care provider, such as a hospital, is on assessing and improving the well-being of the people in the system's target area, and it is this focus that differentiates health care providers from other enterprises. The purpose of this article is to identify the essential factors in the delivery of quality services by hospitals. These factors include patients' active participation in their delivery, the nature of the clinical procedures, and the management of the interaction of all the customers involved in the process.     

军队医院全成本核算探究

医院实行全成本核算是医院经济管理中的一项重大改革,军队医院全成本核算对降低医院经营成本具有重要的意义。随着医疗卫生改革的不断深化,传统的医院全成本核算管理模式已不适应形势发展的需要,新形势下的军队医院全成本核算,对军队医院全成本核算提出了新的要求。本文从军队医院成本核算的现状入手,在剖析军队医院成本核算存在问题的基础上,探讨了我国医院全成本核算体系的具体设计,以期指导军队医院的全成本核算。     

新医改背景下陕西省基层医疗机构人才建设策略

医疗卫生人才是决定基层医疗卫生服务水平的关键,也是我国医疗改革的核心问题之一。本文通过统计年鉴的数据分析和实地基层医疗机构的调查得到,基层医疗机构人才队伍参差不齐,数量缺乏、能力薄弱等多种问题。为从根本上解决问题,促进基层医疗机构发展和医疗水平的提高,在新医改政策的指导下,本文提出了加快加大基层医疗人才队伍建设几种策略。     

公立医院内部控制环境建设研究

良好的内部控制环境,是公立医院内部控制有效实行的前提条件。为保障内部控制制度充分发挥其规范财务管理、提高医院经营管理的重要作用,适应新医改的实践需要,建设稳定、高效的优质内部控制环境,已成为财会领域刻不容缓的重大课题。     

全面预算管理条件下医院财务成本控制研究

全面预算管理是现代医院经营管理中的重要内容,也是实现医院财务成本控制的有效措施,对于医院核心竞争力的提升以及医院事业的稳定发展十分重要.随着新时期的到来,社会也在不断进步,同时医疗卫生体制也加入了改革的潮流中,医院需要积极做好财务成本控制工作,充分发挥出全面预算管理的价值,为医院财务成本控制工作提供重要保证,有效促进医...     

Health sector reform and human resource management: Britain in comparative perspective

This article examines the impact of health service restructuring for employment practices in Europe, using Britain as the basis of comparison. It first considers trends in West European health care reform and examines the extent to which reform measures have been accompanied by changes in employment practices. It focuses on reforms of pay determination arrangements and work organization, examining in particular the experience of nurses, who form the largest occupational group. Finally, some of the implications for a future research agenda are considered. It concludes that research on health sector employment practices is under-developed and outlines a research agenda that recognizes the importance of workplace restructuring within a comparative framework.     

Total quality management and statistical quality control: practical applications to waste stream management

TQM offers a completely new approach to problem solving in health care. The approach requires dedication and persistence in monitoring, understanding, and changing systems at a level that has never been reached before in the United States' health care system. Materiel management, purchasing, nursing, housekeeping, and administration now have the necessary tools to centrally study the medical waste stream flow at their facilities. The intent of this article is to display how TQM techniques can be applied to minimize a hospital's medical waste stream. The approach of studying medical waste as a defect generated during the process of delivering high-quality care enables a hospital to pinpoint causes of these defects, modify the parent system of the defect, and lessen the generation of medical waste defects. Successful implementation of these techniques as a continuous process will enable hospitals to be leaders in the preservation of their host communities' environments.     

区县级妇幼保健院绩效工资分配的实践与思考

随着医院改革的不断推进,各种改革方案不断出现。在如今的新形势下,区县级妇幼保健院所采用的传统财务管理模式已不再适应社会发展的需要,特别是在绩效工资分配方面。基于此,论文从区县级妇幼保健院绩效工资分配的角度出发,对其实践过程和结果进行了分析和探讨,希望为区县级妇幼保健院的绩效工资分配向更好的方向发展提供一些借鉴。     

医院应加强外办门诊财务的规范化管理

实施"医药分开核算,分别管理"、病种限价和农合、医保病人利润微薄,以及医疗卫生体制的不断改革,医院的获利空间相对缩小。医院为了在困境中求得生存和发展,各医院在辖区内外相继开设了多个综合门诊和专科门诊,以增加医疗收入。但加强院外办门诊的规范管理尤为重要,一是开办院外门诊应首先报卫生主管部门批准:二是开办院外门诊要具备房屋、设备条件:三是制定合同要实事求是,积极可靠:四是明确管理体制,使国家各项政策、法令、经济措施的宣传、贯彻得以落实:五是会计人员应由医院指派。会计、出纳应同时配齐:六是完善分配机制:七是严格医德医风考核。只有不断加强管理,才能使其朝着健康的方向发展。使院外办门诊对医疗卫生事业起着拾遗补缺的作用。     

浅谈民营医院的声誉问题

民营医院作为公立医院的补充,其存在是必要的。但是随着医疗市场的发展,民营医院的经营出现了问题,民众对于其信任感大大降低,声誉面临极大的挑战。本文分析了民营医院存在的一些声誉问题,并提出了一些解决措施。     

Local government reform between ‘exogenous’ and ‘endogenous’ driving forces

Abstract

Configuration is an appealing concept to help understanding the complex arrangements that guide organizations' actions and contribute to their coherence. Although health care organizations are often described as professional bureaucracy a deep understanding of their structure and systems is still lacking. In this article, we draw on empirical data gathered in a Canadian teaching hospital to expose the nature of interdependencies and themes that drive some of its configurations at health care unit level. Five clinical activities were investigated (ocular surgery, brachytherapy, vascular surgery, rheumatology and geriatrics) using direct systematic observation. Four sub-orchestrating themes emerged. Based on the findings it is argued that the operating core of health care organizations is not homogeneous but rather heterogeneous. Therefore it is our contention that hospitals and other public organizations where professionals control the activities at operating level might be better regarded as ‘diversified professional federation’ than as professional bureaucracy.     

Free-standing surgery centers; the wave of the future

To summarize, it should be realized that acceptance of surgicenters has happened. Surgery centers expect heightened awareness of their services as patients, in conjunction with their own physicians, make decisions based on cost, service, and convenience of the care provided. As copayments and deductibles increase, consumers have become better educated, taking a more active role in selecting their health care providers. This activity has given rise to joint ventures between physicians and hospitals offering new ambulatory care packages previously based in hospitals alone. The net effect will divide the health care industry into two markets, one that will manage high-intensity surgical procedures and one that will promote outpatient surgical procedures.