【作者】 王艳；

【导师】 张金锁； 陈林；

【作者基本信息】 西安科技大学 ， 工商管理硕士（专业学位）， 2021， 硕士

【摘要】 随着社会的发展和医疗卫生体制改革的推进,公立医院所处的内外部环境发生了巨大变化,尤其是2020年席卷全国甚至全世界的新型冠状病毒,对公立医院的运营造成剧烈冲击。在外部资源有限、医院生存面临严峻挑战的形式下,公立医院必须加强自身“软实力”建设,向内要效率。开展内部控制建设正是公立医院提升运营效率,实现高质量发展的重要手段。为此,国家有关部门于2020年底出台了《公立医院内部控制管理办法》,为公立医院内部控制的落地实施指明了方向。ZY医院作为陕西一家公立三级甲等中医医院,因内部控制体系不够完善,导致医院运营效率低下,并成为阻碍医院发展的重要原因。为此,本文专门对ZY医院的内部控制体系进行优化研究,对于建立健全医院内部控制体系,提升管理水平和促进其可持续发展具有重要意义。本文在对国内外相关研究现状进行综述的基础上,首先对内部控制相关理论、方法和政策进行了概述;其次,以ZY医院为研究对象,采用问卷调查法、深度访谈法等方法,对ZY医院内部控制的现状和存在问题进行了调查研究,诊断出了 ZY医院内部控制体系在风险识别与评估、单位层面、业务层面和评价监督层面存在的问题;再次,确定出了 ZY医院内部控制体系优化的目标及应遵循的原则,并针对诊断出的问题进行了逐一优化,提高了 ZY医院内部控制建设水平。在风险识别与评估阶段,ZY医院应从控制目标、风险识别、风险分析进行优化,在单位层面应加强制度建设并建立联动机制,在业务层面应重点完善预算与收支、政府采购、资产、建设项目、合同、医疗业务管理、科研项目和临床试验、教学管理、互联网诊疗、信息系统的薄弱环节,在评价与监督层面应加强内外部评价和监督。最后,从健全组织领导、加大宣传培训、强化监督检查、注重外部环境等方面提出了ZY医院内部控制体系实施的保障措施,并对研究结果进行了展望。以上研究内容对ZY医院健全内部控制体系具有重要的参考价值,同时也对类似公立医院内部控制体系的搭建有借鉴和指导作用。更多还原

【Abstract】 With the development of society and the advancement of medical and health system reform,the internal and external environment of public hospitals has changed greatly,in particular,New Coronavirus,which swept the whole country and even the whole world in 2020,has a severe impact on the operation of public hospitals.In the form of limited external resources and severe challenges for hospital survival,public hospitals must strengthen their own "soft power" construction and seek internal efficiency.Carrying out the construction of internal control is an important means to improve the operation efficiency and achieve high-quality development of public hospitals.To this end,the relevant departments of the state issued the "measures for the management of internal control in public hospitals" at the end of 2020,which pointed out the direction for the implementation of internal control in public hospitals.ZY hospital,as a public third class a hospital of traditional Chinese medicine in Shaanxi Province,due to the imperfect internal control system,leads to the low efficiency of hospital operation,and has become an important reason for hindering the development of the hospital.Therefore,this paper focuses on optimizing the internal control system of ZY hospital,which is of great significance to establish and improve the internal control system of the hospital,improve the management level and promote its sustainable development.Based on the review of the relevant research at home and abroad,this paper first summarizes the relevant theories,methods and policies of internal control;Secondly,taking ZY hospital as the research object,using the methods of questionnaire survey and in-depth interview,the current situation and existing problems of internal control in ZY hospital were investigated,and the problems in risk identification and evaluation,unit level,business level and evaluation and supervision level of internal control system in ZY hospital were diagnosed;Thirdly,the objectives and principles of internal control system optimization of ZY hospital are determined,and the diagnosed problems are optimized one by one,which points out the direction of internal control system construction of ZY hospital.In the stage of risk identification and evaluation,ZY hospital should optimize its control objectives,risk identification and risk analysis,strengthen system construction and establish linkage mechanism at the unit level,and focus on improving budget and revenue and expenditure,government procurement,assets,construction projects,contracts,medical business management,scientific research projects and clinical trials,teaching management,Internet diagnosis and treatment,etc For the weakness of information system,internal and external evaluation and supervision should be strengthened at the level of evaluation and supervision.Finally,from the aspects of improving the organization and leadership,increasing publicity and training,strengthening supervision and inspection,paying attention to the external environment,the paper puts forward the guarantee measures for the implementation of internal control system in ZY hospital,and prospects the research results.The above research content has important reference value for ZY hospital to improve the internal control system,and also has reference and guidance for the construction of internal control system in similar public hospitals.更多还原