Study On Management Model Of Enssential Public Health Services Fund

[Objectives] This paper aims to establish the fund management mode of county essential public health service and put forward the policy suggestions to improve the domestic fund management of county essential public health service by taking internal control theory, financial expenditure management theory and system management theory as the guidance.[Methods] The research materials are mainly obtained by document research and field investigation methods. Randomly select13counties (cities, districts) from Guangdong Province, Hunan Province, Henan Province, Chongqing City and Sichuan Province as sampling regions. Select O County in Heilongjiang Province and the N County in Guangdong Province as the typical sampling regions with two randomly selected township health centers, totally15sampling counties and four sampling townships. The objects of investigation refer to the managers in county health institution, public health agency and the essential medical and health organization as well as the staff in public health service. The essential public health service of sampling regions is evaluated with Rank Sum Ratio method. The fund management of essential public health service is analyzed under descriptive statistics method. Similarities and differences of fund management were under comparative analysis method. The domestic fund management of county essential public health service is constructed using Standard Research method and Logic Analysis method.[Results and Discussions]1The research defines the connotation of fund management mode of county essential public health service. The fund management mode of county essential public health service means the county finance department, health institution as well as other relevant departments achieved the fund planning, organization, leadership and control effectively as well as the organic combination among various elements, layers and links of management functions through designated system arrangement so as to reach the objectives of essential public health service project. The links of fund management of county essential public health service mainly includes the fund procurement and appropriation as well as the supervisory control applied by the essential medical and health organization.2The main existing problems on fund management in sampling region are as follows:first, the insufficient county finance support(19.875Yuan in N County in2012); second, expenditure misappropriation or diversion in health administrative department(more than30percent of essential public health fund was from new rural cooperative medical fund); third, the fund retention budget unit can no bet timely appropriated to essential medical and health organization; fourth, illegal appropriation of public health professional institutes; fifth, the non-standard internal distribution of essential medical and health organization; sixth, lack of external supervision on capital application. The procedure of fund appropriation, budget management system and performance appraisal systems were different.3The paper proposes the framework of essential public health service fund management mode in counties and optimizes operation links. In terms of fund-raising, the major management measures include national treasury centralized payment system, budget balance and check system and auditing system. In terms of fund appropriation, the major management measures include national treasury centralized payment system, centralized accounting checking system and department budget management system. In terms of supervision control after fund utilization, the major management measures include national treasury centralized payment system, national treasury dynamics supervision system, centralized accounting checking system, performance appraisal system, public participation system, etc.4The paper proposes some policy suggestions on basic public health service fund management in counties in our country, including establishing fund appropriation mechanism centering on national treasury centralized payment system, improving budget management on the projects in basic medical care institutions, enhancing checks on the standardization of expenditures in basic medical care institutions as well as boosting the openness of information so as to disclose the information about basic public health service projects timely and fully.[Innovations and Limitations] The innovations of the paper are manifested in:1Based on theories such as Systematic Management theory, Internal Control theory to build essential public health service fund management mode in counties, so as to support the fund management study theoretically and promote the extension and progress of Internal Control theory, Management Control theory from the field of management to essential public health service fund management.2This paper optimizes the key links of essential public health service fund management and carries out suggestions. These are benefit for the application of Systematic Management theory, Internal Control theory, so as to promote the equalization of essential public health service.The deficiencies of the research are mainly manifested in:1Due to the complexity of management practices, the author fails to carry out empirical detection on the management mode, whether it can be applied fully requires for further detection.2Rural health clinics and community health service stations generally participate in providing basic public health service, but the corresponding financial investment and financial management systems are different from township hospitals and community health service centers. Due to the limited research ability and time, the author does not carry out comprehensive and in-depth investigations. It is also the deficiency in the paper.