| At the beginning of 2009,China initiated a new round of medical reforms.The State Council promulgated the Opinions on Deepening the Reform of the Medical and Health System,which clearly stipulates that public hospitals should focus on patients and use public welfare and social benefits as the criterion.Public hospitals must return to public welfare and undertake corresponding social responsibilities.However,so far,public hospitals have been required to use operating compensation as the main compensation mechanism.Grading diagnosis and treatment and zero-plus-drug increase have also made it difficult for hospitals to make operational compensation through the market.How to reflect public welfare under the conditions of operating compensation? How to deal with these difficulties to better serve patients and take corresponding social responsibilities? One important measure is to reasonably control and reduce costs.Large public hospitals are affected by the past frantic,expansive,and high-cost operating models.They are in urgent need of changes in operational efficiency,service models,resource utilization,andmanagement concepts.Improvements in quality,efficiency,and cost reduction are internal to large public hospitals.The inevitable choice for reform.By studying the development and evolution of cost management related theories and applying the theory to practice,the current cost management has passed simple cost accounting,rough control and post-event cost control,and gradually developed to be guided by organizational strategy and analyzed through the value chain.,taking into account the effective balance of internal and external cost resources,and fully achieve the modern strategic cost management of the pre-budget,intra-state analysis control,and post-account evaluation.As the latest cost management theory,the core idea of strategic cost management is to integrate the strategic objectives of the organization with cost management,integrate the organization’s strategy into the process of cost control,and strive to meet the needs of cost management that is applicable to the development of the organization’s strategy.Competitiveness.The idea of strategic cost management has been widely used in enterprise management,but the use of hospital cost management is still at the stage of preliminary theoretical research and exploration.The Balance Scorecard(BSC)is a tool for performance management and evaluation developed in the past 20 years.Many practices have proventhat BSC is an effective management tool.In the hospital cost management,BSC takes the strategy as the starting point and establishes a set of scientific index system to evaluate the hospital’s cost control,so as to provide a reliable basis for the decision-making of the hospital.It takes into account the patient-centered,social responsibility and management.Sex is one of the modernization cost control evaluation tools that managers recognize as having high practicality.This subject selects X Hospital as the target hospital for research,and X Hospital belongs to a three-level A-level integrated Chinese and Western medicine hospital in a city in the northeast of Sichuan Province.It belongs to a new type of hospital that has only expanded in recent years.X Hospital is in the leading position among the Chinese medicine hospitals in the northeastern Sichuan region.At the same time,X Hospital is also one of the two top three hospitals in the city(the other belongs to the General Hospital of the three grades,and its size is twice that of the X Hospital.).Constrained by the influence of many factors,the cost management of X hospitals is relatively lagging,and even basic costing is not carried out in cost management,let alone cost management and strategic cost research.The economic management of X hospitals is only accounting treatment of income and expenditure and bonus accounting under the "reduction and reduction mode",and there is no real sense of cost management.AsSichuan Province,where Hospital X is located,is a pilot city for grading diagnosis and treatment systems,a grading system has been fully implemented.The elimination of drug additions was also fully implemented in 2017.As a new type of hospital built in recent years,it faces multiple policies.The impact of X Hospital’s operation is facing many difficulties and challenges.How to improve the level of hospital cost management,improve the efficiency of hospital service patients and the efficiency of resource utilization,improve the survivability and competitiveness of hospitals,and pursue the need to obtain better economic and social benefits with relatively less resource consumption,is currently urgently needed by hospital administrators.Research and efforts to solve the problem.This topic takes the X hospital cost management as the research entry point,and uses the Delphi method combined with the data collected from the X hospital to study the establishment of the X hospital based on the BSC under the guidance of the BSC theory by referring to the related domestic and foreign literature data.The cost control indicator system provides theoretical guidance for X hospitals to use this indicator system to control and evaluate their costs.Although the current research content is only the establishment of the indicator system and put forward the theoretical recommendations for the application of practice,the author willcontinue to follow up the cost management of the X hospital,follow-up research on the index system applied to the hospital’s cost management practices,and ultimately expect to link the theory with practice.,Summarize experience and provide new ideas and methods for exploring the cost management of large-scale public hospitals in the new era. |
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