Research On Optimization Of Internal Control In Public Hospitals

Now that the new medical reform has been promoted for nearly ten years,the competent department of health industry,some scholars and hospital managers in China have gradually realized the necessity and urgency of building a sound internal control in public hospitals;and they have started to study and learn from both domestic and foreign successful practical experience,aiming at introducing internal control in the operation and management of public hospitals.However,due to domestic public hospital’s dual goal orientation(functional goals and public welfare goal)and the particularity of operation and management(the complexity of vocational work and related policies),the internal control theory system has not been established and the effective implementation of Internal Control Norms of Administrative Institutions(Trial)cannot be achieved overnight.Based on that fact,further more researches are needed in this field.In the terms of theory,this paper uses the literature review method to learn from both domestic and foreign literature.Through the study of cybernetics,information theory,system theory and the theory of internal control frameworks,this paper thoroughly interprets the related concepts of public hospitals and their internal control.It defines public hospitals in China as public institutions run by the government or other organizations with state-owned assets for the purpose of public welfare,engaged in medical and health services,meeting the people’s medical and health needs,and included in the financial budget management.Chinese public hospitals’ five basic functions,three characteristics and four particularities make determine that the construction of internal control of domestic public hospitals is challenging.In the terms of practice,this paper takes H public hospital as a case and carries out an in-depth analysis combining theory and reality.H public hospital,as a state-level city public hospital with a long history,huge volume and rapid development in recent years,its operation and management has always been the benchmark in the domestic industry.However,H public hospital has accumulated some problems that cannot be ignore at the unit level,vocational work level and information system level.As results,H public hospital’s internal control has failed to work as a whole and the optimization of internal control has been in stuck.To change that situation,this paper proposes five major countermeasures for its internal control environment,risk assessment,and internal control evaluation,including the improvement of internal control institutions,clear division of responsibilities,preparation of systems,comprehensive internal control evaluation,and classification and optimization of information systems.The hospital’s internal control environment,and give full play to the role of risk assessment and optimization of internal control,so as to improve the overall effectiveness of its internal control system.