A Study On Refined Cost Management Of Public Hospitals Under The Background Of New Medical Reform

As one of the basic livelihood issues,medical problems have always been the focus of national attention,especially how to protect the public welfare of medical institutions and improve the quality of medical services.In order to make health care better benefit people’s livelihood,the state actively promotes the reform of medical system,adheres to the marketoriented and patient-centered reform direction,and encourages public hospitals to reduce fees and increase efficiency.In Article 14 of the report on deepening medical reform approved and transmitted by the central office and the State Council,it is emphasized that in the process of deepening medical reform,the fine management of public hospitals should be strengthened and combined with medical quality management,medical service management and medical expense management.With the economic development of the times,the state has found that the short-term effect of the development mode of medical institutions with high investment is too obvious.In the long run,it is not only not conducive to the development of public hospitals,but also causes a high debt ratio of medical institutions,which has a negative impact on their development.In order to ensure the sustainable and healthy development of medical institutions,the new medical system reform pays more attention to the reform of cost,cancels the bonus of drugs and high-value consumables in public hospitals,and puts forward stricter requirements for the cost control of public hospitals.In order to comply with the requirements of the new medical reform and reduce the operating costs of public hospitals,public hospitals can only carry out fine management of costs.Combined with the background of the new medical reform,this paper selects x public hospital as a case to study the current situation of its cost management,analyzes the composition of the cost project of X public hospital,analyzes the key factors affecting the cost,summarizes the main problems existing in the process of cost management and analyzes the main reasons,and constructs a cost refined management system,so as to provide reference for other public hospitals in the cost management under the background of the new medical reform The effective implementation of fine management provides a reference guidance scheme.This paper is divided into six chapters.The first chapter is the introduction.Including research background,research significance,research content and research methods,technical route and innovation.The second chapter is literature review.This paper systematically combs the content and importance of the existing cost accounting system,the composition and control methods of cost,and the research on the fine management of cost.The third chapter is related concepts and theoretical analysis.This paper mainly defines the related concepts of public hospital cost control,medical system reform and cost fine management,and analyzes the development process of medical system reform and the current situation of public hospital cost accounting.The fourth chapter is the research of X public hospital cost fine management under the background of new medical reform.Combined with the background of the new medical system reform,mainly from the cost of manpower,drugs and health materials,this paper analyzes the setting of cost posts,the composition of cost items and the development of cost accounting in X public hospital,analyzes the key factors affecting the cost,and studies the main problems and reasons in the process of cost management in X public hospital.The fifth chapter is the design and analysis of the cost fine management of public hospitals under the background of the new medical reform.This chapter uses feedback control method and value chain analysis method to analyze the cost fine accounting system,and systematically expounds the cost fine management system from the aspects of fine cost organization setting,fine cost accounting and fine cost assessment.The sixth chapter is the research conclusion,deficiency and prospect.The analysis draws relevant conclusions,summarizes the deficiencies and prospects the future research.After research and analysis,the main conclusions are as follows: first,due to the lack of theoretical basis and practical experience,the cost fine management of public hospitals is chaotic,and the waste of cost is serious.The development of public hospitals in China is very difficult due to the lack of financial aid and the burden caused by poor cost management.Second,the cost fine management of public hospitals is not systematized,the attention to the cost fine management is low,the management mode is extensive,the hospital management and grassroots personnel do not have a good understanding,the hospital cost management system is not perfect,the hospital cost accounting level is not deep,the hospital assessment mechanism is not perfect,and the information level is not high.Third,to realize the fine cost management of public hospitals,we need to build a perfect fine cost management system,pay attention to the core of cost accounting,refine the cost accounting center,accurately allocate indirect costs,and make full use of the feedback control of cost assessment to implement closed-loop management of fine cost management.In addition,in order to realize the cost fine management of public hospitals,we should pay attention to the guarantee work of information platform construction and improve the construction of information platform.In a word,there is a lot of room for improvement in the cost fine management of public hospitals.The research innovation of this paper mainly includes two aspects:(1)it constructs a complete cost accounting system,innovates the research content of activity-based costing combined with the attributes of public hospitals,further classifies the controllable costs of departments,and creatively puts forward the concept of medical subgroup,which makes up for the shortcomings of the existing cost research in public hospitals.There are two advantages in the research of medical team.First,it can reduce the workload and improve the accuracy of the research.Second,compared with the disease cost method,the research of medical team can find the specific problems in the process of medical service development.(2)This paper studies the fine cost management on the premise of the new medical system reform by linking the fine cost management with the medical system reform.There are few studies on the cost fine management of public hospitals in the existing literature,and few studies combined with the new medical system reform.The new medical system reform and the cost fine management are complementary.The new medical reform points out the direction for the cost fine management,and the cost fine management provides the perfect data support for the new medical reform.This paper focuses on the cost fine management of public hospitals,combined with the new requirements of the new medical system reform for public hospitals,puts forward new ideas on the cost fine management of public hospitals,and improves its research.