Research On The Whole Life Cycle Follow-up Audit Of PPP Integrated Medical And Nursing Care Project

With the aging degree of Chinese population deepening,how to provide for the aged in the future has become a big problem that neither country nor individual can avoid.In the report of the Party’s 20 National Congress,the active response to population aging has become a national strategy,and promoting the combination of medical and old-age care is an important measure to optimize the supply of health and old-age care services for the elderly,and an important way to actively respond to population aging and enhance the sense of gain and satisfaction of the elderly.However,the industry is faced with the current situation of high input and low income,low participation of social capital,and insufficient effective supply of the industry.The introduction of PPP model is a breakthrough to increase the effective supply of medical and nursing services for the elderly.However,while the PPP model is being promoted in our country,some local governments carry out disguised financing through guarantee commitments,repurchase arrangements,shares and bonds,etc.,packaging projects as PPP projects.In addition,PPP combined medical and nursing projects also have the characteristics of complex participants,huge investment scale,long construction period,strong social public welfare,low project income,the traditional audit model based on post-audit is no longer applicable.Therefore,it is of great significance to clarify the process and key points of tracking and auditing the whole life cycle of PPP medical care combined projects to enrich the audit theory of PPP medical care combined projects and guide the audit practice of PPP medical care combined projects.Based on the whole life cycle theory,stakeholder theory and fiduciary responsibility theory,this paper clarifies the audit process and key points of the whole life tracking audit of PPP medical care combined projects,focusing on the evaluation of project value for money,financial affordability demonstration,implementation plan,bidding and bidding,contract management,project construction,operation performance and so on.Based on the case study of the PPP Hospital of Traditional Chinese Medicine in D County,this paper finds that there are some problems in the tracking and auditing process of the whole life cycle of the PPP hospital,such as the imperfect legal basis,the inaccurate positioning of the audit focus,the inadequate attention to the risk of government implicit debt,the imperfect information disclosure mechanism of the project,and the incompetence of the professional quality and ability of the auditors.To solve these problems,the author puts forward the following suggestions: first,establish and improve the legal system of tracking and auditing the whole life cycle of PPP medical and nursing combination projects;The second is to clarify the audit objectives to ensure the comprehensive focus of the audit;Third,focus on the government hidden debt risk in the audit process;Fourth,improve the audit supervision and management mechanism and audit results publicity system;Fifth,the construction of PPP medical and nursing combination project life cycle tracking audit personnel training system.This paper hopes to enrich the audit theory of PPP medical and nursing projects and provide some enlightenment for the audit work in related fields in the future.