Strengthening of Hospital Cost Accounting and Management

[Abstract] strengthen the hospital's Cost Accounting and management related to the social health insurance and livelihood issues, the hospital must address an important issue. Author based on their years of work at the hospital in accounting practice and experience to the hospital Cost Accounting knowledge to solve problems , objects and methodological issues, further strengthening cost management issues, were discussed.

[Keywords:] hospital; costs; accounting; Management

West China Hospital is a famous large hospitals, Cost Accounting and how to strengthen management and improve the hospital's social, economic efficiency and competitiveness, and promote greater development of the hospital, is currently the subject must be seriously addressed. The author has long been engaged in the hospital accounting work, based on years of practice and experience, is for the status of hospital Cost Accounting and management to hospitals, Cost Accounting and management study, to further improve hospital cost management and accounting to improve the hospital's economic and social benefits.


First, the hospital cost accounting knowledge required to solve the problem

Currently, the treatment cost of the qualitative state-owned hospitals and scope, there is no uniform understanding of standards. People often look at the other one does not see, just grasp the economic needs, while ignoring the needs of society; only the calculation of financial need spending, excluding social expenditure needs. To this end, to stand a high degree of unity of social and economic benefits, dialectical look at the cost of hospital management and accounting.

(A) The Hospital should be laws of the market for cost management and accounting
Should be conducted according to market principles Hospital cost accounting management. The market benefits of economic stress, the hospital cost accounting management necessary is a matter of common sense. Now that the hospital is the economic entity, but not exactly the same enterprise. If the hospital should reflect the nature of the cause , the cost of a full accounting of the reluctance, because the nature of the work to determine its economic sense, not fully pay attention to the cost of, and sometimes need to pay the cost of social significance, that is, government policies need to pay the hospital; if the hospital as economic entity, to be a true reflection of the facts of Medical activities, to show the full sense of the panoramic view of hospital financial management is indeed necessary. At present, I believe that two-way state-owned hospitals should be established cost accounting management system: one to establish a strict cost control and management accounting mode, take the path of intensional development; the other hand, on the costs from the perspective of economic and social understanding and grasp of the two, both from the economic perspective of costs, but also from the perspective of social costs.

(B) the right to establish the range of costs
Medical activities in the hospital how much the cost is entirely cost, or non-full-cost fees, at all levels has long been the financial sector, health authorities in the management of state-owned hospitals in the debate. The hospital as an economic entity should be based on the requirements of full-cost accounting and management, while both state-owned hospitals also social responsibility, commitment to government functions, in which case the cost of the hospital may not be complete. So the cost of the scope of the hospital can not be generalized, to distinguish the situation, set conditions the law recognized that seriously implemented. But on the whole, the absolute emphasis on hospital management to strictly control costs, according to the requirements of full-cost accounting management should not arbitrarily increase or decrease. But in the implementation of the policy factors, we should focus on the political prerequisite fulfilled by non-full cost to be borne by social responsibility.

(C) establish the "livelihood" concept of service does not pass the cost of fees
The high cost of hospital now under difficult, largely because some hospitals starting from the standard, the cost of the Medical part of the infinite stretch to achieve the income-generating purposes. This is of course lack of government investment in the macro reasons, but subjectively , we should focus to determine the management, to be effective management. to completely reverse the Hospital for the past errors in income-generating awareness on the issue: the cost of the hospital is that patients need to bear the cost. but to shift the focus of hospital cost management is to reduce patient the burden, reduce unnecessary Medical activity, the expenditures do not need to make hospitals and costs and expenses relative to revenue decoupling, with the thrift, the results strengthen the internal control closely linked.


Second, the object and method of hospital cost accounting

(A) the object of cost accounting
Hospital Cost Accounting is the object of inpatient and outpatient, inpatient and outpatient hospital services throughout the work has always been. To determine the purpose of hospital cost accounting of the object or hospital out-patient cost of living labor income and materialized labor situation, so the hospital should include the cost of cure patients to meet the expenditure needs of all patients with Medical, pharmaceutical and management costs. and West China Hospital is a large hospital, and affiliated sections of the cost accounting, management, assessment of significance is to meet the needs of community and hospital management.

West China Hospital, is the object of the hospital cost accounting with certain management rights, and assume the corresponding responsibility of the hospital within the unit, according to the actual situation, determine the hospital cost accounting department for the object. The department of West China Hospital cost accounting cost accounting is the basis for "two-tier responsibility" to provide assessment based management style, which inspired the hospital's internal energy.

Object is the unit project cost of medical care project is to complete a medical project account to pay for services and consumption goods. Through the medical project cost, on the one hand can increase the cost of medical awareness of the project operator, active participation in management, to form a good internal control mechanism; the other hand, can provide managers to carry out medical and government departments to develop project management services, prices and other aspects of medical decision making.

(B) the costs of collection, allocation and calculation
Hospital cost accounting department should calculate the monthly cost, cost accounting in all departments regularly carried forward on the basis of aggregate costs of the department. And, where necessary, to carry out medical project cost.

1. Costing department. To further improve the hospitals and the cost of management and accounting departments, you must do the following: (1) the establishment of hospital cost management system of the accounting structure; (2) the establishment of cost accounting objects of different management models; (3) clear control of the hospital cost accounting principles of the various departments; (4) specification method of revenue sharing; (5) uniform cost allocation methods for extraction; (6) to establish cost accounting control performance reporting. the cost of each department can be divided into controllable and uncontrollable costs of the cost two categories.

① controllable cost sections: is the responsibility of the department may direct control of expenditure. The calculation is based on accounting information directly at the object of the imputation to the accounting department wages, extra wages, other wages, employee benefits, social security, official fees, health materials, other materials, consumables, operating expenses, acquisition costs, repair costs, entertainment expenses, leasing costs, other expenses and other projects, constitute the controllable costs of the department. Some can not determine the amount consumed distribution according to the level of benefit costs. ② departments do not control costs: refers to the responsibility of each department's expenditures do not directly control, mainly referring to administrative costs, the allocation is generally based on a poll.

2. Periodic medical cost accounting. Medical cost calculation method for parallel carry-over carry-over costs of the department, the cost of the medical departments at the various sections of the level of benefit distribution.

3. Medical services costs. Mainly the basic standard cost method, the basic standard - once enacted, as long as the medical conditions, materials, and no major changes in labor costs, the cost of basic standards for medical items can be guided in a certain sense, practical work, and can as the pricing basis. standard cost includes direct materials, direct labor, equipment depreciation and management costs.

(1) direct material consumption and specific operations by management personnel, materials, prices are determined by the accounting department and procurement departments. (2) direct labor: is carried out under the current medical standards of the time required by health care to be the medical staff of the service units of the average wage. (3) depreciation of equipment: life method or amount of work by the depreciation method. (4) management costs: (direct material cost + direct labor + equipment depreciation) x management expenses ÷ medical expenses
(C) cost accounting should note that the issue of child
1. Strengthen the health care cost accounting, will help improve the hospital cost, but this is not the ultimate goal. The ultimate goal is the implementation of cost accounting: to enable patients to enjoy both high quality and efficient medical services, but also the patient's medical costs be reduced, should not be one-sided pursuit of lower costs, leaving damage to the interests of the patient or lower quality of medical services.

2. The implementation of hospital cost accounting will involve the country, hospitals and economic interests of individual workers, and many other adjustments, to actively and steadily carried out. It is necessary to the pursuit of efficiency, but also due consideration to fairness, it is necessary to take into account the fundamental interests of the state and the patient, also take into account the hospital, medical staff interests.


Third, the hospital's cost management

(A) establish the full cost of management philosophy
In a market economy, hospitals can focus on improving efficiency is to reduce the cost and improve efficiency, it should be seen as combination of full-cost accounting characteristics and needs of the hospital carried out a modern management methods. To do extensive publicity work, establish and improve various rules and regulations to form a "top-down" for cost management and control self-complete system, so that progressively expanded and in-depth cost accounting, cost accounting to achieve full cost accounting has never fully transition.

(B) the construction of the theoretical system hospital cost accounting
The health sector should together with the financial department of the hospital as soon as possible specific measures for cost accounting, cost accounting clearly defined scope. Meanwhile, the hospital cost accounting in accordance with the provisions of national unity and the implementation of the work of their own characteristics, and send a certain number of full cost accounting staff responsible for cost accounting and control. reposted elsewhere in the Research Papers Download http://www.hi138.com (c) make indirect cost-sharing, the implementation of full cost accounting
Hospitals cost accounting and management purposes is to reduce health care costs, reduce the burden on patients, and enhance the competitiveness of the hospital, to achieve high-quality, high efficiency, low consumption operation. Hospital medical services should be the full cost of the course fees are included in the scope of cost accounting , in accordance with the principles of benefit and matching, combined with their actual local conditions, to take per capita, were amortized by the project, and according to workload or other reasonable method of apportionment, as far as possible reflect the costs at the right cost at the same time, relevant departments of the benefits assessment and the distribution of benefits to minimize the impact of factors, the implementation of full cost accounting to minimize the negative effects of the process.

(D) to do the forecast and full cost-benefit analysis of management
Hospital cost management in the implementation of full-time, to refine and deepen the basis of cost accounting department, the establishment of index system of cost accounting, cost analysis and cost evaluation system for information system and do the cost analysis, control and benefit analysis. To based on cost analysis and evaluation of results and standards, staff wages, all kinds of material consumption, water consumption, official fees and equipment purchase costs to achieve control in advance. to pass on medical service quality, service, assessment of patients the level of fees, the cost of quality enhancement assessment management, and the whole process of medical services, full, full range of cost control. At the same time, but also to select the number of medical services or carry out the project of diseases, disease cost accounting, pricing decisions for the public hospitals provide the basis for fees to carry out single disease management, reduce costs of patient care data.

(E) establish organizational cost accounting
Hospital cost accounting is an important part of hospital economic management, which involves all hospital departments, all departments and the vital interests of each employee to ensure the smooth progress of cost accounting, cost accounting organizations to build the hospital. Dean of hospital cost accounting should be implemented responsibility to the accounting department as the center, the cost accounting staff, the relevant department division of labor, formed from the leadership to the staff, from administrative logistics to clinical medical technology sector, full co-ordination of the hospital cost accounting system.

(F) to do the basic work of cost accounting
1. Undertaken through public bidding and quota management, and lower material costs. In the market economy, medical and health industry has also been to the market. On the material cost control and management of the implementation of comprehensive, full use of material resources to effectively limited efficient use of funds, reduce the cost of hospital supplies. To strengthen the audit supplies, supervision, control, seize the material procurement costs, improve the material adhere to quota management.

2. Accelerate the reform of personnel and distribution system to reduce labor costs. In the hospital cost structure, the personnel expenditures accounted for about 30%. Therefore, accelerating the reform of hospital personnel and distribution system to reduce the personnel expenditures is an important way to reduce the cost of the hospital - . For this reason, I think we can take the following measures: (1) competition, merit-based employment posts; (2) optimization of human resources, the rational allocation of human resources; (3) improve the distribution of wage incentives.

3. Active mobilization and effective use of funds and reduce the cost of capital. With the continuous development of the hospital, how to raise and use funds, reasonable to reduce the cost of capital, hospital management has become an important part of the work. To strictly control the direction of capital investment, the funds into low-risk, high return projects, and enhance the effect of the use of funds, the hospitals maintain a reasonable debt structure (should be controlled within 35%).

4. To strengthen cash management, timely analysis of cash flow dynamics. In the cost of the hospital management should grasp the cash flow of information, analysis of hospital investment, financing, financing of the impact of economic performance, evaluate the hospital's solvency and financial ability to pay demand.

(Vii) improve hospital operations and management, lower management costs
Reduce management costs should be mainly the following tasks: First, real reductions in bad debt losses; second is to improve hospital management efficiency, and promote the standardization of hospital management, networking and scientific, improve quality and efficiency indicators to complete the work as much as possible; Third, deepen the logistics sector reform, in line with internal and improve security, opening up the principle of operation, the hospital canteen, kindergarten, laundry, utilities and maintenance logistics sector, the implementation of independent accounting, autonomous, self-financing, and promote community support services , thus enabling back-office services to shift from the managed services business model to reduce non-productive costs.

(H) implementation of the "target cost" management, good cost control analysis
Target cost control is the complete output from the input to the cost control system. Therefore, the implementation of the "target cost" management of the hospital staff must be allowed to participate in the management, the goal becomes to determine the cost of staff initiative. This inherent incentives of medical quality and work efficiency with protecting and promoting the role, they are able to effectively reduce costs. do well first to establish goals target cost management cost management organization system, the target cost management into the daily work of the hospital areas, the implementation of target cost regular assessment of target cost, based on cost management indicators, combined with the workload and the corresponding fixed costs, changes, etc., will be indicators to the people, and take the reward and punishment measures.

To control costs, should be good at analysis and comparison, identify gaps from the comparison, the cost data obtained were compared and analyzed, to be meaningful only to compare both the performance of various departments comparison between the cost control, but also different Comparison of results of the annual cost control, but also compare the cost of the industry.

In summary, the only correct understanding of the hospital's cost accounting and management in order to correctly handle the country, patients, hospitals, interests, only to take effective measures to strengthen cost accounting and management, in order to improve the hospital's social, economic and competitiveness promote greater development of the hospital. reposted elsewhere in the Research Papers Download http://www.hi138.com