1、 我院是1959年建院，是我市一家中型国有医院，历年实现利税超5000万元，经济效益、社会效益比较显著，但由于近两年风机行业受经济不景气的影响，20XX年与20XX年相比较，医院收入减少219万元。出现了亏损现象。 Along with transformation of Chinas economic system and advancement of the national policy of domestic progresses, it is very fundamental to strengthen the hospital financial management and im
2、prove its internal financial system. Established in 1959, our hospital is medium-sized and state-owned, and used to make an average annual revenue of over RMB 50 million. We have achieved both fine social and economic benefits. But, due to the declining economical situation of Chinain past several y
3、ears, the hospitals income reduced by RMB 2.19 million in 2003 from that of 2002, and we are experiencing a financial loss.针对医院出现的这一局面，市卫生局医院领导非常重视，召集班子成员及主要部门领导参加的扭亏增盈会议，认真分析医院亏损原因，查找漏洞，制定出20XX年度扭亏为盈的目标。 围绕这一专题，首先由财务部在成本核算方面入手。发现当年药品的成本普遍高于往年水平，个别型号药品成本高于售价。经核实，问题不是出现在财务计算环节。接着，我们又深入科室了解情况，发现跑、冒、滴、
4、漏现象存在，但这些远不足以使成本如此高。To combat this situation, the Chengdu Bureau of Public Health gives much importance, and summoned a conference attended by all its major leaders, discussing approaches to combat deficits for profits. They earnestly helped us to analyze the reasons of our loss and to find financia
5、l loopholes, and eventually set up the 2004 target indicators to eliminate the loss and gain profit. In this respect, we started to focus on the cost budgeting, and discovered the medications cost of the year was generally higher than that of previous years, and some medicines even had a cost higher
6、 than the selling price. According to our confirmation, the problem existed in the financial accounting. After that, we went down to section offices and also found financialloopholes. But, according to our investigation, such loopholes are far from being able to make the cost so high.财务部又会同有关部门对科室的药
7、品进行了实地盘点，经过盘点，问题终于暴露出来。 其一，原来科室每月向财务报送的“药品成本表”严重不实，差错较大。 其二，我院于1986年制定的药品计划成本一直采用，它的价格与现在市场价格相差甚大。因此，我院立即组织人力，重新修订了药品计划成本，使之与实际市场价格接近，使医院能够准确计算药品成本。Then, our financial department joined hands with related section offices. Upon our examination of the inventory, we discovered the real cause. First, th
8、e section offices submitted a monthly “Cost Table of Medications” which so happened to have so many errors. Second, our hospital still used the 1986 medication costs table which was much different from that of the current market cost table. Therefore, the hospital organized the staff to revise the m
9、edication cost table which is now much closer to that of the current cost table, therefore more accurate calculation of medication costs will be resulted. 这两项是“用药”不实，致使药品成本居高不下的主要原因，属潜盈因素，这是我们管理上存在的漏洞。 经过调整纠正，20XX年的药品成本大幅度下降，消除了药品利润的红字现象；另外，经过一段时间的抓管理，堵漏洞，各项费用与上年比较也明显下降，实现了扭亏为盈的目标。经过这一经验教训，大家一致认为：做为
10、一个医院，首先要有健全的规章制度，另外在实际工作中还要将其不断完善，使之符合医院的发展。The above two “statistic inaccuracies” are the major reason for high cost of the hospital medications, that also serve as both the management loophole and the potential factor for profits. After our adjustment and correction, the 2004 medication cost reduc
11、ed significantly, which helped to eliminate our deficits. In addition, through a series of management measures, other costs also reduced evidently over that of previous year. We realized our target of making up the deficit and get profits. This lesson teaches us that the hospital must have a set of
12、sound regulations which much get improved for its overall development.围绕这一问题，我认为财务部门应做好以下工作： 第一、提高财务人员素质，做好各项基础工作。 提高财务人员素质，除了要组织财务人员进行必要的理论学习外，还要使相关部门乃至全体职工提高认识，形成一种全员搞管理的热潮。只有这样，管理工作才能做得深入细致。只有基础工作做好了，医院一些新政策的出台，才能得到较好的贯彻落实，才能把各项指标制定在先进合理的水平上。这样，才能调动广大职工的积极性，从而达到合理用药,增加收入的目的。我院从七月份开始，在科室进行了二级核算试点，
13、收到了一定效果，积累了经验，计划在明年开始在全院实行二级核算。In this respect, I believe that the financial department should do the following work. First, enhance the professional quality of its staff and improve its fundamental works. For enhancement of the professional quality, the staff should be organized for necessary theor
14、etical studies. Staff of other sections of the hospital should also participate management activities. Only by so doing could the management wok be deepened; and only by fine fundamental work could the hospital formulate new policies, the indicators of which can be realized on an advanced and ration
15、al platform. Therefore, we should arouse the initiative of all staff for rational prescription and increase of the hospital increase. From July last year, we started the pilot work at the section offices, i.e., the secondary accounting, with good results. Next year, we plan to expand the secondary a
16、ccounting in all offices and departments of the hospital. 第二、根据我院情况，需制定和健全以下财务制度 （一）财务人员每月必须深入科室，了解情况。 作为一名财务人员，不仅要精通业务知识，依“两则”办事，还要深入科室了解情况，掌握第一手资料。只有对科室用药及设备利用情况有所了解，才能使成本核算趋于真实。如果我们只是靠科室报送资料，那么核算工作很容易脱离实际，而且很难发现问题（如前所述）。 我院现在一直实行这一制度，效果很好。 （二）凭证审核制度。 凭证审核工作包括原始凭证审核和记账凭证审核两部分，审核记账凭证主要是审核会计科目是否正确、凭
17、证上下、里外是否相符，尽量减少记账以后发现问题再调账，造成不必要的麻烦，更主要的是避免有问题未及时发现给医院造成经济损失；原始凭证的审核是对原始凭证的真实性，完整性，合法性进行审核。在进行差旅费审核过程中，我们发现有长途汽车票及住宿单据不实的问题。 为了维护医院利益，严肃财经纪律，院领导责成有关部门领导，对当事人进行批评教育，作废虚假票据，并积极做出堵塞漏洞措施。参照【1996院财发】“差旅费开支标准”文件，结合我院及社会实际情况，重新制定院内差旅费开支标准。 文件中规定，公出人员出差一律乘火车，其宿费伙食费实行大包干，提高补助标准，将一些杂费一并在包干中，不另报销。截止7月份末统计，比上年同
18、期减少差旅费开支4万元。 院部还对招待费的开支做出规定：来客就餐一律在厂食堂，并规定了就餐标准、陪客标准。此项费用与去年同期比较，下降了5万元。Second, based on actualities of our hospital, we should formulate sound financial systems. 1. The financial staff should visit the section offices every month for field investigation. The financial staff should not only be well
19、versed in his profession, but also work on the “two principles”. They should go down to the section offices for first-hand information. Only by knowing the situation of medication uses and equipment are they able to make accurate calculation. If we only rely on reports submitted by the section offic
20、es, our accounting would not be made on solid ground, therefore we are unable to discover problems （as we mentioned before）. Our current financial regulation works fine. 2. Voucher examination system this includes examination of both original vouchers and book-keeping bills. Examination of book-keep
21、ing bills is expected to detect whether the financial items are correctly set up, whether the bills are correct in all their related bills. This is able to help to reduce troubles of account adjustment, and more importantly, to timely avoid potential problems and financial losses to the hospital. Ex
22、amination of original vouchers is to examine their authenticity, completeness and validity.In our examination of travel expenses, we discovered unauthentic vouchers for long-distance bus rate and housing charges. To safeguard the hospitals interest, we adopted the financial measures, such as critici
23、sm of the person concerned, cancellation of his reimbursement, and new approaches against financial loopholes. We reformulated the regulations for travel reimbursement on the basis of the 1996 Hospital Finance Document, as well as on the hospital and social actualities. According to this new documen
24、t, all staff on business errands must ride the train, and his house and food subsidies are made on an increased sum basis, covering miscellaneous items. Except such, no further reimbursement is authorized. By July last year, our travel expenditure reduced by RMB 40,000. The hospital also formulated
25、regulations on reception fees. For instance, all visitors should eat in the hospitals dining room on a regulated standard. In comparison with that of last year, we reduced the expenditure of this item by RMB 50,000.（三）物资定额管理制度。我院的各项定额工作已基本就序，以往物资管理方面所存在的问题，经过物资管理部门及科室的配合,财务部的监督、纠正，已履行物资出入、领、退制度，改变了以
26、往不合理的操作方法，严格控制了跑、冒、滴、漏现象，减少了浪费，使我院的物资管理工作向正规化管理方向发展。3. Management system of supply quota our quota calculation system has come to work. Addressing previous problems in supply management, the financial department, together with supply management section and offices, formulated this system to strength
27、en supervision and correction, to regulate procedures oflogistics/supply entry, taking, and withdrawal. This helps to change previous unregulated approaches, to eliminate management loopholes, and to orient the hospital supply management on standardized track. 第三、加强资金管理，合理利用资金 当前各医院所面临的共同问题，即是资金紧张问题
28、。如何筹措资金，把有限的资金运用到医院经营最关键的环节上，是考核医院财务负责人当家理财本领的最好课题。 理财，首先要筹集资金。企业筹集资金渠道很多，但从筹资成本及长远发展利益看，最好的方法是清理外欠款。Thirdly, strengthen the capital management, and rationally use the capital sources. Of all hospital problems, the capital shortage is most serious. The No. 1 issue of the hospital financial managemen
29、t is to collect funds and to use the fund at the most key link of the hospital. Work of capital management is, first of all, to collect funds. There are many ways to collect funds, but in consideration of costs and the hospitals long-term interest, the best way is to straighten out the outside debts
30、. 由于三角债及内部管理等多方面因素，我院的外欠款达数百万元。 院领导对清欠工作非常重视，设置了专门机构，负责清理陈年老帐及呆死帐。院领导多次召开清欠专题会议，制定清欠方案，并制定了相应的清欠奖励政策。 在资金运用上，每月初制定本月开支计划。在资金使用上本着“一保医疗，二保生活”的原则，快收快投，量入为出，使我院整体资金基本处于良性循环状态. 在各项费用支出上严格控制，不合理开支坚决拒付，能延后支出的决不提前支出，能抹帐则抹帐，能顶帐则顶帐. Due to the debt chain as well as factors of internal management, our hospita
31、l has a payable account amount of over several million RMB. The hospital leaders attached great important and set up a special organ to collect these debts. They also summoned meetings to discuss the matter and formulate plans to collect the debts and award the collection staff. In capital operation
32、, a monthly expense plan is formulated at the beginning of each month. The capital is used to ensure the “medical work first, and living second”.We should collect the debts as soon as possible and use the available sources for planned purposes, all for a benign situation of the hospitals fund uses. We should strictly control all expenses, and turn down all unreasonable expenditures, and the payment is made as car
