随着当前我国社会市场经济的不断急剧变化和快速发展,公立医院必然会不断受 到强烈的社会市场经济冲击。由于公立医院具有的公立性质，难以有效适应医疗市场 化发展进程，造成我国公立医院与市场偏离。再者随着我国社会主义市场经济的快速 健康发展,民营医院如雨后春笋般相继诞生。现代民营医院凭借先进的管理方法和有 效的内部控制，在激烈的医疗市场竞争中始终处于主导地位。公立医院往日的主导地 位已经不复存在,面临严峻挑战。全面预算管理是现代化管理中最有效的管理方式之 一。由于我们国家医疗卫生管理体制改革不断地发展,国家越来越重视和支持医疗卫 生管理事业,我国整个医疗卫生管理行业面临的环境也在不断变化。对于公立医院来 说,全面预算管理是一个有效的经济管理手段,在对公立医院进行财务管理中可以说 是举足轻重的地位。我国各级公立医院亟待建设科学完善的全面预算管理制度,以更 好地适应内外部环境变化。公立医院必须要从根本上提升自身全面预算管理水平,才 能取得更加长远的发展。 本文以Y公立医院为案例,从基础理论出发,阐释全面预算管理的相关经济学与 管理学等内涵,分析Y医院的全面预算管理运行情况并深入剖析其中存在的问题，如 编制内容完整性欠佳，编制方法单一；执行控制流于形式，信息化水平低下；目标设 置缺乏合理性，忽视长期战略目标；考评体系存在缺陷，激励效果不够明显等，并以 此为依据对Y医院全面预算管理的问题剖析原因，提出相应的解决对策,具体从健全 全面预算管理内容和方法、优化全面预算管理执行控制、科学地设定全面预算管理的 目标、着力提升全面预算绩效考评以及预算的绩效考核方面提出完善建议。希望通过 本文对具体案例的分析研究,可以为其他公立医院实施全面预算管理提供参考,优化 公立医院的工作流程,避免财务和经营风险的发生,为公立医院的管理提升做出贡献, 促进医院的长远发展。 关键词：公立医院全面预算管理对策 II Abstract WiththerapidchangeanddevelopmentofChina'ssocialmarketeconomy,public hospitalswillinevitablybesubjectedtostrongimpactofsocialmarketeconomy.Duetothe publicnatureandinherentbudgetmanagementmodeofpublichospitals,itisdifficultto adapttothedevelopmentprocessofmedicalmarketizationeffectively,resultinginthe deviationbetweenpublichospitalsandthemarketinChina.Moreover,withthefastand robustdevelopmentofChina'ssocialisteconomy,privatehospitalshavesprunguplike bambooshootsafteraspringrain.Modernprivatehospitals,withtheiradvanced managementmethodsandeffectivenessofinternalcontrol,havealwaysbeeninadominant positioninthefiercemedicalmarketcompetition.Thedominantpositionofpublic hospitalsinthepasthasbeenlostandtheyarefacingseverechallengesprehensive budgetmanagementisoneofthemosteffectivemanagementmodesinmodern management.Asthenationalmedicalandhealthsystemreformdevelops,thecountry attachesmoreandmoreimportancetothemedicalandhealthundertakings,andthe environmentfacedbythewholemedicalandhealthindustryisalsochangingconstantly. Forpublichospitals,comprehensivebudgetmanagementisaneffectivemanagementtool, whichplaysadecisiveroleinthefinancialmanagementofpublichospitals.Itisessential forpublichospitalstoestablishanoverallscientificbudgetmanagementsystemtoadaptto thechangesofinternalandexternalenvironmentsothattheycanimprovetheirbudget managementlevelandachievemorelong-termdevelopment. ThispapertakesYpublichospitalasacase,explainsrelatedeconomictheoriesof comprehensivebudgetmanagementfromthetheoreticalpointofview,analysisofhospital comprehensivebudgetmanagementoperation,anddeeplyanalyzestheexistingproblems, suchasincompletecontentandsinglecompilationmethod.Theimplementationcontrolis notinplace,theinformatizationlevelislow;Theobjectivesettingisnotscientific,andthe long-termstrategicgoalisignored.Thedeficiencyintheevaluationsystem,incentiveeffect isnotobviousandsoon,andonthisbasistheYproblemanalysisreasonsofhospital comprehensivebudgetmanagement,putforwardthecorrespondingimprovementmeasures, concretefromimprovethecomprehensivebudgetmanagementcontentandmethod, III optimizationofcomprehensivebudgetmanagementexecutivecontrol,scientificallysetup thecomprehensivebudgetmanagementgoal,toimprovecomprehensivebudget performanceevaluationandSuggestionstoperfectthebudgetperformanceevaluation.Itis hopedthatthroughtheanalysisandstudyofspecificcasesinthispaper,itcanprovide somereferenceforotherpublichospitaltocarryoutfull-scalebudgetcontrol,optimizethe workingprocessofpublichospitals,avoidtheoccurrenceoffinancialandoperationalrisks, makecontributionstothemanagementimprovementofpublichospitalsandpromotethe long-termdevelopmentofhospitals .Keywords:publichospital；comprehensivebudgetmanagement；measures 1 目录 摘要.....................................................................................................................I Abstract..................................................................................................................II 目录....................................................................................................................1 第一章绪论........................................................................................................1 1.1研究背景..........................................................................................................1 1.2研究目的和意义..............................................................................................2 1.2.1研究目的.............................................................................................................2 1.2.2研究意义.............................................................................................................2 1.3国内外研究概况.............................................................................................2 1.3.1国内研究现状...................................................................................................2 1.3.2国外研究现状.....................................................................................................5 1.3.3国内外研究述评................................................................................................6 1.4研究内容和框架..............................................................................................6 1.4.1研究内容............................................................................................................6 1.4.2研究框架............................................................................................................7 1.5研究方法和主要创新点..................................................................................8 1.5.1研究方法.............................................................................................................8 1.5.2创新之处.............................................................................................................8 第二章全面预算管理相关基础理论................................................................9 2.1全面预算管理的含义......................................................................................9 2.2全面预算管理编制的内容、模式及方法.....................................................9 2.2.1全面预算管理编制的内容..............................................................................9 2.2.2全面预算管理编制的模式..............................................................................9 2.2.3预算管理编制的方法.....................................................................................10 2.3全面预算管理的相关管理学理论.................................................................11 2.3.1PDCA理论.......................................................................................................11 2.3.2内部控制理论..................................................................................................12 2 2.3.3激励理论..........................................................................................................13 第三章Y公立医院全面预算管理现状.............................................................13 3.1Y公立医院基本情况.....................................................................................13 3.2Y公立医院收支出情况.................................................................................14 3.2.1Y医院收入情况......................................................................................14 3.2.2Y医院支出情况.............................................