会计学院知识库

      公立医院是我国医疗服务体系的主体，对社会提供公益性服务，其服务质量关系到人民群众的身心健康。公立医院能否承担起社会责任，在很大程度上取决于内部控制的建立与有效实施，所以，完善公立医院的内控制度就显得尤为重要，而对医院内控实施效果进行检验就是内部控制有效性评价。基于此，如何做好公立医院内部控制有效性的研究工作，保护国有资产的安全完整，完善公立医院的内控制度并确保其能够得到有效实施，就成为了亟待解决的课题。

      本文首先对国内外相关文献进行了研究与梳理，并根据文献对公立医院的内部控制以及内部控制有效性评价等概念进行了界定，并将委托代理理论和控制理论作为本文的理论基础；其次，本文引入 M 公立医院作为具体研究对象，并对该医院内部控制的现状进行了分析梳理；再次，本文将《行政事业单位内部控制规范（试行）》作为构建该公立医院内控体系的基础框架，并结合财政部出台《关于开展行政事业单位内部控制基础性评价工作的通知》这一文件，分别从单位和业务两个层面构建了 M 公立医院内控有效性评价指标体系，然后利用层次分析法确定各项指标的重要性矩阵，并结合Yaahp10.3 软件对重要性矩阵进行计算，以此得出了各指标的权重；最后，运用模糊综合评价法对 M 公立医院内部控制有效性进行综合分析评价。

      通过对该医院内部控制有效性进行分析评价发现，M 公立医院内部控制有效性处于中等水平，说明该医院内部控制在运行方面存在诸多问题。基于此，本文就从单位层面和业务层面为如何优化该公立医院的内部控制提出了相应的对策建议。

      Public hospitals are the main part of China's medical service system which provides public welfare services to the society, and the quality of its services is related to people's physical and mental health. Whether public hospitals can assume social responsibility depends to a large extent on the establishment and effective implementation of internal control. So it is particularly important to improve the internal control system of public hospitals, and the effectiveness evaluation of internal control is to test the implementation effect of hospital internal control. Therefore, how to carry out the study of the effectiveness of internal control in public hospitals well in order to protect the safety and integrity of state-owned assets, improve the internal control system of public hospitals and ensure it can be effectively implemented, has become an urgent issue to be solved.

      Firstly, this paper studies and sorts out relevant literatures both domestic and abroad, defines the concepts of internal control and effectiveness evaluation of internal control of public hospitals according to the literatures and takes principal-agent theory and control theory as the theoretical basis. Secondly, this paper introduces M public hospital as the specific research object, and analyzes the current situation of internal control of the hospital. Thirdly, this paper construct the M public hospital
internal control effectiveness evaluation index system from units and business aspects by the basis of building the public hospital internal control system framework which combine the "administrative institutions internal control standard (try out)" and then "on basic administrative institutions internal control evaluation work notice" that issued by the Ministry of Finance as. Then, the weight of each index in the importance matrix is determined by AHP and calculated by Yaahp 10.3 software. Finally, the faintness synthesis evaluation method is used to analyze and evaluate the effectiveness of internal control in M public hospital comprehensively.

      Through the analysis and evaluation of the effectiveness of the M hospital's internal control, it is found that the effectiveness of M public hospital's internal control is at a medium level and indicate that there are many problems in the operation of the hospital's internal control. Based on this, this paper puts forward corresponding countermeasures and suggestions on how to optimize the internal control of the public hospital from the unit level and business level.