王明丽 王国强 祝勇

[摘要] 医院预算管理水平是医院财务管理效能的核心，涉及医院管理目标及其运行的方方面面；目前，随着新时期医疗改革步伐的持续深入，医院预算管理正面临着诸多新问题及挑战；探讨医院预算管理创新的新方法和新思路，正成为相关经济管理领域研究的热点课题。本文将以医改新形式为背景，立足于公立医院“职能-效益”降费增效框架，从预算管理面临的形势和任务出发，以医院预算管理现状以及存在的普遍性问题为出发点，从预算编制、执行、控制路径等多个管理主题给予实践讨论，分层次阐述医改新形式下医院预算管理创新的目标策略，旨在对推动医院财务管理的持续健康发展提供理论依据。

[关键词] 医疗改革；预算管理；问题；创新

[中图分类号] R197.1 [文献标识码] A [文章编号] 1673-7210（2018）08（b）-0173-05

[Abstract] The hospital budget management level is the core of the hospital financial management efficiency， which involves the hospital management goal and all aspects of its operation. At present， with the continuous deepening of medical reform in the new era， hospital budget management is facing many new problems and challenges. It is becoming a hot topic in the field of economic management to explore new methods and ideas of hospital budget management innovation. This paper will take the new form of medical reform as the background， and base on the "function-benefit" of public hospitals to increase the cost-benefit framework， starting from the situation and tasks faced by budget management， and based on the current situation of hospital budget management and the existing problems of universality. From the aspects of budgeting， execution， control path and other management topics， this paper gives practical discussion， and elaborates on the target strategy of the innovation of hospital budget management under the new form of medical reform. It aims to provide a theoretical basis for the sustainable and healthy development of hospital financial management.

[Key words] Medical reform； Budget management； Issues； Innovation

医改新形式下医院预算管理创新与探索是公立医院改革工作实施的重要组成部分，2009年4月，《中共中央國务院关于深化医药卫生体制改革的意见》[1]（中发[2009]6号，以下简称《意见》）正式出台，同年发布《关于印发医药卫生体制改革近期重点实施方案（2009-2011年的通知）》[2]（国发[2009]12号，以下简称《实施方案》）。提出推进公立医院收入补偿机制改革，逐步施行将公立医院补偿由原服务收费与药品加成收入及财政补助三个渠道改革为服务收费与财政补助两个渠道。由政府负责公立医院的基本建设、大型设备购置与重点学科发展以及符合规定离退人员……