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随着财政预算体制的改革,国家对医疗机构的补偿形式也改为“核定收支,定额或定项补助,超支不补,结余留用”的方式。笔者认为,在市场经济条件下,医疗机构“吃饭”部分要靠自己,发展部分靠国家(定额或定项补助)。当前,医疗机构要搞好经营,应遵循以下几个原则:1 挖潜降耗,努力降低成本的原则 在目前的医疗收费构成中,检查费用大,而医务人员的技术劳务收费水平低。要逐步提高劳务收费标准以及劳务收入占总收入的比重,降低药品和大型设备检查收入占总收入的比重,充分体现医务人员的技术价值。同时,医疗机构需要根据新的会计制度要求加强成本核算。但是鉴于目前医疗纠纷较多的具体情况,笔者建议在医疗成本核算中应该包括医疗机构的风险测算和核算的内容,如实反映医疗工作的实际成本。
With the reform of the fiscal budget system, the State’s form of compensation for medical institutions has also been changed to the form of “approved income and expenditure, fixed or fixed subsidies, over-expenditure, and surplus, retained funds”. The author believes that under the conditions of a market economy, the “meals” part of the medical institutions depends on themselves and the development depends partly on the state (fixed or fixed grants). At present, medical institutions need to follow the following principles in order to do a good job in their operations: 1. The principle of tapping potential and reducing consumption and striving to reduce costs In the current composition of medical charges, the cost of inspections is large, and the level of medical workers’ technical service charges is low. It is necessary to gradually increase the proportion of labor charges and the proportion of labor service revenue to total revenue, reduce the proportion of inspection income of medicines and large-scale equipment to total income, and fully reflect the technical value of medical personnel. At the same time, medical institutions need to strengthen cost accounting in accordance with the new accounting system requirements. However, given the current situation of more medical disputes, the author suggests that the medical cost accounting should include the contents of the medical institution’s risk measurement and accounting to accurately reflect the actual cost of medical work.