Experimental centralized accounting advantages and disadvantages of primary health care institutions?

In order to strengthen the primary health care institutions of financial management and supervision, standardize their financial behavior, and improve the effectiveness of the use of financial funds, the state provides for the implementation of primary health care institutions of accounting centralized accounting. After the implementation of the centralized accounting of the primary health care institutions by the accounting independent of the primary health care institutions outside of the centralized accounting center, in accordance with the "centralized accounting, standardized management, unified account, sub-account settlement" principle of centralized accounting, supervision of the primary health care institutions of the various financial income and expenditure activities.

1 grassroots health care institutions financial accounting system has the following characteristics.

1.1 Strengthen the budget mechanism and implement the responsibility. *** The budget management method of "approved tasks, approved income and expenditure, comprehensive income and expenditure to make up for the difference" has been implemented for primary health care institutions. Requirements for the budget and financial management responsibilities to be implemented to all departments, and through the interface between accounting and budgeting, to achieve the purpose of strengthening financial supervision and accounting supervision, strengthening the internal management of primary health care institutions, to ensure that funds are earmarked for specific purposes, and give full play to the effectiveness of the use of funds.

1.2 Reasonable division of income and expenditure, reflecting the functional positioning. It is clear that the income of primary health care institutions consists of medical income, financial subsidies, higher subsidies and other income, and the accounting process clearly reflects the inflow of various subsidies. According to the function of primary health care institutions to provide basic public **** health services positioning, in the "health care expenditure" account under the establishment of the "public **** health expenditure" secondary account, at the same time, reflect *** on the capital construction and purchase of equipment to arrange the budget of compensation **** mechanism, will **** the assumption of health care expenditures, the budget of the primary health care institutions to provide basic health care services. At the same time, reflecting *** to the capital construction and equipment acquisition budget compensation mechanism, the *** to bear the capital construction and equipment acquisition expenditures are reflected in the "financial infrastructure and equipment expenditures" account separately.

1.3 Standardize asset management and prevent financial risks. According to the budget management requirements and compensation mechanism of primary health care institutions, there is no requirement for accrual-based cost accounting, depreciation of fixed assets or withdrawal of funds for repairs and purchases. Reasonable division and accounting for all types of income and expenditure, to prevent unreasonable increases in medical costs, control financial risks, and maintain the public **** health care public welfare.

1.4 Combined with the implementation of performance pay, the establishment of incentive funds, the establishment of incentive mechanisms. In the primary health care institutions in the special fund to set up incentive funds, the implementation of the approved revenue and expenditure and other budgetary management of the primary health care institutions, at the end of the year on the completion of the approved tasks performance appraisal qualified, according to a certain percentage of the balance of revenue and expenditure of the business to extract incentive funds from the primary health care institutions in conjunction with the implementation of the performance of the salary for the performance appraisal of the employee reward, in order to improve incentives and constraints, to fully mobilize the medical staff of the primary health care institutions. To improve the incentive and constraint mechanism, to fully mobilize the enthusiasm of the primary health care institutions, medical staff, prompting them to better participate in and serve the work of health care reform.

2 primary health care institutions to implement centralized accounting has the following advantages.

2.1 Centralized accounting can objectively reflect the accounting revenue and expenditure activities of primary health care institutions, both to promote the legitimacy of the primary health care institutions to charge special projects, to eliminate the phenomenon of indiscriminate charging, but also to promote its strict compliance with the "two lines of income and expenditure" provisions, to ensure that all revenues in a timely manner, in full into the treasury, to prevent concealment. It can also promote its strict compliance with the "two lines of income and two lines of expenditure" regulations, ensure that all revenues in a timely manner, the full amount into the treasury, to prevent concealment, retention and misappropriation for other purposes, and have a positive effect on the elimination of lawlessness and indiscipline, the preservation and enhancement of the value of state-owned assets, and improve the bidding system and promote the implementation of the *** procurement system. It will help the financial sector and business authorities to supervise the primary health care institutions.

2.2 Centralized accounting is conducive to helping primary health care institutions to establish and improve the property management system. At the same time, it strictly enforces the relevant management regulations and conducts regular and irregular property inventories to ensure that the accounts are in line with the actual situation.

2.3 The centralized accounting center uses the computerized accounting system to carry out accounting according to uniform standards and processes, making the accounting business more professional. It also uses methods such as licensing to implement effective internal control and better implement the Accounting Law regarding the separation of incompatible positions. At the same time, the centralized accounting center is independent of the primary health care institutions, so that it has a better independence, the accountants can better exercise their supervisory functions, the authenticity of the accounting information, legality, completeness of the supervision, to improve the quality of accounting information.

3 primary health care accounting center is a major reform of the management of budgetary units, the successful realization of the centralized accounting of funds and comprehensive supervision. But at present, the centralized accounting center for primary health care institutions accounting also because the unit of each primary health care institutions have their own specificity of economic operations, the implementation of centralized accounting after the existence of the following problems need to be urgently resolved.

3.1 The implementation of centralized accounting in primary health care institutions, external financial supervision has been strengthened, but the internal control mechanism is weakened. Accounting centralized accounting will be bookkeeping, accounting, reporting and other work concentrated in the accounting centralized accounting center, while in kind, assets, contracts and other economic matters need to be reflected are still scattered in the unit, so that the unit's financial management work is out of touch with the unit, weakening the unit's own financial management.

3.2 Primary health care institutions accounting operations to the accounting centralized accounting center agency accounting, primary health care institutions do not set up accounting positions, only a financial liaison. The scope of the unit's financial situation to narrow the informed surface, the financial director of a pen approval, financial expenditure is not open and transparent. Although the accounting centralized accounting center in the agency bookkeeping also performs a supervisory function, but because it is, after all, located in the external environment of the unit, the authenticity of the unit's economic operations can not be grasped, and some of the complexity of the problem is difficult to distinguish. Like some of the accounting business agent accountant can only identify the legality and compliance of the bills, can not identify the authenticity of the bills and the authenticity of the economic matters. Some units to accommodation, meetings, printing, repairs and labor and other non-compliant expenditures charged to the bills, the accountant even if the above irregularities are found to be charged to the behavior, but due to the lack of sufficient evidence and energy is also very difficult to further investigate.

3.3 The implementation of centralized accounting is not conducive to the division of responsibility. Accounting centralized accounting center accounting far away from the primary health care institutions management site, can not understand the unit management activities of the real situation, the daily face of a large number of bills, can not be in-depth study of bills to analyze the real legitimacy. Although the precondition for the establishment of the centralized accounting center of primary health care institutions is that the three rights of the funds remain unchanged, the centralized accounting unit still pushes the responsibility of accounting and financial management to the centralized accounting center. The centralized accounting center, which is not involved in the process of economic activities of the unit and does not understand the substance of economic operations, is always caught in a dilemma. When there is false accounting information or omission of accounting matters, there will be accounting centers and accounting units between the mutual blame, the responsibility is unclear.

4 For the current implementation of centralized accounting for primary health care institutions in the problems put forward the following recommendations.

4.1 Improve the accounting post responsibility system, accounting files and accounting software storage and maintenance system, unit income and expenditure management system, performance performance evaluation system, as well as reward and punishment system, etc., to strengthen the internal management of primary health care institutions.

4.2 Implementation of the property and material inventory system, the centralized accounting center regularly conducts material inventory with the property managers of primary health care institutions to ensure that the accounts are consistent with the real and to implement the accountability system. It is recommended that the financial sector should also increase the inspection and supervision of the property and materials of primary health care institutions to ensure that the state-owned assets are not lost to the maximum extent possible.

4.3 Develop a unified and feasible standard of expenditure, especially in the issuance of bonuses, overtime subsidies, welfare costs and other aspects of the development of scientific and uniform standards. For those ad hoc projects involving wide-ranging, strong policies and large expenditures, they must go through a strict approval process before implementation.

4.4 It is recommended to implement a remote account processing system, the financial liaison staff of primary health care institutions can log in the financial processing system in the hospital to carry out relevant operations and inquiries, so that primary health care institutions and the centralized accounting center of the information resources **** enjoy, the unit can be timely understanding of the financial situation of income and expenditure, and to enhance the centralized accounting center of the accounting information between the primary health care institutions and the exchange of accounting information. The first step is to make sure that you have the right information to be able to do so.

References

[1] Miao Changjian, the party of centralized accounting for business units, "New Money" *** Money Management 2012/10/15 Issue 10

[2] Yao Jie, on the implementation of centralized accounting practice and thinking about the implementation of primary medical and health care institutions, "Jiangsu Health Care Management," Issue 3, 2012 < /p>