With the deepening of the current medical system reform, strengthening drug cost accounting has a vital impact on the economic interests and future development of medical institutions.
With the deepening of medical system reform, a series of reform measures have been clearly put forward, and the way of separating medicine from medicine is also being actively explored. Hospital drugs gradually cancel drug addition and implement zero price difference sales. In order to create conditions for further medical reform, the Ministry of Finance and the Ministry of Health jointly issued a new Hospital Financial System and a new Hospital Accounting System, and the methods of drug accounting were revised accordingly, and the contents, methods and means of drug accounting changed. Based on practical experience, this paper discusses how to strengthen drug cost accounting under the new situation.
Keywords: new situation; Drug cost accounting
First, the necessity of strengthening hospital drug cost accounting under the new situation
(A) The transformation of hospital management mode makes the development of drug cost accounting an inevitable trend.
With the deepening of medical reform, the management mode of hospitals has undergone fundamental changes, and medical institutions have begun to move from the nature of previous institutions to marketization, self-financing and independent operation, so it is inevitable for hospitals to control costs. Carrying out cost accounting and reducing the cost of related projects are conducive to enhancing the competitiveness of hospitals and improving the efficiency of medical resources. Drugs occupy an extremely important position in the whole medical process and are special commodities in the daily operation of medical institutions. It has the characteristics of large quantity, variety, great mobility and difficult management. However, at present, the method of drug cost accounting in hospitals is still relatively backward, and medical resources are not well allocated, resulting in a waste of resources. Under the current situation, how to strengthen the management of drug cost accounting has become a key issue in the economic management, financial management and even the development of hospitals.
(B) Drug cost accounting management plays an increasingly important role in the overall accounting management of hospitals.
Financial management is an important part of hospital internal management. Financial management is not only the core of hospital management, but also a necessary factor for hospital survival and development. As an important part of hospital internal financial management, hospital drug cost accounting runs through all aspects of hospital financial management. With the implementation of the new system, drugs are included in inventory management, and drug accounting management plays an increasingly important role in the overall accounting management of hospitals. Therefore, under the new hospital accounting system, we should strengthen the management of drug accounting and take effective measures to constantly standardize drug accounting according to the requirements of the new accounting system.
(3) The new "Hospital Accounting System" puts forward higher requirements for strengthening the management and control of drug expenses.
The new "Hospital Financial System" and "Hospital Accounting System" require hospitals to establish and improve the cost management system, strengthen cost accounting and cost management, and take effective measures to control costs and expenses on the premise of ensuring the quality of hospital medical services. The new system stipulates the principles and basic methods of cost accounting, which embodies the scientific nature and superiority of the new system. Hospital cost accounting is divided into three levels: the first level accounting is the cost accounting within the whole hospital, which mainly includes the overall economic benefits such as hospital income and expenditure; Secondary accounting is departmental cost accounting; Three-level accounting is project cost accounting, including consultation cost accounting and single disease accounting. After the implementation of medical reform, the focus of cost control has shifted to department cost accounting and project cost accounting, and drug cost control has also shifted from simple total cost statistics to secondary and tertiary accounting, and from rough accounting to fine accounting.
(D) The compensation mechanism of system reform has promoted the implementation of hospital drug cost accounting.
The comprehensive reform plan of urban public hospitals points out:? Get rid of it in the reform of public hospitals? Fill the doctor with medicine? At the same time, the mechanism cancels the drug addition, and adjusts the medical service price, medical insurance payment and financial compensation policy. ? After the cancellation of drug addition, hospitals can compensate by adjusting the price of medical services, medical insurance payment and financial subsidies. However, the financial investment in health care is decreasing, and the proportion of financial subsidy income in the hospital's income is getting lower and lower. The income (including the cost of drug storage, storage and loss) reduced by the cancellation of drug addition in hospitals will be digested by hospitals themselves except by adjusting the price of medical services. In this situation, it is particularly important for hospitals to increase revenue and reduce expenditure, strengthen drug cost management and control, and reduce drug storage and custody costs.
Second, the dilemma of hospital drug cost accounting at this stage
(A) hospital drug purchase and sale price difference is difficult to directly reflect.
The new "Hospital Accounting System" has changed a lot in drug accounting methods, both accounting subjects and accounting concepts have changed. What's the difference between buying and selling drugs? 、? Drug revenue? And then what? Drug expenditure? All the first-level subjects have been cancelled, will they? Drug revenue? Listed as? Medical income? Secondary subsidiary account, will it? Drug expenditure? Listed as? Medical expenses? Secondary subsidiary account? What's the difference between buying and selling drugs? Incorporate the accounting content of. Medical balance? Medium. This shows that the main body of hospital income is no longer mainly to charge patients the price difference of drugs, which has changed the tradition? Take medicine to support the doctor? This concept weakens the compensation effect of drugs on medical expenses. However, there is a process for traditional public hospitals to cancel the price difference between drug purchase and sale, which cannot be achieved in one step. Drugs should still be given to patients. This makes the difference between the purchase and sale of drugs more hidden before the hospital completely cancels the drug addition, which can not be clearly reflected directly from the accounting treatment, which is not conducive to supervision.
(b) The account is inconsistent with the facts due to timeliness differences or imperfect management procedures.
1. Time difference
There are many varieties, specifications and quantities of drugs, and there are many circulation links. In practical work, the discrepancy between accounts and facts caused by time difference is a difficult point in drug accounting management. The new "Hospital Accounting System" clearly requires that accounting should be based on accrual basis, and drugs should be managed on accrual basis in every circulation link. According to this principle, as long as the patient has paid the fee, whether the drug is distributed or not, the expenditure of the drug should be confirmed, but in fact, the payment and distribution of the drug by the patient are the responsibility of two different departments, namely finance and pharmacy, and the time is difficult to synchronize; For hospitalized patients, it often happens that pharmacies give medicines to patients without paying hospitalization fees. These differences in time will lead to inconsistent caliber of drug revenue and expenditure, and drug revenue and expenditure cannot be matched.
2. The drug management process is not perfect.
After drug replenishment in the pharmacy, the pharmacy staff failed to prepare the receipt or review the transfer order in time, which would lead to a negative drug inventory balance after the drugs were distributed to patients. In the process of treating patients, patients often have unexpected situations such as early discharge, discharge or drug allergy, which will lead to the situation of remaining drugs in the ward.
(C) the lag of hospital information management system
Hospital drug accounting, in addition to accounting treatment in the financial management system, is often carried out through the hospital HIS system. The new hospital accounting system puts forward drug management? The material management department establishes a detailed account of quantity and amount according to the name and specification? It is required that all drugs in all aspects of hospital circulation should be accounted for in one-to-one correspondence between quantity and amount, and all drugs should be controlled in both quantity and amount, so as to realize the sharing of network resources in the hospital and keep the data caliber consistent. This puts forward higher requirements for hospital information management. However, the informatization construction of some hospitals has lagged behind, and the investment in the new system has not been followed up, which has affected the implementation effect of the new system.
Third, the strategy of strengthening hospital drug cost accounting under the new situation
(a) to strengthen the accounting of drug circulation process, improve the level of drug management.
When conducting drug accounting, hospitals should pay full attention to the differences in drug management and circulation. In order to ensure that the accounts of drug management are consistent with the facts, every link of drug circulation should be managed according to the corresponding drug accounting. The new system stipulates that accrual accounting should be adopted. As long as the patient has paid or booked, it will be confirmed to be issued to prevent the phenomenon of not reporting the loss of medicine. In addition to making normal drug in-out and storage reports, we should constantly improve various management reports such as drug breakage statistics, drug price adjustment table, drugs to be sent, and patient receivable expenses statistics. Establish a daily special person check system, find the differences in time, make changes in time, solve the problems such as mismatch of drug revenue and expenditure and distortion of drug data and information, effectively eliminate the differences caused by time, and improve the level of drug management.
(B) to strengthen the awareness of cost management and cost control
The new "Hospital Accounting System" requires hospitals to strengthen cost accounting and cost management to reduce medical costs. The purpose of cost management is to comprehensively, truly and accurately reflect hospital cost information, strengthen cost awareness, improve hospital performance and enhance the competitiveness of hospitals in the medical market. Drug cost accounting is an important part of cost management. According to the accounting object, it can be divided into department drug cost accounting, patient consultation cost accounting, disease drug cost accounting, etc., which can effectively control drug costs and expenses and lay a data foundation for hospital performance evaluation and assessment. In the process of accounting, the actual drug cost is analyzed in detail in strict accordance with the principle of accuracy and cost matching, so as to increase the accuracy of cost accounting, especially before the drug addition is cancelled, the detailed drug cost accounting can improve the accuracy of the calculation of the difference between drug purchase and sale.
(C) Pay attention to the analysis of financial indicators in pharmaceutical accounting.
Hospitals should set up statistical reports and analysis functions of drugs, observe the changes and abnormal data of various drug indicators, and provide accurate and effective information for hospital managers. Strengthen the analysis of drug income and drug expenditure when carrying forward drug cost, set up various drug detailed statistical tables and analysis functions, and use the data of various departments to match, so that the proportion of drug income and drug expenditure in the medical process is more and more reasonable. A drug dynamic analysis table can be added, and various indicators for measuring drugs, such as drug capital turnover rate, drug profit and loss 100%, drug loss rate, the proportion of basic drugs used, and the proportion of outpatient and inpatient drugs, can be compared horizontally and vertically on a regular basis, so as to quickly reflect the comparison with the same period last year.
(four) to establish and improve the drug inventory system.
Drugs in hospitals need to be counted regularly, and the control system of drug loss, damage and reimbursement should be established and improved. The person in charge of the hospital, the finance department, the audit department, the pharmacy department and other personnel form an inventory team to conduct physical inventory of drugs on a regular basis. The pharmacy makes its own inventory every month, and the inventory results are reported to the finance department and the competent dean for approval. The financial department and the audit department can participate in the inventory of drugs, or conduct spot checks on drugs in pharmacies to carry out effective accounting control. The financial department should carefully check the differences in the quantity changes of various varieties, analyze the rationality of the changes, and adjust the book quantity of drugs after the approval of the competent dean. For excess inventory, it is necessary to judge whether the overflow is normal; For the loss of inventory, find out the reason. If it is not well kept, individual liability for compensation shall be investigated. If it is a normal loss, it should be included in the hospital expenses and cannot be guaranteed.
(5) Increase the construction of hospital accounting information.
The update speed of hospital information management system must keep up with the new situation and the changes of hospital environment, constantly meet the needs of financial departments and pharmaceutical departments, adapt to the standardized drug management process, and match the accounting standards of the new hospital accounting system, so that the drug accounting information and drug material outbound information can be completely connected, and the goal of efficient drug management in hospitals can be achieved. Relying on the information management system, we can effectively count all the information of drugs from warehousing to storage to the whole process, manage and supervise every detail of drug income, expenditure and balance in time, analyze and warn abnormal data, and truly realize the transparent management of drug circulation process while improving work efficiency. The amount of drug revenue and expenditure required by the new hospital accounting system needs to be subdivided into clinical departments, medical technology departments and auxiliary departments, which is heavy in workload and easy to make mistakes. The financial department can also use the information management system for auxiliary statistics.
(six) to improve the professional quality of medical accountants.
The new hospital accounting system puts forward higher requirements for drug accounting, which is no longer limited to simple drug accounting and inventory, but also should fully participate in the process of drug supervision and management. Understand the relevant regulations of drug management in detail, be clear and familiar with drug process management, take the initiative to pay attention to relevant medical insurance and price regulations, do a good job in daily drug accounting supervision, check its mistakes and fill its shortcomings, so as to deepen the communication between relevant departments of the hospital and make drug cost accounting play a more important role in the overall financial management of the hospital.
Four. conclusion
With the deepening of the current medical system reform, strengthening drug cost accounting has a vital impact on the economic interests and future development of medical institutions. Medical institutions should attach great importance to the management of drug cost accounting, face up to the problems existing in the current work, actively explore and seek solutions and strategies, and promote the scientific and standardized development of drug cost accounting management.
;