寧夏公立醫院負債成因及化解對策研究

張桂宏　楊靜　王婷

[摘要] 目的 分析寧夏回族自治區縣級以上公立醫院資產負債水平、負債結構和償債能力，為化解債務和促進公立醫院改革提供科學依據。方法 利用寧夏衛生計生統計網絡直報系統2014—2016年的資料，對全自治區縣級以上公立醫院資產負債情況進行分析并就債償能力進行評價。結果 寧夏縣級以上公立醫院整體負債規模呈擴大趨勢，負債主要由流動負債和長期負債構成，補償機制不完善、醫院規模幾乎無限制擴張、超標準配置設備是負債的主要原因，基本建設和設備購置加大了醫院的負債規模，市級以上公立醫院流動資產償還流動負債的能力在降低，但縣級醫院、市級以上中醫院、縣級中醫院的流動負債償還能力在提高。結論 加大對市級以上公立醫院日常運行支持力度，提高財政對公立醫院人員工資保障水平，化解縣級醫院2016年底以前形成的長期債務，理清政府與公立醫院在人事、資產、財務等方面的責權邊界與關系。

[關鍵詞] 公立醫院；負債成因；化解對策；研究

[中圖分類號] R197.32 [文獻標識碼] A [文章編號] 1672-5654（2018）10（c）-0006-03

Study on Liability Cause and Countermeasures of the Public Hospital in Ningxia

ZHANG Gui-hong， YANG Jing， WANG Ting

Information Center， Ningxia Hui Autonomous Region Health and Family Planning Commission， Yinchuan， Ningxia， 750004 China

[Abstract] Objective To analyze the Level of assets and liabilities， Liability structure and debt service ability thus providing scientific basis for dissolving debts and promoting the reform of the public hospital above the county level in the Ningxia Hui Autonomous Region. Methods The assets and liabilities in the public hospital above the county level in the Ningxia Hui Autonomous Region were analyzed and the debt service ability was evaluated according to the data from 2014 to 2016 in the Ningxia health counting network direct reporting system. Results The holistic debt scale in the public hospital above the county level in Ningxia showed an increasing trend， and the debt was mainly composed of the current liabilities and long liabilities， and the major causes of liabilities included the imperfect reimbursement mechanism， unrestricted expansion of the hospital size and ovet-standard configuration， and the basic construction and equipment purchasing increased the hospital liability size， and the ability to pay the current liabilities in the public hospital above the city level decreased， but the ability to pay the current liabilities in county-level hospital， hospital of TCM above the city level and hospital of TCM in the county level increased. Conclusion We should increase the daily operation support force in the public hospital above the city level， improve the guarantee level of the finance to the salary of the staff in the public hospital， solve the long-term debt formed at the end of 2016 in the county-level hospital， and make clear the boundary of rights and obligations and correlation between the government and the public hospitals in the aspects of personnel， asset and finance.

[Key words] Public hospital； Cause of liability； Countermeasure； Study