全面预算管理下公立医院的成本管理分析

成本管理是公立医院经济管理不可或缺的关键部分,但是当前我国公立医院的成本管理方面还存在着预算管理与成本核算模式单一、流于表面,医院运行规模庞大,支出过高造成浪费,规章制度不健全,职工成本控制意识淡漠,缺乏内部审计监督机制等问题。建立全面预算管理能使医院有效决策,能有效提高医院职工的成本意识,降低医院的管理成本。在全面预算管理下公立医院应当明确定位成本控制的目标,健全成本控制规章制度,财务部门统一管理,改善医院的资本结构,提高资金使用效益,重视人力成本的管理,树立成本控制的理念,加强内部审计监督,从而进行有效的成本管理。     

医院全面预算集成管理系统设计初探

以项目组所在医院预算管理系统项目实施为契机，结合医院实际，按照财政部企业会计信息化工作规范的要求，进行了预算系统的总体设计。在框架设计上重点考虑预算系统在医院内部与医院外部系统的整合，梳理了各系统间的数据交互逻辑关系。     

新《医院财务制度》下的财务管理观念更新与功能升级

新《医院财务制度》中预算管理、成本管理、绩效评价和财务分析是财务管理的前沿模块,其中许多内容需要财务人员有一定的知识积累与钻研精神,才能发挥这些工具的作用,产生对管理决策有价值的参谋信息,参与医院管理,实现从核算、报账型向管理型转变。     

平衡计分卡在军队中心医院医疗成本控制中的应用

将平衡计分卡运用到军队中心医院成本管理中,从财务、患者、内部流程、学习与成长4个维度将军队医院成本控制这一战略目标转变为可衡量的目标和方法,建立起平衡计分卡医院成本控制评价指标体系,有效增加了医院总收入,降低了成本,医疗市场竞争活力明显增强。     

完善我国政府预算监督机制的建议

政府预算监督是政府预算管理中的重要环节,对政府预算实行监督是预算公开化、民主化的重要体现。本文对我国政府预算监督机制的进一步完善提出了建议。     

公立医院开展项目支出预算绩效评价的探讨

目前,我国大部分公立医院尚未广泛开展内部项目支出预算绩效评价工作。随着财政部与国家卫生和计划生育委员会的预算项目绩效管理的深入开展,公立医院通过加强多部门的合作,以战略发展为导向开展项目支出预算绩效评价工作对提高资金使用效益具有重要意义。     

浅谈市场经济中医院财务管理的特点和重要性

现代化的经济建设,必须有现代化的经济管理,以管理的现代化推动经济的现代化.改革的浪潮冲击着我国近几十年形成的卫生工作管理模式,医疗单位的财务管理,由全额预算管理改变为差额预算管理,使医疗单位由只注重社会效益,不注重经济效益,转变到在保证社会效益的同时,努力提高经济效益的轨道上来.本仅就在社会主义市场经济条件下,对医院财务工作进行一下探讨。     

全面预算在高校财务管理中的应用

全面预算管理是现代高校财务管理工作的核心重点。高校财务管理中借助于全面预算管理的应用,对高校内部进行的各种项目活动进行资金运用的统筹管理,科学化的分配高校的财务资金,进而实现高校管理的战略目标。基于此,本文就以全面预算在高校财务管理中的应用为切入点,对全面预算管理如何提升高校的财务管理水平进行深入化的研究,进而实现高校财务管理的终极战略目标。     

医院职能部门贡献度评估指标体系构建?????? ——基于目标管理和关键绩效指标 ?

医院职能部门的业绩考核一直是难点,亟须建立一个客观、公正的指标体系对职能部门在医院发展中的贡献进行评估。基于目标管理理论和关键绩效考核方法,针对目前医院职能部门考核中存在的问题进行分析,提出了建立贡献度评估体系的思路,并就我院构建该指标体系的实践进行了探讨。     

基于医院核心财务的医院资源规划业务管理分析

以核心财务系统为落脚点,依次展开医院资源规划系统对应的业务设计,为医院资源规划系统的实施提供有力的参考方案。基于核心财务系统,医院资源规划业务主要包括预算业务、科研教学业务、费用管理业务、固定资产及物资业务、药品材料试剂业务。业务数据与核心财务系统实现对接,数据最终汇集至核心财务系统完成成本核算和绩效考核,形成完整的以“财务一体化”为主线的运营管理平台。     

水库磷收支及其调控措施研究进展

磷是主要的富营养化限制性因子,其收支途径和调控措施的研究是水库生态安全的重要保障.为推动水库磷的系统研究,进一步完善磷调控体系,本文归纳了水库磷的收支途径,分析了不同因素对磷收支的影响,并对常规调控措施进行了梳理.水库磷输入的主要来源包括上游河流、地表径流、生活生产污染、养殖投入、大气沉降和底泥释放.其中上游河流的输入是水库磷最大的来源.磷主要的输出途径为泄洪或放水,并受不同排水方式的影响.另外生物收获也会输出部分磷.水库磷收支平衡受水库功能、水文条件和水体理化性质等因素的影响,不同季节和地域的收支情况差异很大.在磷的调控治理上,人工湿地、前置库、底泥疏浚和生物操纵法是目前采取的主要措施.为有效去除磷,需根据水库不同生态特性和水质管理目标,选择或结合多种不同的调控方式.因此,未来的研究应突出水库生态特性,进一步对水库磷收支及其影响因素进行系统分析,并开展水库磷收支与其他营养物质之间影响关系的研究,在此基础上构建科学完善的管理体系,是有效削减水库磷的根本保障.     

蛋白质预算：合成生物学的成本标尺

合成生物学以创建人工生命体系为目的.实践中人们希望人工生命体系具有更强的生产能力、转化能力、环境适应与监测能力,从而获得更优质的生产方式.生命体系的优化涉及到多层次的调控网络,而根本上还是对细胞中蛋白质的含量、定位、活性的控制.在蛋白质表达水平上进行控制是合成生物学元件设计、模块组装以及适配性研究最核心的手段.类似于工厂中的成本计算,合成生物学创建的人工生命体系(人工细胞工厂)以蛋白质预算为依据.优化蛋白质预算的研究策略已经成功应用于合成生物学研究实践中.     

台湾地区全民健保总额预算制度设计与运行效果评述

总额预算制作为医保对供方主要支付方式之一在国际上得到广泛应用,我国的上海、北京等地区也开始在不同程度上通过总额预算方式实现支付方式改革。总额预算作为一种控制医疗费用过快增长的方式既有优势也存在弊端。以我国台湾地区为例,介绍总额预算制度的运行机制和总额制定方式,并探讨总额预算制的实施效果,分析总额预算达到效果最优化的制度设计,为改革提供政策借鉴。     

Time Budget and Activity Patterns of Oncilla Cats (Leopardus tigrinus) in Captivity

Researchers have reported on the diet of Leopardus tigrinus and ecological aspects, but studies of behavior are scarce. The aims of this study were to describe the time budget and activity patterns of 10 captive Leopardus tigrinus individuals. The group had an activity budget of 66% resting, 20.66% moving, 6.08% vigilant, 3.12% feeding, and 4.14% other activities during 720 hr of observations. The activity budgets of the males and females did not differ significantly; however, males ate more than did females. The nonhuman animals spent more time resting during the day than during the night. Moving, socializing, maintenance, and vigilance showed statistically higher mean values at night. Group analysis of the temporal pattern of behavior showed bimodal peaks. Activity levels were high from 5 a.m. to 6 a.m. and decreased through the day only to peak again at 7 p.m. Stereotypic pacing peaked at dawn and at dusk. Patterns of vigilance, feeding, and maintenance were also determined for the group during a 24-hr period. These results may be useful for the development of management plans and effective conservation strategies for captive cats.     

基于卫生经济学的公立医院国有资产管理策略探讨

随着医院财务制度的完善和医院精细化管理的推进,公立医院国有资产管理将更加注重科学有效的方法学。研究主要针对设备使用率低、库存物资闲置、无形资产保护不足等3个医院面临的主要资产管理问题,探讨需求分析、市场战略分析、成本效益分析、成本核算、预算控制等卫生经济学方法在公立医院资产管理中的应用与实践,以此探索公立医院资产管理的科学方法,提高资产管理效率。     

Sexual dimorphism, activity budget and synchrony in groups of sheep

The activity budget hypothesis has been proposed to explain the social segregation commonly observed in ungulate populations. This hypothesis suggests that differences in body size – i.e. between dimorphic males and females – may account for differences in activity budget. In particular, if females spend more time grazing and less time resting than males, activity synchrony would be reduced. Increased costs of maintaining synchrony despite differences in activity budget would facilitate group fragmentation and instability of mixed-sex groups. In this paper two prerequisites of the activity budget hypothesis were tested: (1) that males should spend less time feeding and more time resting than females in single-sex groups and (2) that lower activity synchrony should be observed in mixed-sex compared to single-sex groups. The activity budget and synchrony in mixed and single-sex groups of merino sheep (Ovis aries) of different sizes (2, 4, 6, 8 individuals) were measured in three contiguous 491-m² arenas located in a natural pasture. Three same-size groups, one of each category, were observed simultaneously. We found no sexual differences in the time spent inactive and active (i.e. grazing, standing, moving, interacting). Males spent significantly more time grazing and less time standing than females. These differences disappeared when yearling males were omitted from the group. Males and females had similar bite and step rates. Sheep of both sexes spent less time resting and more time grazing and moving and had lower bite rates when in mixed-sex groups than when in single-sex groups. The synchrony among visually isolated groups was near zero, indicating that they changed activities independently. On the contrary, within-group synchrony was high; however it was higher in single-sex groups, in particular for males, than in mixed-sex groups. Our results suggest that differences in activity budget and synchrony alone are insufficient to explain social segregation.     

区域尺度陆地生态系统碳收支及其循环过程研究进展

地球系统的碳库和碳循环过程变化是影响气候系统的重要因素,而陆地生态系统的碳收支及其循环过程机制研究一直是全球气候变化成因分析、变化趋势预测、减缓和适应对策分析领域的科学研究热点。回顾了过去几十年区域尺度陆地生态系统碳循环和碳收支研究领域的国际前沿及其关键科学问题,并分析了我国在该研究领域的科技需求和发展方向。当前国际科学研究的热点和前沿领域主要包括:生态系统和区域碳储量和碳收支的清查、综合计量与碳汇认证,陆地生态系统碳通量的联网观测及其循环过程机制,陆地生态系统碳循环过程对气候变化响应野外控制试验,陆地生态系统水、碳、氮循环及其耦合关系机制和模拟模型研究等,同时指出在这些研究领域依然存在且急需解决的关键科学问题。我国近期的科技工作重点工作应该是努力构建天-地-空一体化的碳储量和碳收支动态监测体系、开展生态系统碳-氮-水耦合循环及其区域调控管理的前瞻性研究,定量评价中国生态系统的碳收支状况和增汇潜力,评估各种典型生态系统增汇技术的经济效益,为国家尺度的温室气体管理和碳交易机制与政策体系的建立提供可报告、可度量和可核查的科学数据和技术支持。     

Sexual segregation in Tibetan gazelle: a test of the activity budget hypothesis

Tibetan gazelle Procapra picticaudata , a threatened endemic species on the Qinghai-Tibet Plateau, is a sexually dimorphic ungulate. Males are larger than females and both sexes live in different groups, except during the rutting season. In order to test the activity budget hypothesis, which was proposed to explain social segregation in ungulates, we studied the activity budget of male and female Tibetan gazelles during the summers of 2005 and 2006. The activity budget hypothesis predicts that females spend more time feeding and group members synchronize their activities more in the same-sex groups than in the mixed-sex groups. We found that females and males of Tibetan gazelle had different activity budgets; females spent significantly longer time feeding and comparably less time on other activities. Activity synchronization indexes between female groups and male groups were similar (female groups: 0.81±0.17, male groups: 0.80±0.19), whereas both of them were significantly higher than that of mixed-sex groups (0.58±0.29). These results suggest that although sexual segregation might be caused by multiple mechanisms, the activity budget hypothesis about sexual segregation is supported by our studies of Tibetan gazelle on the Qinghai-Tibet Plateau.     

An investigation of relationships between climate and dengue using a water budgeting technique

Climatic water budget indicators were used to assess intra- and interannual variations in dengue incidence for San Juan, Puerto Rico. Multivariate stochastic relationships between dengue and the water budget were developed to (1) determine and quantify the particular climatic measures and their associated lag periods related to dengue variations, and (2) assess their use for dengue prediction and initiation of emergency response procedures. Such a predictive model would be advantageous because it is based on reliable, easily obtained, and low-cost weather observations. Daily running averages of water budget variables over an 8-week period were related to daily running averages of unconfirmed dengue totals (1988–1993). Resultant models show that a variety of water budget and traditional climate measures over the full 8-week period are associated with dengue. The mean seasonal variation in dengue is highly related (R ²=88.1%) to the mean seasonal climate variation, with those thermal and energy variables immediately preceding the dengue response showing the strongest relationships. However, moisture variables, predominantly in the form of surplus, are more influential many weeks in advance. For the interannual model (R ²=44.1%), energy change, thermal change, and moisture variables are significant across the 8-week period, with moisture variables playing a stronger role than in the intraannual model. Standardisation substantially changes the importance and timing of the variables, and suggests that dengue during this period is more associated with the mean annual variation of climate than deviations from mean conditions. A dengue early-warning model (based on 5 weeks of climate data) was also developed to predict dengue incidence 3 weeks later. While this predictive model is not reliable as a sole predictor of dengue in San Juan, it may be useful as part of a multifaceted watch/warning system. Received: 5 September 2000 / Revised: 12 March 2001 / Accepted: 21 March 2001