The dilemmas and breakthroughs of comprehensive budget management in hospitals: a study on optimization strategies led by the finance department
医院全面预算管理的困境与突破——财务科主导下的优化策略研究

摘要

全面预算管理是医院精细化运营、高质量发展的核心工具，在医保支付改革与公立医院经济管控趋严的背景下，医院预算管理普遍存在战略脱节、编制粗放、执行软化、业财分离、考核虚化等问题。财务科作为医院经济管理核心部门，肩负统筹规划、过程管控、数据支撑与绩效评价的关键职责。本文以财务科为主导视角，梳理当前医院全面预算管理的主要瓶颈，从组织架构、编制模式、执行管控、信息融合、绩效联动五方面提出落地性优化路径，旨在构建“战略引领、业财融合、全程闭环、精准高效”的预算管理体系，提升医院资源配置效率与经济运行质量，为公立医院可持续发展提供理论参考和实践借鉴。

Abstract

Comprehensive budget management is a core tool for the refined operation and high-quality development of hospitals. Against the backdrop of medical insurance payment reform and increasingly stringent economic control of public hospitals, hospital budget management generally suffers from problems such as strategic disconnect, extensive budgeting, weak execution, separation of business and finance, and superficial performance evaluation. As the core department of hospital economic management, the finance department bears the key responsibilities of overall planning, process control, data support, and performance evaluation. This paper, from the perspective of the finance department, identifies the main bottlenecks in current comprehensive budget management in hospitals and proposes practical optimization paths from five aspects: organizational structure, budgeting model, execution control, information integration, and performance linkage. The aim is to build a budget management system that is “strategically guided, integrates business and finance, has a closed-loop process, and is precise and efficient”, thereby improving the efficiency of hospital resource allocation and the quality of economic operation, and providing theoretical reference and practical guidance for the sustainable development of public hospitals.