Abstract: At present, public hospitals at all levels in China are actively responding to the call of medical reform policy and actively promoting the reform of medical system. In this process, hospital internal audit plays an increasingly important role. Strengthening the internal audit of public hospitals to ensure the realization of medical reform goals in public hospitals has become an important link in medical reform. However, there have been many problems in the internal audit of public hospitals in China. This paper discusses the problems and countermeasures of internal audit in public hospitals.

Keywords: internal audit; Problems; Countermeasures

With the gradual advancement of China's medical system reform, the development of public hospitals is also facing unprecedented opportunities and challenges. Under the new situation, it is urgent to establish and improve the hospital internal audit system and promote the sustained and healthy development of hospital economy. In particular, public hospitals belong to public welfare hospitals, so how to ensure the personal interests of employees are not lost, how to avoid unreasonable expenditures and improve the economic benefits of hospitals has become an important responsibility of hospital internal auditors. At present, the internal audit of many hospitals is mostly traditional audit methods, which has not risen to the audit level of hospital internal control and management. In order to adapt to the new situation of medical reform, the hospital management model must be changed accordingly to meet the needs of market competition and achieve a double harvest of economic and social benefits. As an aspect of hospital management, hospital internal audit should be reformed according to the new situation of hospital development. This paper mainly studies the problems existing in internal audit of public hospitals in China, and puts forward corresponding countermeasures.

First, the problems existing in the internal audit of public hospitals

(A) the lack of independence of internal audit institutions, professional quality is not high

As a department of the hospital, internal audit is inextricably linked with other departments, and it is difficult for a social third-party audit institution like an accounting firm to carry out audit work independently. Many public hospitals don't even have internal audit departments and lack professional auditors. In some public hospitals, the members of the internal audit department are all transferred from other departments, or temporarily transferred from the financial department to form the audit department in order to cope with the inspection of the superior departments, so it is difficult to ensure their independence and objectivity in the audit process, and it is also difficult to achieve corresponding results in the implementation of the audit work because of the lack of audit knowledge and skills of hospital auditors.

(B) Hospital internal audit work is not taken seriously

Many public hospitals do not take the initiative to conduct internal audit, and think that internal audit is not important. In order to cope with the superior inspection or complete the audit function, the hospital's financial revenue and expenditure and accounts are symbolically inspected. These checks are often a mere formality. In order to avoid offending people, hospital internal auditors often can't conduct in-depth inspection of the inspected departments, can't effectively control the financial risks of the hospital, and lack investigation and tracking. This will make the quality of hospital internal audit very poor and the credibility will be greatly affected. Because we can't find the problems in hospital financial management, leaders will not pay attention to the annual internal audit report, which will form a vicious circle in the long run.

(C) Hospital internal audit methods are traditional and backward.

At present, the internal audit of many public hospitals still focuses on daily financial accounting, mainly focusing on whether there are errors in the accounting treatment of financial revenue and expenditure, whether the use of financial bills is reasonable, and the integrity and safety of hospital assets. , has not risen to the level of controlling hospital financial management and financial risks. Financial information lags behind. When auditing the above aspects, internal audit can only stay in the audit of results and fail to play its due role in the process audit. At the same time, there is also a lack of audit of major economic projects related to the future development of hospitals, such as the purchase of large equipment and the audit of infrastructure projects. With the increasing competition among hospitals, hospital informatization construction has increasingly become the focus of competition among hospitals, which puts forward higher requirements for hospital internal audit. Without the support of information system, it is difficult to analyze and compare a large number of hospital background data and financial data. However, at present, many public hospitals are mainly audited manually. By reviewing original vouchers, accounting vouchers and accounting statements, the financial revenue and expenditure of the hospital is audited, and the informatization process of the audit is seriously lagging behind, which not only makes it difficult to find problems in financial processing, but also hinders the internal audit function of the hospital.

Second, the countermeasures against the above problems

First of all, hospitals must ensure the independence of internal audit, which is also determined by the particularity of audit. Hospital leaders should attach importance to audit work, realize the important role of internal audit in improving hospital financial management level, reducing hospital financial risks and improving hospital economic benefits, rationally plan audit departments, ensure the independence of audit work, actively help organize and coordinate the difficulties encountered by internal auditors in the audit process and give necessary support to ensure the normal development of internal audit work and create a good audit working environment for internal auditors. Secondly, we should improve the functions of audit institutions. We should not only focus on auditing the hospital's financial revenue and expenditure, the use of special funds, equipment purchase, infrastructure investment, etc., but also expand the scope of the audit, and grasp all aspects of the hospital's economic operation from multiple angles and in an all-round way, such as checking whether the hospital's financial internal control system is perfect, whether the corresponding financial risks can be avoided, and whether the hospital medical insurance and the new rural cooperative medical system reimbursement process meet the system requirements. Strengthen communication with external audit, make full use of the results of external audit, and reflect the audit work on pre-supervision and post-improvement so that the whole audit work can be successfully completed and the value of internal audit work can be reflected. The problems found in the audit process should be reported to the relevant departments and competent leaders in a timely manner, and the relevant departments should be urged to put forward rectification measures as soon as possible and improve the corresponding mechanism. Finally, we should attach importance to the informatization of audit work. The data of hospital economic operation is huge. Internal auditors should make full use of the advantages of information technology, improve the level of information technology, use information technology to control the risk points of hospital internal control, and carry out targeted rectification to improve audit efficiency and effectiveness. In a word, hospital internal audit plays an important role in the reform and development of public hospitals. Public hospitals should attach importance to internal audit, create a good internal audit environment, expand the influence of audit, and provide necessary supervision and guarantee for the healthy and benign development of hospitals.

References:

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[2] Sally. On the contents and measures of hospital internal audit [J]. Finance and Economics (Academic Edition) 20 15( 19).

[3] Chen Qingqing. On the present situation and thinking of hospital internal audit [J]. Administrative assets and finance, 20 14(08).

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