一、当前医院内部控制存在的主要问题及原因(一)医院内控环境薄弱,管理者认识不足内部环境是医院实施内部控制的基础。现在的卫生系统内控环境普遍薄弱,其最直接的表现就是组织机构设置不合理,仅考虑到行政管理上的方便,导致管理层次多,机构职能重叠,工作效率低下等。多数医院院长来源于医疗骨干或学科带头人,缺乏系统的管理知识,对内控制度的认识不到位,还停留在原有内部牵制的管理水平。(二)医院作为事业单位,风险评估能力欠缺长期以来医院对风险评估未予以充分重视。盲目投资,以基建项目为例,普遍存在争项目、争投资的状况,且投资规模日益扩大,多数医院因不能争取到财政专项补助、拨款,只 First, the main problems existing in the hospital’s internal control and the reasons (A) the hospital control environment is weak, lack of understanding of the internal environment is the basis for the hospital to implement internal control. At present, the internal control environment of the health system is generally weak. The most direct manifestation of this is the irrational organizational setup. Only administrative convenience is taken into account, leading to multiple levels of management, overlapping functions of institutions, and inefficiencies in work efficiency. Most hospital chiefs come from the medical backbone or academic leaders, lack of systematic management knowledge, lack of understanding of the internal control system, and still stay in the original management level of internal control. (B) the hospital as a public institution, lack of risk assessment capabilities The hospital for a long time did not give due attention to risk assessment. Blind investment, taking infrastructure projects as an example, there is widespread competition for projects and competition for investment, and the scale of investment is expanding day by day. Most hospitals are unable to obtain financial subsidies and funding only