Hoàn thiện tổ chức công tác kế toán các bệnh viện y học cổ truyền trên địa bàn thành phố hà nội tt tiếng anh

STRY OF EDUCATION AND TRAINING MINISTRY OF FINANCE ACADEMY OF FINANCE NGUYEN THI PHUONG ANH IMPROVING ACCOUNTING WORK ORGANIZATION IN TRADITIONAL MEDICINE HOSPITALS IN HANOI CITY Faculty: Accounting Code no.: 9.34.03.01 DOCTORAL THESIS ABSTRACT HANOI, 2020 The thesis is accomplished at: ACADEMY OF FINANCE Scientific Supervisor: Associate Prof Nguyen Dinh Do Counter Argument 1: Counter Argument 2: Counter Argument 3: The thesis will be defended at Doctoral Dissertation Assessment Council for Academic Level,………………Location: Time: After the publication, the thesis will be stored at: - National Library of Vietnam - Academy of Finance Library INTRODUCTION Reasons for choosing the research topic In the context of a highly progressive global economy, the Vietnamese Party and Government have made many innovative policies for the health sector's activities to enhance the operational capacity of the state and economic units On the one hand, these policies have created a wide legal corridor for non-business units to promote their autonomy and self-responsibility to reduce their dependence on the state budget for their activities As a result, the health sector in general and the traditional medicine sector in particular have gained achievements in the areas of inheritance, staff training, scientific research, medical treatment, medicine production and medicinal production , making an important contribution to the cause of caring and protecting the people's health, supporting the national health and medicine and raising the position of Vietnamese traditional medicine and pharmacy in the world The system of traditional medicine has been strengthened, the health care and examination and treatment network have been upgraded and improved, and the system of health service provision has been expanded, improving medical ethics, responsibilities of health workers, improving the effectiveness of medical examination and treatment In particular, the Party and the State have issued many directives and circulars of agencies, agencies and policy makers to overcome difficulties and exist traditional Vietnamese medicine in general and in Ha noi in particular: The 4th Resolution of the Central Committee of the Communist Party of Vietnam VlI "On urgent issues in the care and protection of people's health", The Conference The 6th Central Committee of the 12th term issued Resolution No 20 / NQ-CP dated October 25, 2017 on "Strengthening the protection and improvement of people's health in the new situation", Decision 1092QĐ / TTg dated September 2, 2018 on "approving Vietnam's health plan" In the new financial mechanism, the assignment of autonomy and self-responsibility in implementing tasks, organizational structure, payroll and finance for public non-business units in general and for traditional medicine hospitals transmission in Ha noi in particular has helped hospitals to actively expand activities to increase finance and reduce the burden on the state budget Organizing accounting work is a tool for organizing the management, economical and efficient use of the financial resources of the unit in the direction of such autonomy, publicity and transparency At the same time, it helps the ministries and branches better manage their financial resources and come up with the right policies and strategies to promote and preserve the long tradition of traditional medicine, contributing to the expansion of People's health care activities Although, the Government issued Decree 16/2015/ ND-CP on February 14, 2015 (ND16/2015) replacing Decreditional medicines lead to difficulty in calculating post-dosage drug prices and are not yet responsible for calculating the rate of drug loss during the preparation process + Traditional medicine hospitals in Hanoi conduct training courses for short-term professional certificates, this revenue is collected once at the beginning of the period and is recorded by the accountant as the right turnover at that period, because the cost of this training activity usually lasts for the following accounting periods; or rental of car park premises upfront for many accounting periods Thus, the recognition of this revenue is not true of the time of recording revenue and expenses + In the hospital, patients often not have treatment at the end of the course, not pay for hospital discharge, cause financial losses, the accountant has not agreed with the accounting method and has not opened a separate account to monitor the hospital fee This loss for each patient object This loss is often used by hospitals to help offset costs + These hospitals have not set up a specific fund (the fund to support the poor) to help patients in difficult circumstances The support for poor patients is mainly from the Welfare Fund + Traditional medicine hospitals have not yet agreed to set a detailed code of raw material accounts and have not yet coded drugs to comply with the regulations of the Ministry of Health so it has not created a synchronization in the medicine management system of the whole health sector - About the organization of the accounting book system Accounting books, when printed, sometimes lack the date of recording, signatures of book makers or chief accountants and heads of units; Many documents are not stamped + About the detailed accounting book 17 In addition to using the right type of general accounting books according to the State's regulations, the system of detailed books at these hospitals has not been fully opened and detailed, such as detailed book of corporate income tax and value added tax, detailed book of revenue, detailed record of hospital fee voluntarily * Analyzing and providing information of the accounting information system The provision of financial information of traditional medicine hospitals in Hanoi through the financial statements and financial statements system The Ministry of Health relies on the size of the hospital to submit financial statements that are appropriate for each unit, but hospitals usually submit it later than the prescribed time - Regarding the organization of information analysis: these hospitals have only used comparative methods and ratios to analyze the content on the financial statements, not using many other methods * Organizing the accounting inspection These hospitals have not established regular inspection plans and internal inspection departments, accounting checks usually focus on the initial information collection and processing stage, only at the perspective of comparing documents in accounting at the beginning stage, checking the process of setting up the financial statements, financial statements, checking responsibilities, work results of the accounting apparatus; Check asset management policies and use of hospital resources Traditional medicine hospitals have not yet performed internal audit in accordance with the provisions of Decree 05/2015 / ND-CP of January 22, 2019 * Organize application of IT in accounting information system + Accountants are not really proficient in all accounting practice in computer software, as well as features on hospital management software, so the implementation of accounting reports Payment is limited + The computer system used for organizing accounting work has been out of date + This software has not been exploited to use all features such as using automatic prescriptions, electronic medical records, + There is no connection to update accounting data from hospital management software into insurance software + The bank has not yet made payment for medical examination and treatment + Not yet fully used the features of accounting software in analyzing and providing accounting information + The IT application has not been well implemented in the organization of accounting inspection due to the limited qualifications of people doing accounting inspection (2) Restricting the organization of accounting work from a management accounting perspective Despite achieving certain successes, the introduction of management accounting as a management tool and part of the accounting information system in traditional medicine hospitals in Hanoi remains fragmented, small, even executives as well as accounting practitioners are not aware and aware of this First: About operating cost classification Hospitals have just ceased at cost classification according to the economic content in accordance with the state budget index for recurrent and non-recurrent expenditures, originating from the state budget However, for the service production and business activities, the cost classification is not applied according to the economic content of the 18 expenditure according to the control requirements of each hospital and the cost classification criteria have not yet been classified by function and by activity level In order to use cost information by activity level, mixed costs must be separated into variable and fee variables Second: About the method of determining costs The cost of operation is determined by the method of determining the cost by process, per patient The process cost determination only collects direct costs (cost of medicine, consumable medical supplies, remuneration, outside doctors, etc.) and a number of identified expenses according to the norm (bandage, gauze, ) Many expenses cannot be determined or allocated to each patient Accounting of the collection of costs, calculating the cost of curative care services as required by the unrealized expenditure items, it is difficult to properly assess the effectiveness of medical examination and treatment activities as required Third: About setting cost norms Regarding the norm making department: mainly functional sections such as the general planning department, the research department have not had the effective participation of the accounting department The construction of cost norms that are of particular interest to all hospitals has developed internal spending rules Most of the regular duties were quantified and unit prices Fourth: Regarding construction of cost estimates Regarding estimation department: mainly accounting department, not much reference from other functional departments Basis of cost estimation: The estimation based on the State's norms has not been changed in many years, so the estimation levels of some items are no longer suitable to the reality, not flexible yet This affects the timely decision making of the administrator Regarding the process of estimating: In these hospitals, the estimation is carried out in the order from the department / department and the final decision-maker is the hospital leader With this process, the budget estimator tends to make unsuitable estimates with the actual ability to achieve, the cost estimates are higher or lower than the actual costs Accordingly, the difference between revenues and expenditures will achieve the results as estimated This reduces the control of estimation information 2.3.3 Causes of limiting the organization of accounting work in traditional medicine hospitals in Hanoi Objective reasons Firstly, the State's legal policies are not complete Secondly, the mechanism of autonomy and self-responsibility for organizational structure and finance can lead to the organization of the accounting system according to the subjectivity of the hospital Thirdly, Awareness of socialization is not sufficient Subjective reasons Firstly, the qualifications of the personnel engaged in accounting work are limited and uneven Secondly, the coordination between the accounting department and other departments in the institute is still not scientific, leading to the inadequate timely rotation, checking and processing of documents and much delay Third, internal spending regulations have not been fully effective 19 Fourthly, the work of accounting and internal audit has not been focused on, so that the examination is still formal and perfunctory, not promoting the effectiveness of inspection and auditing Fifth, there is no encouragement the effective application of IT in the organization of accounting work Sixthly, the accounting management system has not been paid due attention yet CHAPTER 3: IMPORVING THE ACCOUNTING ORGANIZATION OF THE TRADITIONAL MEDICINE HOSPITALS IN HANOI 3.1 Development orientations, requirements to improve the accounting organization of traditional medicine hospitals in Ha noi 3.1.1 Orientation for development of traditional medicine hospitals in Ha noi 3.1.2 Principles of perfecting the organization of accounting work at traditional medicine hospitals in Ha noi 3.2 Some solutions to improve the accounting organization of traditional medicine hospitals in Ha noi 3.2.1 Perfecting the accounting organization, approaching from the perspective of accounting is the information system 3.2.1.1 Improve the organization of human resources in the accounting information system - Determine the BMKT function and tasks of each accounting practice section - The need to use accounting personnel should be based on the actual workload of the hospital, along with professional qualifications and job requirements in each accounting section - Accounting organization should pay attention to financial accounting organization combined with management accounting in the unit 3.2.1.2 Complete data organization for the accounting information system - Firstly, the organization builds uniformly the list of accounting vouchers and accounting voucher forms Complete the system of vouchers applied at the unit under the guidance of the current accounting regime, supplement a number of voucher forms as a basis for accounting a number of arising accounting objects in the unit - Secondly, complete the organization of accounting documents about: the time of issuing hospital bill payment, information, hospital fee payment documents, other payment documents such as surgical, surgical bill payment sheets, techniques, calculation and distribution of the value of depreciation, depreciation of fixed assets, vouchers of payment of expenses for drugs, blood, fluids, chemicals, consumable supplies for patients - Thirdly, check accounting records + Develop a method to classify and arrange documents in a logical way + Need to classify and encode accounting vouchers in order to organize according to the types of vouchers, meeting the data collection of each accounting practice section + Need to review the information on vouchers, in addition to ensuring the legality of documents, also ensure the compatibility between the information on vouchers and the actual business arising of each responsible department in the hospital - Fourthly, organize the rotation of accounting vouchers + Clear assignment and development of a process of rotating scientific vouchers, suitable to the characteristics, operational scale and organization of the unit 20 + Specifying the time limit for the rotation of written documents within the hospital as in the case of exporting using medicine supplies, synchronous combination of solutions on the detailed account design, the delivery notes will be transferred for the accounting department to record the book right after the export operation has arisen - Fifth, organize the preservation and archiving of accounting records + Developing regulations on management, use and preservation of accounting documents, which clearly define responsibilities and rights for each department and each accountant + Storing accounting vouchers and accounting documents into archives for 12 months from the end of the annual accounting period or the end of accounting jobs The legal representative of the accounting unit is responsible for organizing the preservation and archiving of accounting documents + Destroying overdue vouchers and accounting documents which must be archived according to regulations 3.2.1.3 Improve the organization of data processing for accounting information systems Traditional medicine hospitals must record assets, liabilities, net assets, turnover and expenses according to the accrual accounting principle: Accordingly, all of the hospital's economic and financial operations related to assets , liabilities, net assets, revenues and expenses must be recorded in accounting books at the time of arising, not on the basis of actual collection or actual payment of cash or cash equivalents The recording of revenue and expenses for medical examination and treatment must be compatible with each other Hospitals must follow the appropriate principle, that is, when recognizing a revenue, a corresponding cost associated with that revenue must be recorded Costs corresponding to turnover include expenses of the period in which revenue is generated and expenses of previous periods or expenses payable but related to the turnover of that period Recognition of revenue from medical examination and treatment: Not recognized at the end of the accounting period with regard to patients who are continuing medical examination and treatment at the end of the accounting period; (ii) For the revenue from payment of the health insurance fund for patients who are entitled at the end of the accounting period, it has not been recognized or not fully recorded the unpaid social insurance agency due to concerns of the unapproved part when making final settlement Improving the organization of the technical design system to use, such as completing accounting for hospital fees with patients, completing material accounts, accounting of revenue sources, completing the time of revenue recognition and accounting revenue sources, finalizing the accounting for transferring revenues to funds, completing the organization of detailed coding of accounts, perfecting the organization of the accounting document system 3.2.1.4 Perfecting the organization of analysis and provision of information of the accounting information system - Upgrading the provision of information: improving the time of preparation and submission of the financial statements, improving the financial statements explanation, improving the publicity of the financial statements - Perfecting the organization of financial statement analysis: an independent financial analysis department which is an accounting department and its employees must understand the finance and have experience in financial work; The analysis of financial statements 21 needs to be more detailed and considered in a broader perspective such as analyzing the efficiency of using the funds, the volatility of assets, etc 3.2.1.5 Perfecting the organization of accounting inspection The inspection is only effective when the leader in charge of accounting clearly determines the purpose and tasks of the financial and accounting inspection Select the form of selfexamination to suit the organizational characteristics of the unit Unit testing format can be selected by time or scope of work Determine the content and method of implementation Internal audit must be performed in accordance with Article 9, Section of Decree 05/2019 / ND-CP dated January 22, 2019 on internal audit 3.2.1.6 Improving the application of IT to the organization of accounting work 3.2.2 Improving the organization of accounting work from the perspective of management accounting - Solutions to cost classification: Classify costs according to the relationship of costs with activity level, cost classification according to the ability to charge expenses into medical expense bearers of medical examination and treatment services - Solutions on norm construction and cost estimation 3.3 Conditions for implementation of perfect solutions - There is a must comply with the Accounting Law as well as legal documents, regulations of the State, and have access to international practices - There is a must ensure the consistency between financial information and information on the use of budget funds in the system of revenue-generating administrative and non-business units - There is a need to ensure the appropriateness of the characteristics of traditional medicine hospitals - There is a must be consistent with the regulations on the autonomy mechanism of public non-business, according to the development orientation of the health sector in general and the traditional medicine industry in particular, pioneering traditional medicine hospitals in Ha noi 3.3.1 On the side of the State and regulatory agencies - First: Improving policies and mechanisms for traditional medicine hospitals + For the Ministry of Finance: It is necessary to promulgate specific guidelines on the autonomy mechanism for the health sector in general and traditional medicine hospitals in particular in accordance with Decree 16/2015 / ND-CP The State should promulgate specific documents guiding the implementation of socialization in the health field on capital mobilization policies, preferential policies, tax policies, rates, and time of capital recovery of investors strengthen cooperation with foreign partners in the field of health, especially traditional medicine and pharmacy + For the Ministry of Health: The Ministry of Health shall coordinate with units to set up a price bracket for on-demand medical examination and treatment services, service prices at establishments conducting joint-venture socialization, link of the unit The Ministry of Health should coordinate with the Vietnam Social Insurance agency to continue speeding up the roadmap and soon complete the correct and full calculation of costs in the price of medical services, and at the same time ensure the rights of patients + For social insurance agency: The social insurance agency needs to assign appropriate cost estimates for medical examination and treatment with health insurance The social insurance 22 agency needs to make advance payment and settlement of expenses of medical examination and treatment with the health insurance for the medical examination and treatment facilities in accordance with the provisions of the Health Insurance Law and the legal documents implemented under the Law - Second: Improving the legal framework on accounting The State needs to improve the legal framework system to conform to the trend of international economic integration to ensure adequate, systematic, standardized and comparable financial information At the same time, building a legal framework on the accounting regime to ensure that the accounting work is carried out in accordance with the law, with consistency in the whole health sector in general and traditional medicine hospitals in particular It is necessary to study and improve to ensure the rationality, feasibility and consistency of the accounting system, forms of vouchers, accounting books, and financial and accounting reports suitable to the IT development conditions Currently, in line with international public accounting standards The application of IT in hospitals and health care facilities is a management policy of the medical industry that still has many problems when hospitals want automation Besides, there are difficulties in capital, especially public hospitals are constrained in spending and it is not easy to find budgets to implement informatics projects Therefore, the authorities need to invest a stable source of funding for hospitals to implement the application of IT to connect between hospitals and functional agencies such as the Ministry of Finance, the Ministry of Health, and Medical Insurance International, Taxes, 3.3.2 On the traditional medicine hospitals in Ha noi Traditional medicine hospitals in Ha noi shall base themselves on the operation scale and characteristics to organize accounting work suitable to the scale and type of operation, suitable to the financial regime, maximizing promotion Multi-effect resources Traditional medicine hospitals in Ha noi should develop internal spending rules in accordance with the autonomy mechanism and the documents guiding the current spending norms of the Ministry of Finance Improve the quality of accounting human resources to ensure quantity and quality Traditional medicine hospitals in Ha noi ought to strengthen financial management capacity for managed subjects and carry out the appointment of the chief accountant in accordance with the law Traditional medicine hospitals in Ha noi also need to recognize the importance of management accounting in the financial management of the unit Since then, building a competent management accounting organization organization to collect, process and provide management accounting information in a timely manner, helping leaders make the right decisions suitable in their development orientation Based on Decree 05/2019 ND-CP dated January 22, 2019, these hospitals to perform internal audits to help control the their accounting work in accordance with regulations These hospitals have to strengthen IT applications in financial management in hospitals Promote IT application with building and linking the software "Hospital Management", "Patient Management" and "Accounting" software, etc 23 CONCLUSION Accounting organization in public non-business units is crucial in planning the strategies for developing financial sources; at the same time, they need to help the Board of Directors and ministries to have the right orientation in managing and using financial resources, expanding and developing the size of the unit Therefore, the completion of accounting organization of public hospitals in general and traditional medicine hospitals in Ha noi in particular is indispensable, consistent with the trend and orientation of economic development of our country Because of these, the author chose the research topic: "Improving the organization of accounting work in traditional medicine hospitals in Ha noi", the thesis has solved the following issues: Firstly, the thesis has summarized and presented in a comprehensive and systematic manner the concept, classification, operating characteristics and financial management mechanisms in public non-business units, clearly identifying the influential factors affecting the organization of accounting activities of public non-business Secondly, the accounting information system is an important tool for public nonbusiness units to identify their strengths and build a long-term development strategy Accordingly, the content of the accounting organization is approached by the author on two angles: accounting organization approaching from the accounting perspective is the information system and organization of accounting work from the perspective of management accounting The author stated that accounting access organization in terms of information system includes human resource organization for information system, data collection organization, data processing organization, distribution organization, analyzing and providing information, organizing the accounting inspection and the application of information technology in the organization of accounting work; The thesis chooses the approach of organizing management accounting work according to the management process associated with the types of activities that generate revenues and expenditures of a public non-business, this approach is provided useful information of management accounting for each stage of the management process, serving the management function in controlling each type of activity of a public non-business Thirdly, the thesis presented an overview of the system of traditional medicine hospitals in Ha noi on the organization of operation, management apparatus, financial management mechanism and factors affecting accounting the organization of traditional medicine hospitals in Hanoi Fourthly, through studying the situation of organizing accounting work in traditional medicine hospitals in Ha noi by qualitative research methods including statistics, description, analysis, comparison, and comparison, projection, and quantitative methods include: surveys, interviews, observations, from which data analysis methods are used to assess the advantages, limitations and basic causes of real that situation for these hospitals Fifthly, the thesis proposes solutions and implementation conditions to improve the organization of accounting work of Traditional Medicine hospitals in Hanoi The author is particularly interested in solutions on policies such as autonomy mechanism, fee conversion mechanism of health service units, agreed guidance on the implementation of the circular on accounting regime In general, the health sector and traditional medicine hospitals in particular so that these hospitals can develop sustainably in the current autonomy mechanism 24 ... National Library of Vietnam - Academy of Finance Library INTRODUCTION Reasons for choosing the research topic In the context of a highly progressive global economy, the Vietnamese Party and Government... hospital and the cost classification criteria have not yet been classified by function and by activity level In order to use cost information by activity level, mixed costs must be separated into variable... consistency in the whole health sector in general and traditional medicine hospitals in particular It is necessary to study and improve to ensure the rationality, feasibility and consistency of the