The author of this article: Tun Tun
Recently, the First Affiliated Hospital of Zhengzhou University announced the “2021 Final Accounts of the First Affiliated Hospital of Zhengzhou University” on its official website, announcing the total income, total expenditure, and different payments for the year where to use.
Photo source: Official website of the First Affiliated Hospital of Zhengda University
Soon, this final account was dubbed the metaphor of a “transcript”. The First Affiliated Hospital of Zhengda University, with its “annual income of 20 billion”, “daily income of 60 million” and other data published On the hot search.
In fact, not only the First Affiliated Hospital of Zhengda University, which has been pushed to the forefront, but most of the second- and third-level public hospitals have already disclosed their annual final accounts.
So, what is the level of the First Affiliated Hospital of Zhengda University with an annual income of 20 billion? What do the annual final accounts of public hospitals say?
20 billion turnover, 64 million balance
According to the final accounts data released by the First Affiliated Hospital of Zhengda University, the total annual revenue of the First Affiliated Hospital of Zhengda University in 2021 will be 21.8 billion. Among them, 980 million yuan came from fiscal appropriation income, and it also included an emergency additional 75 million yuan in the middle of the year in response to the heavy rain in Zhengzhou on July 20, which was used for natural disaster relief and restoration and reconstruction.
Source: “2021 Final Accounts of the First Affiliated Hospital of Zhengzhou University”
Public hospitals are differential appropriation units, the state finance bears part of the funds, and the remaining part is paid by the hospital itself. According to the performance assessment monitoring and analysis data of tertiary hospitals previously announced by the National Health Commission (i.e. “National Examination”), in order to meet the needs of epidemic prevention and control, in 2020, governments at all levels have increased their investment in public hospitals. Financial subsidies for public hospitals accounted for 13.15% of total income.
According to the final account data released by various hospitals, the total financial allocation of many hospitals in 2021 is about 300 million yuan, accounting for about 3-4% of the total revenue . Although Zhengda First Affiliated Hospital has a financial allocation of 980 million, it only accounts for 4.48% of its total revenue. Beijing Xiehe’s total financial allocation is relatively high, at 870 million yuan, accounting for 7.6% of total revenue.
Data source: 2021 annual accounts of hospitals
Picture: I made it myself
In addition to financial appropriation income, the total annual income shown in the hospital accounts includes business income and other income. On the way to the construction of “one hospital and four districts” in the First Affiliated Hospital of Zhengda University, the revenue has also increased along the way. From 2008 to 2017, in the past ten years, under the decision of “bigger and stronger”, the revenue of the First Affiliated Hospital of Zhengda University has increased from 600 million to 10 billion, and this year it has exceeded 20 billion.
Comparing the total revenue of other well-known top three hospitals, it can be seen that in the same year, the total revenue of West China Hospital and Wuhan Tongji were both 12.4 billion. From Zhongda Xiangya to Fudan Zhongshan, most of the top hospitals in the country report annual total revenue in the range of 7 billion to 10 billion.
Data source: 2021 annual accounts of hospitals
Picture: I made it myself
Hospital financial management expert Lu An (pseudonym) believes, “This income data also shows that people’s health awareness is increasing, and their health appeals with purchasing power are increasing. Henan Province in China is a province with a large population, and it is normal for a large number of medical consultations.”
At the same time as the high income, the total expenditure of the First Affiliated Hospital of Zhengda University was as high as 20.8 billion, and the gap between income and expenditure was only 1.044 billion. After subtracting the revenue from the fiscal appropriation of 980 million yuan, there is only 64 million that can actually be called the “balance”, and the balance rate is less than 1%.
According to the “National Examination” data released by the National Health Commission, despite a slight balance in the overall revenue and expenditure of public hospitals, there are still 43.5% of hospitals have a negative surplus.
Lu An said, “If you want to evaluate how well a hospital is operating, you can’t just look at the balance. When the hospital is in different stages of development, there will naturally be differences. balance of .”
Especially when the hospital is in the transition period, it needs to spend a lot of money on equipment purchase, talent reserve, laboratory construction and other projects. There may be a negative balance in the short term, but it is a process that hospitals have to go through for sustainable and high-quality development.
Lu An suggested that, in addition to the annual income and annual balance, the operation of the hospital should also be comprehensively evaluated based on indicators such as per capita output value, annual outpatient volume, annual operation volume, capital turnover efficiency, and net asset growth rate. efficiency.
However, these data are not within the scope of public hospital annual accounts.
What else did the annual accounts say?
Although the above indicators cannot be directly obtained in the compilation of the annual final accounts, similar and valuable data can still be obtained by performing some rough calculations based on the publicized projects and hospital information.
For example, based on the number of employees and annual business income in each hospital, the annual per capita business income of employees can be calculated.
In 2021, the First Affiliated Hospital of Zhengda University will have a total business income of 18.6 billion yuan. According to the hospital’s official website, there are currently 14,341 active employees. That is, on average, each employee contributed 1.29 million yuan in career income to the First Affiliated Hospital of Zhengda University.
How does it compare to other hospitals?
In the same year, the per capita career income of Ruijin Hospital was 1.66 million yuan, Wuhan Union Medical College 1.35 million yuan, Huashan Hospital 1.65 million yuan, and Fudan Affiliated Cancer Hospital 1.93 million yuan.
Data source: 2021 annual accounts of hospitals
Picture: I made it myself
On the other hand, according to the Health Statistical Yearbook, in 2019, in public tertiary hospitals, the average inpatient income accounted for 66% of hospital business income.
Image source: 2020 Health Statistical Yearbook
Medical humanities trainer Zhu Renzhi said, “In some juniors with strong surgical advantages, this ratio may be higher.”
The differences between hospitals are even more pronounced when the average business income per bed is calculated.
Fudan Zhongshan brings in an average of 4.78 million yuan per bed, Huashan Hospital has 3.16 million yuan, and West China Hospital and Peking University First Hospital both have around 2.6 million yuan.
Data source: 2021 annual accounts of hospitals
Picture: I made it myself
And how much of the hospital’s revenue falls back to clinicians?
In the “China Health Statistical Yearbook”, the total expenditures and personnel expenditures of public hospitals are counted. Among them, personnel expenses include basic salary, performance salary, allowance, social insurance payment, etc.
According to the number of active employees and total expenditures announced by each hospital, as well as the average staff expenditure ratio of each region in the statistical yearbook, we can roughly get the average annual salary of each hospital including social security expenses.
Data sources: 2021 annual final accounts of hospitals, 2020 Health Statistical Yearbook
Picture: I made it myself
The First Affiliated Hospital of Zhengda University with an annual income of 21.8 billion, with a large number of 14,000 employees, the average annual salary does not seem to be among the top three.
As you say, “withInstead of looking at how much money the hospital makes, it is better to calculate how much money you can earn as a doctor or a nurse here. ”
Experts: The Trend
Actually, public hospitals don’t publish their annual accounts on a whim. As a unit that has obtained state financial appropriation, public hospitals are obliged to explain the specific use of the funds and accept the supervision of the financial department and the health department.
In 2015, the former National Health and Family Planning Commission issued the Interim Regulations on the Budget and Final Account Reporting System of Public Hospitals, requiring public hospitals to prepare annual budget reports and final accounts reports.
Lu An said, “The final accounts of a hospital tell the story of the whole year’s development. For hospital management, it can be clearly seen that Where the income comes from and where the expenses go will guide decisions for the next year.”
On the other hand, public hospitals are state-owned, and hospital managers only have the right to operate. The annual final accounts are also one of the important means of evaluating the management team. The National Health and Health Commission proposed in the “Implementation Measures for the Comprehensive Budget Management System of Public Hospitals” that public hospitals should conduct performance management of budgets, assess budget execution, cost control, work efficiency and other dimensions, and use performance assessment results as resources An important basis for configuration, annual appraisal and internal income distribution.
Image source: “Implementation Measures for the Comprehensive Budget Management System of Public Hospitals”
The Finance Department of the National Health and Medical Commission will also conduct a comprehensive assessment of the annual departmental final accounts of public hospitals, and report to advanced units. West China Hospital, Jilin University Sino-Japanese Friendship Hospital, Peking University Stomatological Hospital, Jilin University First Hospital, Central South University Xiangya Hospital and other hospitals have won the first prize for many years.
In the “National Examination” briefing, the National Health Commission also pointed out that there are still some public hospitals that do not have a chief accountant due to issues such as job setting and establishment; In the hospital, about 30% of the chief accountants have failed to enter the leadership team and have not yet fully functioned.
Last year, the General Office of the State Council pointed out in the “Opinions on Promoting the High-Quality Development of Public Hospitals” that it is necessary to strengthen the overall budget management of public hospitals, regularly disclose hospital-related financial information, and take the initiative to accept Social supervision.
It was also from last year that only the annual budget and final accounts of the relevant departments were originally submitted, which were successively published on the official websites of each hospital.
Lu An said, “Publication allows everyone to supervise and compare the situation of each hospital, and it also forces the hospital to do better in management. In the long run, the publicity of final accounts will It should be a trend.”
“It’s normal for everyone to be shocked by tens of billions of dollars. Before the announcement, many people had no concept of the hospital’s income and cost. It would not be surprising to announce it for a few more years.”
Planning: yuu. | Producer: gyouza
Image source: Visual China
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