Improving accounting work organization in traditional medicine hospitals in Hanoi city

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 1 of Decree 05/2019 /

ND-CP dated January 22, 2019 on internal audit.

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ization of accounting information inspection. - There have been no studies on the organization of private accounting in the traditional medicine industry, specific factors in the operation, management organization, and financial policies that govern accounting organization of traditional medicine hospitals in Ha noi. - There are no specific studies on the application of IT directly affecting the organization of accounting work of traditional medicine hospitals in Ha noi. - There have been no studies and assessments on the current situation of organization of accounting work at traditional medicine hospitals in Ha noi, finding out the factors affecting the organization of accounting work, issues. exist when these hospitals apply a new accounting regime to account revenues and expenses, when applying the law provisions on invoices, vouchers, ...; Basing on these findings, I propose appropriate solutions to organize the accounting work of these hospitals in the current autonomy mechanism. 9 Therefore, I decided to choose “Imporving accounting work organization in traditional mecdicine hospitals in Ha noi” as my research. The thesis will research intensively on the organization of accounting work in the public non-business, associated with the autonomy mechanism for task performance, organizational structure, payroll and finance; the same situation of organizing the accounting work in traditional medicine hospitals in Ha noi, the advantages and limitations, identifying the causes and influencing factors to give solutions to overcome and complete organize the accounting work of traditional medicine hospitals in Ha noi in the autonomy mechanism. 8.2. New contributions of the thesis About the approach: The author approaches to organize the work from the perspective of accounting information system. Regarding the content: The thesis studies the characteristics of the organization of operations, the organization of accounting work, the factors affecting the organization of accounting work of traditional medicine hospitals in Hanoi. About the context: The dissertation studies the accounting work of traditional medicine hospitals in Hanoi in the context that these units are implementing the autonomy mechanism to gradually reduce their dependence on the State budget, and the information technology revolution 4.0. 9. The layout of the thesis The content of the thesis is divided into 3 chapters in addition to the introduction, conclusion, list of references and other structural parts. Chapter 1: General theory of organization of accounting work of public non-business units Chapter 2: Actual situation of organizing accounting work at traditional medicine hospitals in Ha noi. Chapter 3: Solutions to improve the organization of accounting work at traditional medicine hospitals in Ha noi. These three chapters have a logical relationship to carry out research objectives. Figure 1. Research framework of the thesis 10 CHAPTER 1: GENERAL THEORY OF ACCOUNTING ORGANIZATION FOR PUBLIC NON-BUSINESS UNITS 1.1. Overview of public non-business units 1.1.1. Public non-business concept 1.1.2. Characteristics of public non-business 1.1.3. Classification of public non-business 1.2. Organization of accounting work in public non-business. 1.2.1. General issues about the organization of accounting work of public non-business units 1.1.1.1. Concept of organization accounting work of public non-business units STUDY GAP OBJECTIVES AND ISSUES TO CHAPTER 1: GENERAL THEORETICAL ORGANIZATION OF ACCOUNTING WORK AT PUBLIC NON-BUSINESS UNIT CHAPTER 2: CURRENT SITUATION OF ORGANIZATION OF THE ACCOUNTING WORK OF TRADITIONAL HOSPITAL ON HANOI The process of formation and Organization of operation, Organization of financial mechanism Influential factors organizations of accounting work approaching the information system from the accounting The organization of accounting work approaches from the perspective of accounting is the information system the perspective Influential factors 2.1 Overview of traditional medicine hospitals in Hanoi 2.2. Actual situation of organizing accounting work in traditional medicine hospitals in Hanoi 3. Assessing the situation CHAPTER 3: SOLUTIONS TO COVER THE GAP 11 According to the "Accounting Principles Curriculum" of the Finance Academy, "The organization of accounting work should be understood as a system of constituent elements: organizing the accounting apparatus, organizing the application of accounting methods, accounting techniques, organizing the development of accounting regimes, rules,... the relationship and the impact between these factors with the purpose of ensuring conditions for maximizing the functions of system of such factors”. 1.1.1.2. Requirements, tasks and meanings of accounting organization of public non- business units 1.1.1.3. Factors affecting the organization of accounting work of of public non-business units The legal environment and financial mechanism of public non-business units Demand for accounting information in public non-business units. Financial management mechanism and innovation of financial management mechanism in public non-business. 1.1.2. Basic content of accounting organization in of public non-business units There are many views about the content of accounting organization, but according to the author, the most important accounting information system in the financial and economic management of a unit. Calculating correctly and adequately the inputs and well organizing accounting human resources, organizing data, processing data, analyzing, providing accounting information and checking accounting to serve Management requirements are of great significance in improving the performance of revenue-earning of public non-business units. Thus, besides analyzing the needs of society for public services, the accounting information system is an important tool for of public non-business units to identify their strengths and develop improvement strategies. Therefore, the author chooses an approach of organizing accounting work from an accounting perspective as an information system. Studying the content of the organization of accounting work in of public non-business units is to identify the main and basic tasks to be conducted when organizing the accounting work. 1.2.2.1 The organization of accounting work approaches from the perspective of accounting is the information system. Organizing human resources in accounting information system. Organizing data collection for accounting information systems. Organization of data processing for accounting information systems. Analyzing, providing information of accounting information system. Organization of accounting inspection. Organizing accounting work in terms of IT application. 1.2.2.2 Organize the accounting work of public non-business units from the perspective of management accounting. In this content, the thesis chooses the approach of organizing the international economic organization according to the management process associated with the types of activities that generate revenues and expenditures of a of public non-business unit, this approach provides the following solutions: useful information of the international economy for each stage of the management process, serving administrative functions in controlling each type of activities of a of public non-business unit, including: cost classification, norm construction and cost estimation. 1.1.3. The situation of applying international public accounting standards in Vietnam. 12 CHAPTER 2: CURRENT SITUATION OF ACCOUNTING ORGANIZATION AT TRADITIONAL MEDICAL HOSPITAL ON HANOI AREA 2.1. Overview of traditional medicine hospitals in Hanoi. 2.1.1. The process of formation and development. Traditional medicine hospitals in Ha noi, including: - Hospitals under the Ministry of Health include 3 hospitals: Central Traditional Medicine Hospital, Central Acupuncture Hospital, Tue Tinh Hospital - Hospital under the Hanoi Department of Health includes 2 hospitals: Hanoi Traditional Medicine General Hospital, Ha Dong Traditional Medicine Hospital - The hospital directly under the Ministry of Public Security includes 1 hospital: The Ministry of Public Security's Traditional Medicine Hospital - The hospital under the Ministry of Defense consists of 1 hospital: the Military Traditional Medicine Institute 2.1.2. Organization of operations. 2.1.3. Organization management apparatus. 2.1.4. Financial management mechanism. - Content of financial activities: State budget allocations (including regular, irregular); Revenues from medical examination and treatment with health insurance (including sources of health insurance and patient payment); Revenues from medical examination and treatment services and other sources (aids, sponsorships, business cooperation contracts, training, parking space rentals, canteens, ..., ... - Content of financial expenditures: State budget allocations; Expenditure by revenues from medical examination and treatment with health insurance, services and other sources. 2.1.5. Influencial factors. Legal environment, financial mechanism for traditional medicine hospitals in Ha noi. Accounting information needs of traditional medicine hospitals in Ha noi. Financial sources for investment in traditional medicine hospitals in Ha noi. Financial management mechanism and innovation of financial management mechanism. 2.2. Actual situation of organizing accounting work in traditional medicine hospitals in Ha noi. 2.2.1. The organization of accounting work approaches from the perspective of accounting is the information system. Based on the organizational characteristics as well as the scope of operations and the decentralized situation of financial management within the unit, as well as the volume, nature and extent of arising economic operations, the accounting apparatus of the diseases. Traditional medicine institute in Hanoi operates in a concentrated form (accounting for 71.44%), in a concentrated and dispersed form (accounting for 28.56%). 2.2.1.1. Actual situation of human resources organization in the accounting information system. * Organization of the accounting apparatus. According to the survey results, 100% of traditional medicine hospitals in Hanoi do not organize separate economic and administrative departments, but are implemented by the financial and accounting department. * Personnel organization in the accounting apparatus. 13 Accounting workers in these hospitals: graduate with 5%, graduate with 85%, intermediate with 10%. The qualifications of the accountants are uneven at the units, trained in many different training facilities, and there are hospitals that use accountants who are not specialized in the training. 2.2.1.2. Data organization for accounting information systems *Regarding the content and form of accounting vouchers: Traditional medicine hospitals in Hanoi comply with the content, method of making and signing accounting vouchers according to the Accounting Law and Decree No. 174/2016 / ND-CP dated 30 / 12/2016 of the Government detailing and guiding the implementation of a number of articles of the Accounting Law and related legal documents. *About the system of accounting voucher forms: implementing the forms of voucher templates under the system of compulsory general accounting vouchers that are prescribed by the accounting regime. The implementation reflects the units' arising economic and financial operations fully reflected in 4 criteria: labor and wage criteria, including:; criteria of supplies; monetary criteria include: cash receipt, cash payment slip, cash withdrawal check, advance proposal, payment proposal, payment request; Fixed asset targets include ex- warehousing, warehousing, medicine, supplies, ... bills of each department. Each invoice at traditional medicine hospitals in Hanoi is only issued once when the patient finishes the treatment, so it does not reflect the right revenue - cost. Because revenues for subclinical services of patients have been made but the hospital has yet to bill for these subclinical activities. As a result, hospitals have not complied with the regulations on the time of billing at Point 2, Article 16 of TT39 / 2014 / TT-BTC dated March 31, 2014. *Regarding the receipt of accounting vouchers as follows: all accounting documents made elsewhere are transferred to the Finance and Accounting Department of the hospital for inspection and processing. *Checking accounting records and rotation of accounting vouchers: these hospitals are checked for the clarity, honesty, completeness of the criteria, the factors recorded on the accounting vouchers, the appropriateness The rationality and legality of the arising economic and financial operations According to the survey results show that all hospitals apply accounting software to their accounting work, so most of the voucher templates are available. Accountants only need to add documents of necessary business operations. According to the survey, 100% of these hospitals do not have an Internal Control Department, checking accounting records is usually done directly by the accounting department using vouchers to record books and auditing units. For vouchers which have been recorded in accounting books, mistakes and errors cannot be avoided. *Classification and arrangement of accounting documents. The accounting documents of hospitals are classified into 2 types: Original documents (original documents) and general documents (intermediary documents). Accounting documents include vouchers for purchase of fixed assets, payment of wages, drugs, medical supplies, chemicals, etc., vouchers reflecting the recording of hospital fee collection activities: collection of health insurance fee collection, collection hospital fees for medical services, ... *Document storage and preservation: Accounting documents are archived and preserved in accordance with the Government's Decree No. 174/2016 / ND-CP of December 30, 2016. 14 The storage and preservation of accounting vouchers of traditional medicine hospitals in Hanoi are undertaken by the Finance - Accounting Department. According to the survey, 85.72% of these hospitals have archives to preserve documents to ensure compliance with regulations on archiving and preserving accounting vouchers, only 14.28% do not have archives. separate documents (Tue Tinh hospital does not have a separate document for storing documents in the finance and accounting department) 2.2.1.3. Organization of data processing for accounting information systems. Accounting information of public health clinics in Ha noi after being received will be classified by group of information as follows: - Information on the estimation and the situation of the use of funding sources: regular funding sources, irregular funding sources, hospital fee sources and other sources of revenue; - Information on properties, equipment; - Information on labors, salaries, preferential allowances of the profession such as: direct, toxic allowance, surgical procedure allowance, ... - Information on use of drugs, supplies, chemicals, ... *Organizing the application of accounting forms: Through actual surveys at traditional medicine hospitals in Hanoi, it is shown that 100% of the accounting system is applied on computers. *Accounting accounts: -Organizing selection and making a list of accounting accounts. Traditional medicine hospitals in Hanoi use the account system according to Circular No. 10/2017. However, accounting at traditional medicine hospitals in Ha noi when applying this accounting account system still has some limitations: +The opening of details for TK131 has not been unified among hospitals. This will be difficult when the Ministry of Health collects hospital data. At Tue Tinh Hospital, the name TK131- Receivables from customers has been kept and the details of each advance account are opened and details of the advance account are not opened; and Hanoi General Hospital of Traditional Medicine TK131 detail the advance account TK1311-Receivables from patients, TK1312-Receivables from health insurance. +The accounting accounts reflecting the professional prints of these hospitals do not clearly separate the repository for printing for administrative and non-business activities and the depot for serving production and business activities, services, and not yet available. There is no reconciliation to control this activity between departments and rooms. + Revenue of short-term training courses is usually collected once when the activity arises, or the rental of parking space is paid in advance in many installments, the accountant recognizes the lump sum revenue as soon as the fee is collected, but expenses incurred later. + Hospitals have difficulty in recording the accounting books of the fourth quarter KCB settlement expenses from the social insurance agency because the fourth quarter funding is often delayed. - Encrypting detailed accounting accounts. Traditional medicine hospitals in Hanoi have not done well in encoding detailed accounts, for example, detailing revenue accounts has not been able to detail each type of revenue such as revenue of training classes, revenue. parking space for rent, ... The detailed coding of accounts of raw materials and materials has not yet followed the general standards but 15 depending on the qualifications of each accounting unit, it will lead to inconsistencies in the detailed coding of accounting accounts. Bookkeeping system. The system of accounting books of traditional medicine hospitals in Hanoi is being used based on management needs to determine a relatively suitable number of books. 2.2.1.4. Analyzing, providing information of accounting information system. * Providing information on accounting report: Traditional medicine hospitals in Hanoi submit annual reports to the governing bodies such as the Ministry of Health, the Ministry of Public Security and the Hanoi Department of Health in April annually, but the financial statements and financial statements are usually submitted later than the prescribed time. * Organizing analysis of information and accounting reports: - For analyzing the situation of implementation of cost estimates: it is assessed both sides that are efficiency and performance. - For analyzing the situation of implementation of revenue estimates: use the norms of revenues and funding sources to evaluate. These targets are monitored in detail from which a salary and bonus policy is prescribed 2.2.1.5. Organization of accounting inspection. Most hospitals do not have an internal control department, the checking of accounting vouchers is usually done directly by the accounting department using vouchers to record books and auditing units for documents made at accounting entries. Currently, traditional medicine hospitals in Hanoi are eligible to perform internal audit according to Decree 05/2019, but according to the survey, no traditional medicine hospitals in Hanoi have conducted the internal audit. 2.2.1.6. Situations of organizing the application of IT to the organization of accounting work. The application of IT to the organization of accounting work of traditional medicine hospitals in Hanoi has been 100% implemented in hospitals and well implemented the application of drug prices and automatic service prices by software. The degree of choosing IT application level in these hospitals is at the automation level of accounting work. Applying IT in various stages: organizing human resources of accounting information systems, in organizing data, processing data for information systems, analyzing and providing information, organizing accounting checks. 2.2.2. Actual situations of organizing the accounting work of traditional medicine hospitals in Hanoi on the perspective of management accounting. 2.2.2.1. Situations on cost classification. According to the survey results, 100% of traditional medicine hospitals in Hanoi classify expenses according to their spending contents, operation characteristics and autonomy to perform accounting according to the state budget index, regardless of the criteria for classifying expenses other than those used in management reports. 2.2.2.2. Situations on formulating norms and cost estimates (1) The reality of setting cost norms Establishing cost norms is the most important task for traditional medicine hospitals in Hanoi when hospitals are given autonomy, the survey showed that 100% of these hospitals all set cost norms and is specified in the internal spending regulations through the annual staff meeting, after the completed comments will be carried out. The content of specific cost 16 norms and construction facilities usually includes a system of quantitative norms and a system of cost norms (money). (2) About cost estimation According to the survey, 100% of these hospitals make estimates based on the past. Accounting is based on the actual operation results of the previous period and adjusted according to the expected growth rate and inflation rate to make estimates for the next period. 2.3. Assessing the situation of organizing the accounting work of traditional medicine hospitals in Ha noi. 2.3.1. Advantages: In general, the organization of accounting work at traditional medicine hospitals in Hanoi has complied with the provisions of the Accounting Law; Vietnamese accounting regime. Expressed through the application of accounting documents, accounting system, accounting book system and financial statements system to improve management efficiency. On the basis of the current accounting regime, the hospitals have guided accounting for their own accounting in accordance with the requirements and qualifications of the accounting team in the hospitals. 2.3.2. Defects: (1). Restricting accounting organization access from the perspective of accounting is the information system. * Organizing human resources in the accounting information system. Human resources in BMKT at traditional medicine hospitals in Ha noi have not fully exploited the professional skills capacity of accounting workers, have not built a job position suitable to their professional titles. The recruitment of accounting labor contracts through document review, through acquaintances introduced, not widely recruited, so it is impossible to accurately assess the capacity and professional qualifications of the labor contract Math, there is not much competition in recruiting accounting contracts. * Data organization for accounting information systems. The initial information collection process was not timely, delayed, and many shortcomings led to errors in organizing the data for the accounting information system. + Presently, traditional medicine hospitals in Hanoi only issue one time invoice when the patient finishes the treatment, the medical examination and hospital discharge. As such, these hospitals have not properly implemented the time of issuing invoices in accordance with the provisions of Circular 39/2014 / TT-BTC on sales invoices and service provision. + The organization of accounting vouchers has many shortcomings such as information on dates, amounts in words,... have not been fully filled in the accounting vouchers. + There are many shortcomings in the payment of hospital fee payment of insurance patients, the wrong amount of use of drugs, medical supplies, ... leading to difficulties in paying hospital fees to the agency. Health Insurance. + These hospitals have not yet developed a healthcare code for each patient to track patient information for life. + Hospital fee receipts have not divided hospitalization premiums and voluntary hospital fees on the same exposure to inpatient payments. As a result, it is difficult to accurately separate the revenues and costs of each activity. 17 Moreover, many fixed assets are used at the same time for both non-business and service activities. Therefore, the accountant cannot correctly allocate the depreciation value of fixed assets to the origin of fixed assets. + Many hospitals still lack documents to compare expenses for medicines, blood, fluids, chemicals, consumable materials to patients. So at the time of payment, the patient is unclear what drugs he or she has been treated for, how the

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