【摘要】 新医改方案要求公立医院要进一步完善财务、会计管理制度，严格预算管理，加强成本核算与控制，定期开展医疗服务成本测算，科学考评医疗服务效率。新医改将为公立医院开展全成本核算提供政策依据和要求。本文从公立医院所有制的变化，卫生服务需求的改变、公立医院现行财务制度以及当代计算机技术的发展等多个方面分析了公立医院全成本核算的必然性和现实性。

    【关键词】 公立医院； 全成本核算； 必然性； 现实性

    Study on the necessity and realistic of total cost accounting in public hospitals in the situation of new medical reform ZHANG Hong-yan，LI Qing-hua. Henan Chest Hospital，Zhengzhou 450008，China

    【Abstract】 It required that the public hospitals should further improve the system of the financial and accounting management, manage the budgeting strictly, strength the account and control of the cost, estimate the cost of medical services regularly, evaluate the efficiency of the medical services scientifically in the project of the New Medical Reform. The New Medical Reform will provide the support based on the policy and requirement for the total cost accounting in the public hospitals. This article analyses the necessity and realistic of total cost accounting in public hospitals from many points of view, such as the change of the ownership of the public hospitals, the change of the health services demand, the present financial system of public hospitals and the development of computer technology. ......