目的: 探讨适合中国国情的医保基金会计制度,推动医保管理制度改革。方法: 从会计理论方面论述医保基金会计主体假设的理论依据及会计主体假设的根本作用,从会计实务方面分析现行单一基金会计主体与我国行政管理体制存在的冲突。以理论与实践相结合的方式剖析“基金+单位”双元会计主体模式的可行性。结论: 应建立与我国医保基金管理业务相适应的基金会计制度,为推动医保管理体制改革和提高医保基金使用效率提供制度保障。建议: 采用“基金+单位”的双元会计主体模式确立医保基金会计主体,实现提高管理主体决策质量、解脱公共受托责任和提高基金使用效率、降低基金被挤占挪用风险的会计目标。

Objective: The paper explores the accounting system of medical insurance fund suitable for China's national conditions, to promote the reform of medical insurance management system. Methods: From the perspective of accounting theory, the theoretical basis of the accounting entity assumption of medical insurance fund and the fundamental role of the accounting entity assumption were discussed, and the conflict between the current single fund accounting entity and the administrative management system in China was analyzed from the perspective of accounting practice. This paper analyzes the feasibility of the dual accounting entity model of "fund plus units" in a way that combines theory and practice. Conclusion: A fund accounting system suitable for the management of medical insurance funds in China should be established to provide institutional guarantee for promoting the reform of medical insurance management system and improving the efficiency of medical insurance fund use. Suggestion: The dual accounting entity model of "fund plus unit" should be adopted to establish the accounting entity of the medical insurance fund, so as to achieve the accounting objectives of improving the decision-making quality of the management entity, relieving the public fiduciary responsibility, improving the efficiency of fund use, and reducing the risk of fund misappropriation.