Accounting in medical commercial organizations. Logistics of medicines as a point of optimization of medical organizations. How medicines are purchased

Accounting for medicines in hospitals is strictly regulated, it must comply with the rules and procedure for reference medicines In medical institutions. In this article, consider the main aspects of drug accounting, methods and procurement rules, we will learn the rules for accounting for drugs in hospitals with a pharmacy and without, and also get acquainted with accounting wiring and with the treatment procedure for prescriptions. All information is given in accordance with the instructions of the documents and the relevant orders.

Who conducts accounting of medicines

Drugs to be recorded must be monitored by the following organizations:

• Medical institutions (all clinics and hospitals)
• Pharmacy institutions
• Pharmacological companies

The institution appoints special employees who are responsible for the safety of drugs materially. The manager monitors the organization of rules and compliance with the storage standards, the sale of drugs and the write-off of drugs. This account is carried out to avoid the risk of violations by control bodies. A specific decision is made by the most medical organization that forms its own accounting policy framework.

How medicines are purchased

Autonomous (private) Polyclinics themselves determine the procurement procedure. This right is provided by the letter of the Ministry of Economic Development of April 26, 2017 No. D28I-1865. This information must be specified in the local act of a private medical institution. For procurement of medicines, a typical contract is required.

Procurement methods:

• Request for the proposal (through the documentation on the procurement platform).
• Through writing direct letters directly to suppliers with a price request.

In a procurement paper, you must specify the dosage, dosage form and the shelf life of the medication.

Accounting to how medicines need to behave

In the order of the USSR Ministry of Health of 02.06.1987 No. 747, a list of drugs that are subject to mandatory accounting is indicated. These include:

• Medicinal preparations (medicines, serums, vaccines, disinfection products)
• Mineral water
• Dressing materials (they include march, paper, wool, bandages)
• Various packaging (banks, bottles, bidones, flasks)
• Vaccines

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Tackle in specially designed forms in quantitative terms:

• Alcohol
• Clinically studied containers and medicines
• Substances that contain narcotic, potent or poisonous components
• Psychotropic drugs.

How to account

Medications in the hospital and pharmacy are taken into account in this way:

1. Checking the compilation of registers is carried out every three months and is selective
2. Monthly control of special medicines
3. An accountant signature is required on proven documents.
4. To the cost of expenses, auxiliary materials refer immediately upon admission to the pharmacy
5. Changing the price of non-returnable containers occurs simultaneously with the write-off of the relevant medical drugs
6. Mandatory control of the results of the annual inventory of the head of the medical clinic.

	Documentation	Conducted pharmacy registers	Details of compilation
Parish medication from supplier	Exhibited by seller account	1. Form 6-MZ (represents a document registering received accounts) 2. Form 11-MH - represents a report issued by a pharmacy. Negotiates the money coming and consumption of medicines	It is necessary to make 2 reports of the report, one of which is certified by the pharmacy manager and continues to be kept in accounting, and the second is subject to the transfer to the pharmacy manager.
Issuance of drugs from the pharmacy directly for treatment	Patch	1. Shape 7-MW (represents a document that takes into account the requirements for retail prices for drugs) 2. Form 11-MZ (represents a pharmacy report on the arrival and disposal of medicines)	You must arrange two instances. The first is issued to a materially responsible person, the second remains at the pharmacy. Pages are subject to numbering. Also necessary signature of the chief accountant. Then the data is sent to the form 11-MW
Arrival and deduction of medicines subject to quantitative accounting	Registration of the invoice or invoice from the seller	Form 8-MZ (is a document registering the amount of drugs)	The signature of the chief accountant is necessary and the numbering of pages is required.
Consumption of special medicines	Patch	Form 1-MZ (Sampling Sampling of Special Medications)	It is necessary to assign this document by the head or deputy head. The sum of the result goes into form 8-MW

How medications are recorded in the hospital without a pharmacy:

The supply of medications without pharmacies occurs through pharmacy warehouses suppliers. In this case, the quantitative amount of medication is required. Conditions are as follows:

1. The limit of dispensing drugs is stipulated by a specially compiled instruction.
2. Power of attorney for the issuance of drugs
3. The number of drugs meets the current needs of the medical institution

	Documentation	Account registers	Details of compilation
Admission of drugs immediately to the department	1.Noblast 2. Information on the supplier's account (also applied invoices for a certain period of time discussed)		Registration of the invoice is carried out in four copies, each group of drugs for each separation. The prescribed employee of the institution is written off. The basis for this procedure is the invoice
Supply of special medicines	Patch	Form 2-MZ (represents a document-report on medicines, the number of which is subject to accounting)	It is necessary to make five overheads, each group of drugs for each separation

Accounting

Magazines for drugs included in the list should be carried out simultaneously with the turnover of documentation. Document work tracks the arrival, consumption and movement of medicines in a medical facility.

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The procedure for organizing drugs that are not subject to subject and quantitative accounting:

Arrival:

1. Accounting is carried out pharmacy
2. Accounting Register is a form of 6-MW
3. The base document is a commodity invoice, or a written invoice. It may also be a transmitter document that is issued by the supplier.

Issuance in the department:

1. regulating document - invoice requirement (0504204)
2. register - form 7-MW
3. accounting is carried out by a pharmacy.

The procedure for organizing drugs that are subject to subject and quantitative accounting:

Arrival:

1. Accounting leads pharmacy
2. Accounting Register B. this case - form 8-MZ
3. The base document is also an invoice or commodity invoice, or a transmitter document from the supplier.

Consumption of medicines:

1. Accounting is implemented by a pharmacy
2. Accounting register - Form 1-MW
3. The base document is the requirement-overhead (0504204). It necessarily indicates the phids of those who are supplied for these drugs. Mandatory stamp and printing to assign the document.

Accounting wiring for accounting of medicines

According to the accounting of medicines, appropriate accounting wiring. To do this, it is necessary to use the approved order of the Ministry of Finance of the Russian Federation of 01.12.2010 No. 157n.

After receiving medicines in a private clinic, they must be registered with financially responsible persons. Next, there is a vacation for the issuance of drugs with patients. This operation is the gain of medicines on the balance of a private clinic from a higher organization. The arrival of drugs carried out:

• supplier: Dr. 0 105 31 341 Kt 0 302 34 734.
• higher Organization: Dt 0 105 31 341 Kt 0 304 04 341.

Accounting in the pharmacy

The moments that need to be remembered in the process of accounting for medicines in the pharmacy:

1. In the pharmacy institution it is necessary to create an existing commission that calculates all the available medicines.
2. Inventory occurs annually. It takes into account packing, dose and type of therapeutic drugs.
3. Accounting for drugs in the pharmacy is regulated by 8-MH and 1-MH forms.
4. Mandatory signature and print from the head of the organization when issuing drugs.
5. To make sure that medicine accounting logs are correct, it is important to conduct a selective check.

How drugs are released by recipes

The rules of vacation of drugs according to the recipe are regulated by order of the Ministry of Health of Russia of July 11, 17, No. 403n. The sale of prescription drugs can be carried out pharmacy organizations that have been licensed to implement pharmaceutical activities.

To obtain special drugs, it is necessary to have a form that allows the preparation of medicines:

• f.148-1 / y-88 - its shelf life is carried out 3 years. For such a certificate, you can get special (subject to compulsory) medication;
• f.107 / U-NP - is stored for 5 years. It is issued to obtain psychotropic drugs, as well as drugs with narcotic components. On the form of this form, you can get only one type of preparation.

Disability of medicines in medical institutions

Forms for writing off drugs:

• Report 11-MH
• Selection 1-MW

The write-off of medical drugs in accounting is carried out in common order Based on the provisions of the instructions No. 157n, 174n.

To write off medicines in medical institutions, two unified forms are used:

• f. 0504210 (suitable when he is written off the drugs of the senior nurse)
• f. 0504230 (It is possible to write off the drug nurse, which is an accountable person)

The institution itself chooses the form of writing off therapeutic agents:

1. At the average actual price
2. At a price, which is indicated in the commodity invoice

Who is responsible

Accounting and tracking of the implementation and storage of medicines in the LPU is subject to licensing control. The lack of accounting of the organization is regarded as a violation of the requirement, as a result of which can be accessed under administrative responsibility, in the case when it does not contain signs of a criminal act.

Parties are involved in those faces that use medical products with expired Annimity, or those who used medicines in an unregistered law.

The offender is relying a fine. For individuals It is about three or four thousand rubles, for legal - thirty-forty thousand rubles.

A.I. Gaidukov,
KF-M.N, head of development of the line of 1C: Medicine, Firm "1C", Moscow, Russia

D.B. Zheupanova,
Head of AHD Automation Direction medical organizations, firm "1C", Moscow, Russia

E.L. Reburov,
Head of the Office of Organizational Support and Quality Control of Medical Activity, Clinical Center of FGAOU in the first MGMU. THEM. Sechenov Ministry of Health of Russia, Moscow, Russia

S. G. Kuznetsova,
Graduate student, FSBI Central Research Institute of Organization and Informatization of Health of the Ministry of Health of the Russian Federation, Moscow, Russia

Introduction

Stationary medical care is currently the most resource health sector. In the structure of the hospital costs, the article "Medications" is usually one of the largest (see Fig. 1) and takes 10-15% of all costs. An important feature of the reserves of drugs and expenditure medical materials is limited time Sucidity. Excessive reserves of medicines entail not only the cost of their storage, losses in debiting overdue stocks, but also the costs of disposal of medical waste by specialized firms that have a relevant license. Therefore, the task of managing the stock management is always relevant for hospitals, and the automation of this process gives a significant economic effect.

Fig. 1. Approximate hospital cost structure

Methods

Consider the main stages of drug supply drugs in medical organizations:

• formation of annual needs of hospital in medications:
• consolidation of annual needs of hospital units;
• drawing up a procurement schedule;
• formation of lots and the formation of publishing notices on 44-ФЗ or 223-ФЗ (for state and municipal institutions);
• concluding a contract for the supply, in the specification to the contract indicates a list of purchased goods;
• formation of operational (during the year) hospital needs in medications:
• registration of orders for the supply of goods;
• admission to the pharmacy of a medical organization;
• quarterly adjustment of annual needs (schedule plan);
• distribution by divisions of the medications received to the warehouse.

The need to purchase goods is determined by the speed of consumption of goods, the time interval between the placement of the supplier and the supply of goods, as well as the level of their stocks in the warehouse and in the divisions. In stock management theory, several methods of maintaining the level of stocks are distinguished:

• order under the order - the needs for procurement are formed on orders of units. Storage reserves of pharmacies are not taken into account. This method is commonly used for expensive positions that have episodic consumption.
• calculation of statistics - a forecast of goods consumption is performed according to consumption statistics: the average value for the selected detail interval is taken into account (for example, the average daily consumption, average monthly consumption). When the residue is reduced to the level required for the replenishment time, a replenishment requirement is formed based on the alleged average consumption. This method shows well with the rhythmic and regular consumption of the nomenclature position.
• mIN-MAX - with each decrease in the residue to a given minimum, replenishment takes place to a fixed maximum amount of stocks.

For different nomenclature positions, various methods for maintaining the level of stocks can be applied. The MIN-MAX method is highly dependent on the source statistical data and does not allow optimally balanced reserves. To maintain the level of medicine in hospitals is rarely used.

Organization of medicinal support in conditions public procurement It has certain features: the time interval between the placement of the order and the supply of goods to the institution depends on the method of placement of the order (trading, request for quotations of price or purchase at the only supplier), and the method of placement of the order itself depends on the amount of the place being placed. Time from the placement of lot on trading platform Before delivering the drug in the pharmacy can reach 1.5-2 months.

Types of quantitative and sum incorporating stocks in stock used to account for medicines:

• Serial accounting is the accounting of material reserves in the context of the series and the terms of suitability. Serial accounting is mandatory for drugs and medical consumables.
• Partico accounting is a methodology for taking into account material reserves in the warehouses of the organization, in which the parties of the receipt of goods on the warehouse indicating the time, cost and quantity are recorded. It can be used simultaneously with serial accounting.

Decentralized supply scheme

The main document regulating the organization and procedure for taking into account drugs in health institutions is "Instructions for accounting for medicines, dressing and medical products in medical and preventive health care facilities State budget THE USSR", approved by order Ministry of Health of the USSR dated June 2, 1987 N 747. The historically established practice of planning to ensure medicines is reduced to the collection of applications that make up the needs of the divisions (annual and operational plan) in paper or in spreadsheets. Such a scheme has no feedback: Comparison of the annual procurement plan with medicines distributed by comparishes during the year. As a rule, the provision planning process is not automated, and manual comparison of the claimed needs and their execution is too time consuming.

In this storage scheme, stocks are organized on three levels (Fig. 2):

1. hospital pharmacy;
2. warehouse of senior medical sister;
3. stocks of posts and cabinets.

Warehouse accounting is usually conducted only at the level of the hospital pharmacy warehouse. Automation of total subject-quantitative accounting of medicines in stock is usually caused by the requirements of the legislation in accounting. Therefore, two schemes of such accounting are possible: automated inventory control (he is primary), the accounting program is broadcast of summion or quantitatively summary postings on the movement of materials; The second option: the whole accounting is carried out by financial accounting groups directly in accounting programs. To date, accounting in the Russian Federation is automated in all hospitals (100% coating). At the same time, reserves in the divisions are not taken into account, as in accounting, as a rule, the disposal of goods from a hospital pharmacy is considered to be the disposal of goods.

Fig. 2. Warehouse organization scheme indicating automation level

According to the order of 747 in the warehouses of the divisions there must be a stock of medicines for 3-10 days. Thus, stock management is carried out at the level of units, and the hospital pharmacy acts as an intermediary and works according to the "Order order" scheme with the responsible storage of medicines.

To fulfill the requirements of the order of 747 by taxiing (determining the value of the value of material values) and the printing of the AP-73 form "Shelving card" requires the maintenance of partial accounting in the pharmacy.

The decentralized supply scheme is shown in Fig. 3.

Fig.3. Decentralized supply scheme

Scheme features:

• Warehouse accounting is conducted at the level of the organization's warehouses.
• The write-off of the goods is made at the time moving to the unit.
• The actual consumption of materials is not registered.
• The formation of the annual and operational needs of the hospital in medicines is made in the divisions, the hospital pharmacy works under the "order to order" scheme.
• Drugs are performed on the remnants of the divisions.

Disadvantages of the scheme:

• The inability to assess the level of stocks in the medical organization as a whole.
• Objectively evaluate the validity of the requirements formed in units is not possible.
• Since divisions' warehouses have limited sizes, the reserves acquired by the needs of the unit are stored in a hospital pharmacy and become available to the orders to all divisions. To control the distribution of purchased drugs with the needs of units, it is necessary to apply complex schemes, such as reservation or separate storage.
• There is no control over the unbelief budget of the procurement of medicines for each unit, as this is not included in the responsibility zone of the hospital pharmacy.
• There is no control of applications for procurement on the list of nomenclature.

Supply Control Scheme

The decentralized supply scheme has a significant disadvantage - the absence of a single point of control of the reserves of medicines in a medical organization.

Introduction of the supply scheme with reserves management imply the creation of a single center for monitoring the reserves of a medical organization - responsible for stocks. This role can be carried out by the deputy chief physician work. In order for the responsible for reserves to effectively fulfill its functions, it needs a variety of information:

• level of current stocks of medicines;
• the level of need for medicines;
• statistics consumption of medicines.

To introduce supply control circuits with stocks, automation of both accounting processes and security planning processes are needed, therefore, automated operational warehouse accounting of medicines in the warehouses of divisions (Senior Medical Sisters) is added to the automated warehouse accounting of medicines in the warehouses of the medical organization. The entire application campaign is translated into an automated system: a collection of applications, consolidation to the general procurement plan, comparison with warehouse residues, comparison with lots and specifications of already concluded supply contracts and delivered goods, tracking the execution of units, needs adjustments. This allows you to have information about all the needs and current reserves at a single point, as well as accumulate statistics for the consumption of medicines by divisions.

Fig.4. General supply scheme with reserves management

Scheme features:

• Warehouse accounting of materials is conducted at 2 levels: warehouse, unit.
• The medical organization provides responsible for stocks in the entire medical organization (reserves management center).
• Write-off is made at the time of transfer of goods to the post or office (or at the end of some period).
• The formation of annual and operational needs for medicines in divisions is formed taking into account the approved form of a medical organization. The form limits the list of procured medicines and is approved by the guidance of a medical organization.
• When analyzing the annual needs for medicines, which were formed in divisions, responsible for reserves analyzes the statistics of consumption of units for previous periods for the basis of procurement.
• Consolidated purchases are manufactured, i.e. A unified application for the purchase of medicines for the needs of different departments is formed.
• When creating a consolidated application, the need for procurement is reduced taking into account residues in the pharmacy warehouse.
• Consolidated Purchase according to the needs of all divisions makes it possible to abandon the reservation of goods in stock, but at the same time mandatory control of the requirements of units for compliance with the order of the previously formed need.
• Responsible for reserves can use additional cost control methods - control of budgets for the procurement of medicines.
• Drugs are carried out taking into account the residues of the hospital pharmacy.

For both types of schemes, the stages of the movement of medicines from a hospital pharmacy in the units are the same (Fig. 3 and Fig. 4):

1. The goods from the warehouse will be shipped upon request received from the older sister to the division.
2. The older sister of the division according to the destination sheets reports medicines for the post.
3. The postpone / walled sister issues medicines to patients according to the purpose sheets.
4. On the destination sheet, the postponement / store sister is set to the issuance of medicines to patients.

But since in the inventory management scheme, the warehouse accounting in the divisions is automated, the document flow with the warehouse can be organized in electronic form. To simplify warehouse metering, consumer (secondary) packages with assignment of the individual package can be applied in the divisions. The fact of transmitting packaging per post / office is fixed with a scanner barcode.

Scheme of supply management with stocks does not contradict 747 orders, but at the same time expands the possibilities for managing reserves without a significant increase in labor costs. Table 1 shows a comparison of the functions performed with the indication of the differences from the decentralized supply scheme.

Table 1.
Distribution of functions in the supply control scheme with reserves management. Changes are allocated relative to the decentralized supply scheme

Function	Role: Hospital pharmacy	Role: Division	Role: Responsible for stocks
Formation of operational and annual needs		With limit on the form
Control of the operational and annual needs of divisions by quantity
Control of excess budgets
Consolidation of needs for procurement
Reservation of goods under the division
Formation of requirements for moving goods
Control of the requirements of units for compliance with the order of the previously formed need
Registration of the fact of the movement of goods in the division
Registration of the fact of moving goods per post / Cabinet

Personalized Writing Drugs

Introduction of accounting that allows you to track each packaging of goods up to its actual consumption, is often considered as a promising scheme that allows you to achieve significant savings. Consider the features of this scheme.

To conduct personalized accounting of drugs in an automated system, the Middle Medical Personnel sets the issuance of medicines to patients. To ensure accurate determination of the cost of drugs, it is necessary to provide partial accounting both at the level of the eldest sister of the unit and the post / office. The easiest way to ensure such accounting is an additional marking of consumer packages with barcode labels and providing barcode scanners Posts and offices where personalized accounting is conducted.

For accounting with a personalized cancellation, it is necessary to ensure control of accounting by financial and economic services or responsible for the stocks of medicines, which requires the allocation of additional personnel.

In the case of a personalized accounting for the service, this accounting can be used to calculate the averaged standard of consumption of materials on the service (in this case, the maintenance of partial accounting is not required) in order to:

• procurement planning;
• justification of the tariff for a medical service.

In the case of personalized write-off on drugs of stationary patients, it is possible:

• calculation of the standard for standard medical care or clinical and statistical group (in this case, the introduction of partion accounting is not required);
• invoice to a specific patient (for example, for a charity foundation or TFOMS).

Scheme features:

• Warehouse accounting of materials is carried out at all 3 levels: warehouse, division, posts and offices.
• The write-off of the goods for which accounting with personalized cancellation is carried out at the time of the actual consumption.

The advantages of the scheme:

• Implementation of external requirements of personalized accounting of drug consumption.
• Cash savings for drugs.
• Improving patient safety by reducing the number of errors when issuing medicines with medical personnel

Disadvantages of the scheme:

• High labor costs for providing personalized write-off are the additional actions of the average medical personnel, the allocation of employees to monitor accounting. Because of this, the scheme is applied not all products, but only on some groups of goods (for example, expensive).

Results and / or their discussion

The diagram of centralized management of drug reserves was introduced in the Clinical Center of the University of Sechenovsky.

Clinical Center for Sechenovsky University:

• is a university structural division that provides multidisciplinary specialized, including high-tech, medical care residents of Moscow, Moscow region and other regions of Russia;
• every year provides treatment for more than 40 profiles over 60 thousand stationary and about 500 thousand outpatient patients;
• it has the most significant range of power among federal medical institutions - more than 3,000 beds;
• it has more than 5,000 employees in the state, including about 1,000 doctors and 1500 nurses.

Medical assistance is provided in 6 multidisciplinary university clinical hospitals and 2 centers. The supply of all therapeutic and diagnostic divisions provides a centralized pharmacy.

Prior to the start of the automation project, a decentralized supply scheme was used. The acquisition of medicines was carried out in departments, without consolidating the needs of hospitals, drugs were appointed by separation residues, the entire document flow between the pharmacy and hospitals were carried out only on paper carriers.

The main purpose of creating a system of centralized management of drug reserves was a decrease in costs associated with excessive storage of reserves, a decrease in overdue stocks and an increase in the financial discipline of hospitals departments when providing medicines. A comprehensive automated system of supplying university clinical hospitals with medicines was created on the basis software Product "1C: Medicine. Hospital pharmacy. " The distinguishing feature of the project was its scale: in the structure of hospitals - more than 100 multidisciplinary stationary offices, and the number of purchased drugs is more than 1000 positions. Running information system It took place in 2013, in the process of its operation for 5 years the program has been constantly adapted, taking into account the dynamics of the needs of our divisions and in accordance with the changes in regulatory requirements.

In the development process automated system A gradual reorganization of the clinical center supply scheme was made, and as a result, a supply circuit was created with reserves management. The security planning process was fully automated:

• all needs, starting by the annual applications of the clinics, consolidated in the general plan for procurement of medicines;
• after coordinating the procurement plan, electronic lots are formed in the system, which are transmitted to the specification to concluded contracts,
• each clinic has its own financial plan, controls medicines purchased under its needs, tracks the received goods at the centralized pharmacy warehouse, tracks the execution of the plan and budget of the clinic procurement both in quantitative and in summary terms, corrects the need to take into account relevant information.

The introduction of the pharmaceutical goods barcoding, in which the registration of the disposal of the medication goes at the time of its transfer to the post by reading the barcode from the packaging, saves staff time and minimize the risk of errors when issuing medicines.

The created scheme allows you to make a transparent process of comparison of needs and purchases for both the clinics and the leadership of the Clinical Center. Operation of this scheme for 5 years has made it possible to accumulate statistical data and perform an objective comparison of both schemes:

• Reduced by 2 times time costs at the provisions due to the availability of information on the distribution of goods. Acceleration is 10 times the formation of reporting for manual and multiple increase in its authenticity.
• A reduction in 2 times the number of auctions of the procurement of medicines.
• Dynamics of reducing the costs of the clinical center for drugs from 5% to 25%.

conclusions

Thus, the automation of the hospital pharmacy using the supply scheme with centralized reserves management allows reliably and quickly evaluating the rationality of use material resources, make informed solutions to optimize them and redirect material support streams.

In the clinical center of the strategic perspective as part of the development of personalized medicine in university clinical hospitals is the introduction of personal accounting of drugs, and minimizing labor costs is planned by acquiring and integrating with the pharmaceutical system of a robotic packager.

Literature

1. Order of the Ministry of Health of the USSR No. 747 of 02.06.1987 "On approval of the instructions for accounting for medicines, dressings and medical products in medical and preventive health care institutions consisting of the state budget of the USSR".
2. Order of the Ministry of Health of the USSR No. 14 from 08/01/1988 "On the approval of specialized (intermediate) forms of primary accounting for trade-effective pharmacy institutions."
3. Order of the Ministry of Finance of the Russian Federation N 119N dated December 28, 2001 "On Approval Methodical instructions In accounting accounting of material and production stocks. "
4. Federal Law N 61-FZ dated 12.04.2010 "On the circulation of medicines".
5. Vedanov, Yu.V. Comparative assessment of economic costs for the provision of medical care patients of the surgical profile in outpatient and stationary conditions / Yu.V. Vadanov, I.A. Reuthsky, V.Yu. Tegza // Bulletin of the Russian Military Medical Academy, St. Petersburg, Military Medical Academy named after S.M. Kirov, 2009. - 167-175 p.
6. Kadyrov, F.N. Optimization of the use of medicines and consumables / F.N. Kadyrov // Health Manual. - 2009. - № 4.- P. 32-41.
7. Guseva, N.M. Actual issues of planning, financing, accounting, taxation, taxation and internal control in medical institutions / N.M. Guseva, A.F. Kokin - M.: 1C-Publishing, 2018. - 201 c.
8. Yakovlev, A.V. Production Management: Planning and dispatching / A.V. Yakovlev - M., 1C-Publishing, 2018. - 219 c.
9. Belousov, Yu.B. Formulana system: key concepts / Yu.B. Belousov, A.G. Chuchalin, V.S.shukhov // Rus. honey. journal - 1999. - T. 7, No. 15.

The budgetary institution contains objective and quantitative accounting for all medicines. Medications from the pharmacy warehouse are transferred to the older nurse at the request-invoice. Checking indicated that in accounting, it is necessary to see the remains of the senior nurse and the remnants of the post. At the same time, actually residues are listed on the older nurse, as on a materially responsible person.
How is the accounting of medicines in a budgetary institution from the senior medical sister to the post?
How is the disposal of medicines?

Having considered the question, we came to the following conclusion:
Accounting for medicines in accounting budget institutions from the senior medical sister to the post is carried out in the manner defined accounting policies institutions.

Rationale of output:
When organizing accounting, budgetary institutions are guided by provisions:
- Instructions approved by the Ministry of Finance of Russia of 01.12.2010 N 157n (hereinafter - N 157n);
- Federal Standard accounting for organizations of the public sector "Conceptual Fundamentals", approved by the Ministry of Finance of Russia of December 31, 2016 N 256n;
- Instructions approved by the Ministry of Finance of Russia dated December 16, 2010 N 174n (hereinafter - N 174N).
In addition, in a part that is not contrary to the normative later regulatory legal acts, healthcare institutions can use the provisions of the instructions for accounting for medicines, dressing agents and medical products in medical and preventive health care facilities consisting of the USSR State Budget, approved by the USSR Ministry of Health from 02.06.1987 N 747 (hereinafter - the manual N 747), which has not lost Currently its strength. For example, based on the provisions of the N 747 instruction, the specialists of the financial department are building their explanations regarding the accounting of medicines, dressings and medical products in budgetary institutions health care (see, for example, the Ministry of Finance of Russia of 03/25/2016 N 02-07-10 / 17036).
Note that the accounting and "special" accounting of medicines should be distinguished.
Subject and quantitative accounting of medicines for medical use is carried out by a medical institution according to Federal Law from 12.04.2010 N 61-FZ "On the circulation of medicines". In particular, this norm establishes a list of drugs to be subject to subject-quantitative accounting, as well as the procedure for their "special" accounting and relevant documents. In addition, the features of the subject-quantitative accounting of drugs in institutions having a pharmacy are described in section II instructions N 747.
Paragraph 45 of Instructions N 747 provides that the cost of drugs issued in the office (offices) of the institution is discharged. This norm may be due to the fact that drugs are discarded by pharmacy offices (cabinets) in the amount of the current need for them: poisonous drugs - 5-day, narcotic drugs - 3-day, all other - 10-day (p. 19 instructions N 747). As well as in the office (office), it is not allowed to create reserves of drugs over the current need (paragraph 11 of the instructions N 747).
Along with this, the write-off of material reserves in accounting is carried out on the basis of the provisions of NN 157N instructions, 174n. These regulatory legal acts do not contain the features of the write-off of medicines. They are written off in general manner provided for the write-off of material reserves.
At the same time, the question of the writing off of material reserves, which is determined by the institution independently with the relevant justification of this decision. The decision has been enshrined in the institution's accounting policy.
When deciding on the moment of writing off drugs, the institution should avoid extremes and take into account that they are divided into consumed and uncomfortable.
In addition, it is desirable to determine how important it is to ensure control over the preservation of a particular group (species) of material values, as far as they mean. For example, there is no doubt the significance of the implementation of special records of narcotic drugs.
At the same time, it should be understood that the current regulatory legal acts do not establish clear boundaries between:
- consumed and unsuccessful material reserves;
- Property to be debited by direct flow rate when issuing storage facilities, and values \u200b\u200bthat can be written off from the balance only after the design of additional documents.
Accounting for medicines on the balance sheet of institutions throughout the time of their use will avoid claims from the regulatory authorities. At the same time, the benefits derived from information generated in accounting should be comparable to the costs of its preparation.
Thus, in a medical institution in accordance with adopted decisionEnchanting in accounting policies, the disposal of medicines can be carried out both by direct consumption when issuing them from a warehouse to the department and on the fact of the provision of medical services.
If the institution makes a decision to write off from accounting of medicines directly on the fact of the provision of medical services, then in this case, medicines transferred to the senior medical sister continue to be taken into account on account 105 01 until their write-off. Based on the information received by the medical sister from the post with the frequency established by the Institution (but at least 1 time per interval for which the size of the current need is established), it records the date of disposal of medicines, which then reflects their disposal in accounting. In other words, in accounting is reflected in the account of the account 105 01 in the order of the N 174n instruction.
The disposal of medicines is carried out on the basis of the decision of the permanent commission for the admission and disposal of assets, executed by the acquisition document - act in the form established by the regulatory legal acts adopted in accordance with the laws of the Russian Federation by the Ministry of Finance of the Russian Federation (instructions N 157N). Such an act may be an act of debiting material reserves (f. 0504230). In particular, documents can be applied, on the basis of which the actual spending of medicines (Appendix N 5 to the Ministry of Finance of Russia of 30.03.2015 N 52n). That is, documents on the "special" accounting of medicines.
For the purposes of reflection in the accounting of remnants of drugs transferred to the post, the following may be provided analytical accounting Drugs on account 105 01, transmitted by the senior medical sister directly to the department. For example, medicines are taken into account on the balance sheet account 105 01, with an indication of a materially responsible person - senior nurse. When they are transmitted to the department, their internal movement is reflected with the change of analytics, for example, "medicines in the post". The write-off of medicines in accounting from account 105 01 In this case, it will also be carried out on the basis of an act on the write-off of material reserves (F. 0504230), compiled according to the data presented by the senior medical sister. It should be noted that a similar accounting option is the right, not the responsibility of the institution. A specific decision on the procedure for accounting and writing off medicines is made by the institution and is fixed in the framework of the formation of its accounting policies. Taking such a decision, it is necessary to compare possible labor costs with the result obtained.
Based on the situation set out in this situation, the following accounting records may be reflected:
1. Debit 0 105 01 340 (Medicals issued per post) Credit 0 105 01 340 (Medicines at the senior nurse) - reflected in the post medicines;
2. Debit 0 109 60 272 Credit 0 105 01 440 (Drugs issued per post) - reflected the write-off of the actual consumed medicines that form the cost of a specific service directly by the fact of the provision of medical services.

The answer prepared:
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The material was prepared on the basis of an individual written consultation provided within the framework of the legal consulting service.

The document forming a uniform accounting policy for all budgetary institutions is the Instruction on accounting in budgetary institutions (hereinafter referred to as the Instruction) approved by the Order of the Ministry of Finance of Russia of December 30, 1999 No. 107N, (registered in the Ministry of Justice of Russia on January 28, 2000 No. 2064 ).

The accounting policy of a medical institution provides:

completeness of reflection in accounting of all facts of economic activity;

timely reflection in the accounting and reporting of factors of economic activities;

priority recognition and reflection in the accounting of expenses and obligations to possible income and assets, not allowing the creation of hidden reserves;

reflection of the economic content of facts and conditions of farming;

identity of analytical accounting data by turnover and remnants for so-there is synthetic accounting;

rational Accounting Based on the Terms of Hostess Activities and the Organization's size.

The procedure for conducting accounting in institutions established by Instruction No. 107n, provides:

accounting accounts plan in institutions;

memorial and order of accounting;

the method of applying subaccounts of accounting accounts plan to reflect the operations on the execution of the estimates of income and expenses of both budgetary funds and funds obtained through extrabudget sources;

Forms of primary accounting documents and accounting registers;

Methods for assessing assets and liabilities;

Correspondence of subaccounts by main accounting operations;

Other issues of accounting organization.

Organizational aspects of accounting of accounting of medical institutions contain the following main sections:

1. Information about who is responsible for organizing accounting;

2. Accounting Service, its organization and management;

3. The choice of method (form) of the maintenance and organization of accounting;

4. Formation of document management rules and the establishment of document management schedule;

5. Accounting statements of health care;

6. The procedure for the inventory of property and obligations;

7. Typical correspondence of sub-accounts by main accounting operations.

Consider the most important aspects of the accounting policy of the health care institution.

The chief accountant is appointed and dismissed by the chief physician. Thus, it is emphasized to a greater degree of actual role of the chief accountant. In the documents it is determined that chief Accountant Submits directly to the head of the organization and is responsible for the formation of accounting policies, accounting, the timely presentation of complete and reliable financial statements.

Given the importance of the Chief Accountant and its role in the adoption of the right and reasonable decisions on the management of health care, it has been established that it ensures that it has been compliance with the ongoing operations in accordance with the legislation Russian Federation, as well as monitoring the movement of property and the fulfillment of obligations of institution.

For the activities of the institution, the implementation of proper control is very important. Thus, in cases of receipt of documents on economic operations, contrary to the legislation or violating contractual or financial discipline, the chief accountant takes them to execute only with the written order of the chief physician (manager), which brings all the completeness of liability for the consequences of the implementation of pro-tvosoconne operations. To this end, such documents, the chief accountant reports in writing in writing to the chief doctor and only after receiving a written order from the leading document on the adoption of the specified document to account executes it. The sole responsibility of the chief physician is particularly tangible when imposing sanctions by the control bodies. In the future, the leader can punish a specific guilty official or a service provider in accordance with labor law, and in cases of accounting on accounting on the contractual principles of centralized accounting - under the conditions provided for in the contract.

In accordance with the instructions No. 107n, official duties in the Bu-Gateria are distributed according to a functional basis, that is, for each group of workers or a separate employee, depending on the amount of work, a certain area is enshrined. The accounts created the following groups: financial, material calculations. These groups are entrusted with all primary documentation According to the accounting of operas of this institution, monitoring the safety of values \u200b\u200bthat are in financially responsible persons, and the fulfillment of other works, which are provided with the distribution of responsibilities.

Everything structural unitsincluded in the institution, as well as institutions, are obliged to in a timely manner in the accounting department necessary for accountant accounting and monitoring documents (copies of extracts from orders and disposal relating directly to the fulfillment of the estimates of income and races, and Also all kinds of contracts, acts of work performed, etc.).

Requirements of the Chief Accountant in terms of the order of registration and pre-installation in the accounting department necessary documents And information is mandatory for all employees of the institution.

The chief accountant approves job descriptions for employees accounting.

In accordance with the instructions No. 107n, the medical institution carries out accounting of the implementation of estimates of costs for memorial-rational form. The basis this method Memorial orders, registers of analytical accounting: the book "Journal of Main".

Proven and adopted primary accounting accounting documents Systems are matted by dates for performing operations (in chronological order) and are issued by separate memorial orders - accumulative statements on operations at the expense of budgetary funds and funds obtained through extrabudgetary sources, which are assigned to the following regular numbers:

Memorial number 1 (cumulative statement for cash transactions) - f. 381;

Memorial order (accumulative statement on the movement of bud-Social funds on subaccounts 090, 091.097, 100, 101, 102) -f. 381;

Memorial order (accumulative statement on the movement of funds derived from extrabudgetary sources, on subaccounts 110.111, 114, 115, 118) -F.381;

Memorial order (accumulative statement on calculating checks from limited books) - f. 323;

Memorial Order 5 (a set of settlement statements for earnings and scholarships) - f. 405;

Memorial order (accumulative statement for calculations with other debtors and creditors) - f. 408;

Memorial order 8 (accumulative statement for calculations with accountable persons) - F, 386;

Memorial order (accumulative statement for the disposal and movement of fixed assets) - f. 438;

Memorial order (accumulative statement for the disposal and movement of low value items) - f. 438;

Memorial order 11 (arch of the accumulative statements at the bottom of the food) - f. 398:

Memorial order 12 (arch of the accumulative statements on the race of food) - f. 411;

memorial order 13 (cumulative statement on consumption of materials) - f. 396;

memorial order 14 (accumulative statement for income, profits (losses)) - f. 409.

For other operations and on operations, "Storn" in the construction of institution is composed of individual orders. 274 and numbered, starting from the number 16 for each month.

As memorial orders are compiled, records are made in f. 308 Book "Magazine-Home". Accounting in the book is conducted on subaccounts.

To ensure separate accounting of operations on budgetary funds and means obtained by extrabudgetary sources (mother values, funds in the calculations, etc.), the subaccount is assigned to an absent character in the form of a room:

On budget funds - 1;

For funds obtained at the expense of extrabudgetary sources:

On business activities - 2;

On targeted means and gratuitous receipts - 3.

All economic operations conducted by the Organization are issued acquittal documents. These documents serve as primary accounting documents. Based on them is accounting.

Primary accounting documents to give them legal force should contain the following mandatory details (Section 14 Instructions №107N):

Name of the document (forms);

Form code;

The date of compilation;

The name of the organization, on behalf of which a document was drawn up;

Meters economic operation (in physical and monetary terms);

The name of the posts of persons responsible for committing a good operation and the correctness of its design;

Personal signatures and decryptions (including cases of creating documents using computing equipment).

Primary documents are taken to account if they are drawn up in the form contained in the albums of typical (unified) forms of primary accounting documentation.

Traffic primary documents In accounting (document-bore) provides for the following steps:

Creating an internal or receipt of an external document;

Acceptance of a document for accounting;

Document processing;

Transfer a document to the archive.

The document management schedule is decorated in the form of a table with a list of works on the creation, verification and processing of documents and each division, as well as all the performers, indicating their relationship and the timing of work.

Responsibility for compliance with the schedule of document management, as well as for timely and benign creation of documents, the timely transfer of them to reflect in accounting and reporting, for the dignity of the data contained in the data documents, the persons who created and present them are carried out. Compliance with the schedule of document flow controls the main accountant.

The accounting policies reflected dental clinic, and how accounting documents, that is to -.. Component of the orga-nization document. Storage time typical documents Organs and healthcare institutions are established by the rules of the organization of a state archival case. Article 17 of the Federal Law No. 129-FZ "On Accounting" states that organizations are obliged to keep primary accounting documents, accounting registers and accounting reports during the deadlines established in accordance with the rules of the organization of the state archival case, but not less than 5 years.

There is also an approved procedure for current storage of documents. Blanks strict reporting Must be stored in special cohesions, allowing them to ensure their safety. In the event of the disappearance or death of primary documents, the head of the organization appoints the commission to investigate the causes of the disappearance, death.

The reporting of the organization (institution) is a system of indexers characterizing the conditions and results of its work for a certain period. Reporting - the final stage of the accounting process. Reporting is drawn up according to accounting, statistical operational accounting. This makes it possible to include in the content of reporting not only value, but also natural indicators for evaluating and summarizing both quantitative and qualitative characteristics.

The financial statements are recorded on an accrual basis haves-governmental institutions and financial position, results of operations during the reporting period (fiscal year).

Reality and accuracy in reporting information about property, organization commitments, financial position and results in reporting period Depend on the timeliness and completeness of the annual inventory.

To ensure the accuracy of the data accounting balance And the institution is obliged to carry out the inventory of property and obligations, during which their presence, condition and evaluation are checked and documented.

The order of inventories is determined by the head of institution, except in cases where they are required (paragraph 26 of Instructions No. 107N):

When the property is transferred to the rental, transformation of a state or municipal unitary enterprise;

Before the preparation of annual financial statements (the inventory of fixed assets can be held once every three years, and the library foundation is once every five years);

When changing financially responsible persons;

When identifying the facts of embezzlement, abuse or damage;

In cases of natural disaster, fire or other extraordinary circumstances;

In the reorganization or liquidation of the organization;

In other cases stipulated by the legislation of the Russian Federation.

Before the beginning of the inventory, the forms of inventory describing, accurate statements are prepared, the presence and state of inventory books is checked.

Detected when inventory discrepancies between actual presence Property and accounting data are reflected in the accounts in the following order:

a) surplus property arrives market value at the date of the inventory, and the corresponding amount is credited to the F-NANSK results at a commercial organization or an increase in milk-dov in a non-profit organization or an increase in targets on the maintenance of the institution and other activities (subaccount 270) at the budget organization budget activities; to increase the upstream periods (subaccount 400) - on entrepreneurial activities;

b) the shortage of property and its damage within the limits of natural loss standards relate to costs or expenses, over the norms due to the perpetrators; If the guilty persons are not established, then losses relate to a decrease in the financing of the institution.

The shortage within the limits of natural decrease in the budgetary institution belongs to balance value The debit of subaccounts 140, 141, 220, 241, 270 and the loan of the sub-accounts of accounts 04, 05, 06, 08.

The shortage of property and its damage over the norms of natural liability refers to the institution on the perpetrators of the market value by the debit of subaccount 170 and the loan of subaccounts: 040, 041, 043, 044, 050,060-067,069 (by material reserves), 120 (for money), 173 (for fixed assets, intangible assets and low-value pre-methams acquired at the expense of budget funds), 401 (according to basic environments, intangible assets, low-value subjects acquired at the expense of funds from business).

In case not the establishment of guilty or refusal to the court in the recovery of losses from the perpetrators in a budgetary institution, records of the loan of subaccount 170 and the debit of sub-accounts 140, 141, 173, 270, 401 are produced.

In the institution, the results of the inventory are issued:

Inventory comprehension (accurate statement) f. 401. - Objects fixed assets, low-value items, material reserves, finished products;

Act of cash inventory F. 0309014 - for cash;

Inventory comprehension of securities and blanks of documents;

Strict reporting f. 0309015 - PO securities and stroke reporting form;

Act inventory settlements with buyers, suppliers and other debtors and creditors f. 0309016 - by calculations;

Act of the results of the inventory F. 835 with the included discharge discrepancies F. 836.

The amounts of surplus and shortage of commodity values \u200b\u200bare indicated in accordance with their assessment in accounting. Among the documents presented to write off the lack of values \u200b\u200band damage in excess of natural decrease, there must be documents of investigative or judicial authorities confirming the lack of perpetrators or refusal to recover damage from the perpetrators, or the conclusion about the fact of valuables received from the Technical Division control or relevant specialized organizations (quality inspections, etc.).

The Inventory Commission is created in the institution and does not change during the reporting year. The commission is in the clinic included the chief accountant, lawyer, financially responsible persons (the main nurse, pharmacist, etc...) - all at least three people. The commission of the Commission, the deadlines for its work are approved by the head. In exceptional cases, it is possible to replace the members of the Commission on the basis of the order) of the head. The Commission may be permanent. According to the results of the inventory, the Commission is a final document - the act in which:

Accounting status;

Facts are shortened, surplus, damage, loss;

Proposals to eliminate the identified deficiencies.

The act signed by members of the Commission is considered and approved by the head and is kept in accounting in the accounting service.

The results of the inventory should be reflected in the accounting and reporting of the month in which the inventory was completed, and on annual inventory - in the annual accounting report.

The clinic has a scheduled inventory schedule. By fuel and lubricant - Quarterly, in cash - monthly. Every year on time from October 1 to December 31, according to commodity and material values \u200b\u200band means in the calculations.

Accounting performance estimates of income and expenditure of budgetary funds and the funds received from extrabudgetary sources-ing, being the Plan of accounts provided for by the Instruction number 107n. At the same time, a single balance is drawn up on the specified means and a separate balance on the means obtained by extrabudgetary sources.

Characteristics of accounting

In medical institutions 1 2 Kolelenkova L.M. , Voronina Ya.Yu.

Email: [Email Protected]

1klesynkova love Mikhailovna - Candidate economic Sciences, assistant professor;

2Vonina Yana Yurevna - Student, Faculty financial markets, Financial university under the Government of the Russian Federation,

moscow

Annotation: This article considers the importance of accounting in medical institutions, its specificity is reflected, it is considered ways of conducting accounting for individual operations. Article should be regarded as clarifying the accounting for certain transactions, which, of course, is the basic foundation for understanding the techniques of accounting in health care facilities. The article also contains the detailed dynamics of the development of medical organizations in Russia, identified the reasons that are determined.

Keywords: medical institutions, accounting, cash operations, pharmaceutical companies.

Features of Accounting in Medical Institutions

12 Kolesenkova L.M.1, Voronina Ya.yu.2

1Kolesenkova Lyubov Mihailovna - PhD in Economy, Associate Professor; 2Voronina Yana Yurievna - Student, Faculty of the Financial Markets,

FINANCIAL UNIVERSITY UNDER THE GOVERNMENT OF THE RUSSIAN FEDERATION,

Abstract: This Article Examines The Importance of Accounting In Medical Institutions, Reflected Its Specificity, The Methods of Accounting Of Individual Transactions. The Article Should Be Viewed As Clarifying The Specificces of The Accounting Of Individual Transactions, Which is a Basic Foundation for Understanding of the Technology of Bookkeeping in Medical Institutions. The Article Also Stated and Detailed The Dynamics of the Development of Medical Organizations in Russia, Highlighted The ReaSons That Cause It. Keywords: Medical, Accounting, Cash Operations, Pharmaceutical Companies.

The accounting of the organization that provides paid medical services has special specificity, and takes into account many different aspects. On balance, such organizations have hundreds of items, which includes expensive equipment and various consumables. In such organizations, the equipment is constantly changing and reserves are rapidly spent and require timely replenishment. If the organization associated with any surgery, they are forced to work with insurance companies in order to avoid force majeure.

2012 2013 2014 2015

Number of doctors man: Total, thousands of 10,000 people of the population 49.1 48,9 48,5 45.9

The number of medium medical staff, man: total, thousand per 10,000 people population 1520 1518 1525 1550

Number of hospital organizations, thousand 6.2 5,9 5,6 5,4

As can be seen from Table 1, the number of doctors for last years It has greatly decreased, despite the growth of medium medical personnel, this can be explained by the complexity of obtaining a medical profession, as well as not the very favorable state of the entire medical system in Russia.

The number of hospital organizations has also significantly reduced during the period under review. This can be explained by the above factors, as well as by the fact that medical institutions in Russia have a complex accounting system. This problem would like to highlight in this article.

The following operations are subject to accounting:

Material spending.

Operations with medical equipment.

Cash operations.

Calculations with staff.

Calculations for taxes and fees.

Now they will be discussed in more detail, starting with the consumption of consumption of materials.

When taking into account consumables, such as various drugs and medicines, it is necessary to take into account how to issue them into the cabinets and their various movements within a medical institution. The final cancellation main and auxiliary consumables occurs just at the moment when they are actually expended and entered into the medical sheet or, for example, customer card.

It is important to note that due to the nature of pharmaceutical companies to keep records of medicines and medical supplies to the pharmaceutical company, it is most expedient regulatory method.

Medicines for frequent consist of several components. In this regard, pharmaceutical enterprises producing medical drugs must be purchased and stored in warehouses various materials and raw materials, which has expiration date.

First you need to establish the regulatory price of the material.

In certain situations, the value of the materials specified in the contract takes place for the regulatory price. In cases where this cost is different for each batch of materials, the regulatory price is calculated by calculation, while calculating how much materials and transportation costs will cost under the contract.

Changes to regulatory value The organization is obliged to fix in the nomenclature of the price tag.

In all medical facilities, each procedure should be developed a document that determines the norms of consumption of writing through materials.

At the end of each month, a report is drawn up on each medical staff on the basis of the norms of consumption of materials that are transmitted to the accountant. Based on these reports, the accountant produces a write-off of materials on the cost of services rendered.

When it comes to accounting for fixed assets in a medical organization, in most cases, special medical equipment is understood under the main means in medical organizations. Given the high cost medical equipment, It is necessary to correctly form its initial cost.

Sources of replenishment of fixed assets serve:

Acquisition of equipment for a fee;

Assistance to sponsors;

Donation;

Acquisition of equipment on credit.

The high cost of medical equipment makes it possible to use it as a contribution to statutory capital medical organization.

The cost of fixed assets is repaid by depreciation. According to paragraph 18 of PBU 6/01, there are four depreciation calculation methods:

1. Linear method;

2. The method of writing the cost is proportional to the volume of services provided;

3. The method of reduced residue;

4. Write off cost in the sum of the number of years of useful use.

In the future, I consider it necessary to consider the features of cash transactions in medical organizations that have separate divisions (for example, a pharmacy network).

When working S. legal entitieswhich, in addition to the cash check, is needed to arrive cassovoy order give out a receipt, and the calculations are best implemented in the head organization. Cash operations of the branch at the same time it is better to limit the reception and delivery of revenue. However, the organization can develop a special procedure for registration. monetary documents, eg:

1. Assign various codes to the documents of the head organization and branches;

2. In each branch, open a separate section uniform cash book organizations;

3. Make the synthesis of the first and second option.

The organization is also obliged to contact servicing bank And to approve a single limit of cash balance at the box office, but in case the organization has several current accounts in various banks, then it can choose any of them. After the organization approves the limit in one of the banks, it is enough to send notifications to the rest.

The main article of the calculations with staff is calculations for wages having their specifics.

When paying wages to medical workers, a budget institution accountant is primarily guided by the Regulations on the remuneration of health workers of the Russian Federation.

Health facilities that are on budget financing independently determine the types and size of the premiums, additional payments and other payments of a stimulating nature, but within the limits of the allocated budget allocations.

To the salary of medical professionals can be accrued:

Increasing to the salary;

Surcharge for the experience;

Dumping for special conditions;

Surcharge for additional work;

Surcharges of a stimulating character;

Surcharges for work at night;

Cash payments by state Program and etc.

We will make a table showing the average salary of medical workers in the period 2014 to 2017.

Table 2. Middle wages of doctors and employees of medical organizations

Average salary, rubles

including on the form of ownership of organizations

federal subjects of the Russian Federation Municipal

2014 45 150 43 011 45 692 44 834

2015 46 496 45 522 47 352 39 948

2016 48 946 48 838 49 734 40 454

2017 52 953 54 432 53 490 40 622

As we see from this table, the wages of doctors are gradually growing. Many experts believe that this trend towards an increase in wages is associated with the state of health care reform. As a result, more than 90 thousand medical workers have been reduced, and wages are growing due to increased load on workers.

It is impossible not to consider the specifics of the taxation of medical organizations.

Not all medical institutions in the Russian Federation are exempt from VAT.

Chapter 21 "Value Added Tax" Tax Code The Russian Federation contains additional conditions containing the rules for the use of benefits for the manufacture of drugs. To use these benefits, medications must be made in accordance with the contract, which was concluded with a legal entity.

Also, according to subparagraph 18 of paragraph 3 of Article 149 of the Tax Code of the Russian Federation, the VAT services of sanatorium-resort organizations in Russia, decorated by tickets or courses, which are formation of strict reporting. In the event that sanatorium-resort services are not issued by vouchers or courses, then sanitary and resort institutions will be required to accrue VAT.

At the same time, the accrual and payment of VAT pharmaceutical points, whose activities are associated with the manufacture of all types of drugs are mandatory.

Private clinics not receiving funding from the state. The budget is obliged to charge and pay VAT.

Consideration of the specifics of accounting in medical facilities allows you to allocate special, unique features other than booze. Accounting in other institutions. Understanding them - needed both for accountants and for anyone interested in medicine.

At the same time, it should be noted that it is impossible to state all the specifics of accounting in medical institutions, given the volume of the article, rather, it should be considered as clarifying, clarifying the specifics of the accounting of individual operations, which, however, is fundamental basis To understand the techniques of accounting in medical institutions.

References / References

1. Surinov A.E. Main health indicators // Russia in numbers, 2017.

2. Firshova S.Yu. Accounting in medicine. Knourus, 2006. P. 21-23.

3. Tokarev I.N. Accounting B. budget organizations. M.: Prospekt, 2012.

4. Zakharin V.R. Wage in commercial organizations and budget institutions. M.: Publishing House: Prospekt, 2012.

5. Results of the federal statistical observation in the wage of individual categories of workers social sphere and science. [Electronic resource]. Access Mode: http://www.gks.ru/wps/wcm/connect/rosstat_main/rosstat/ru/ (Date of handling: 01/17/2018).

6. Ananyev L.V. Accounting in the public sector: Practical recommendations M.: Infotropic Media, 2012. 360 p.

Modern problems and ways of development of the Russian automotive industry Zaborovsky E.Yu. Email: [Email Protected]

Zaborovsky Evgeny Yuryevich - Magister, Department of Management Organization, Economics, Moscow State University, Moscow

Annotation: The automotive industry is the leading branch of domestic engineering, which is determining the economic and social level of state development. This article discusses the current state of the Russian automotive industry and the main directions of its development. The author analyzed the dynamics of production and import of products. The "industrial assembly" regime and its main results are considered. The main objectives of the development of the industry and measures are determined. state support. The issue of Russia's accession to the World Trade Organization is considered.

Keywords: automotive industry, production, import, import substitution, strategy, industrial assembly, domestic, Russia.

MODERN PROBLEMS AND DEVELOPMENT DIRECTIONS OF THE RUSSIAN AUTOMOTIVE INDUSTRY Zaborovskiy E.Yu.

Zaborovskiy Evgeniy Yurievich - Master, Department of Management Organization, Economic Faculty, Moscow State Regional University, Moscow

Abstract: The Leading Branch of the Domestic Engineering Industry, Which Determines The Economic and Social Development Level of the State. This article Describes The Current Situation In The Russian Automotive Industry and The Main Directions of Its Development. The Author Analyzes The Dynamics OfProduction and Import Of Products. The Regime of "Industrial Assembly" and Its Main Results Are Considered. The Main Tasks of the Industry Development and Measures of State Support Are Determined. The Question of Russia "S Accession to the World Trade Organization IS Considered. Keywords: Automobile Industry, Production, Import, Import Substitution, Strategy, Industrial Assembly, Domestic, Russia.

Today, the Russian automotive industry is developing in accordance with the "automotive industry development strategy for the period up to 2020,"

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