“先诊疗后结算”这一医疗卫生系统革命性的变革,在提高群众医疗服务满意度的同时,很好的缓解了紧张的医患关系,对构建和谐社会也起到了重要的推进关系。但这一付费模式对医院内部的会计控制制度提出了新的挑战。本文即试图从建立新的内部会计控制制度的角度来论述,以期为进一步完善“先诊疗后结算”的付费模式提供有益的借鉴。 “The first settlement after the treatment ” This revolutionary reform of the medical and health care system, while improving the satisfaction of the people’s medical services, it has well alleviated the tense relationship between doctors and patients and played an important role in promoting the building of a harmonious society . However, this payment model poses new challenges to the accounting control system within the hospital. This article attempts to establish a new internal accounting control system from the point of view, with a view to further improve the “first medical treatment after the settlement,” the payment model to provide useful lessons.