1、1本科毕业论文外文翻译译文标题负债融资资料来源医院及医疗保健网络作者LEEANNRUNY债务融资是医疗保健机构资金的主要来源。资金对于掌握先进的设施和信息技术，加强质量管理是至关重要的。为了使得金融和资本规划行之有效，医院领导，包括首席执行官，首席财务官和董事会成员必须意识到资本市场不断变化的条件和资本提供的类型。惠誉国际评级的高级总监JOHNWELLS曾说过“医院有多种不同类型的债务。他们希望通过更复杂的债务类型来实现最低的资金成本，但也有一定程度的风险，并非所有的医院可以承担。”医院必须合理确定负债规模，并考虑自身承受能力。医疗保健财务管理协会产品开发的副总裁理查德认为这就像个人投资一样，
2、没有放之四海而皆准的方法。金融领袖需要从该机构的债务结构中分析出他们正在做什么。丽莎戈尔茨坦是穆迪投资者服务公司的高级副总裁兼车队经理。她指出非传统的债务融资未必可以改善筹资状况，但它可以用较低的成本获得资金。戈尔茨坦说，虽然这种债务在医院之间比较常见，但到最后大部分医院还是会回归传统的债务融资。因为这是一种高效、可靠和免税的筹资手段。评级机构预测不以营利为目的的医院部门在2006年之前将一直保持稳定的状态。除此之外还提到管理机制和经济环境的变化对该部门的影响是不确定的。但有一点可以肯定医院将继续面对日益增加的资本需求，以保持设备在最佳水平。花旗集团保健集团的总经理FREDERICKHESSL
3、ER提出在未来的三到五年，我们将看到更多信贷评级的下调，人口老龄化的增加，商业纳税人之间的整合。但医疗保健消费、供应和劳动力成本不会因此而减少。医院和卫生保健系统之间差距将日益扩大，并处于评定量表的两端。威尔斯说“高端的债务融资将拥有更多的机会；而低端的则会陷入困境，甚至影响其竞争力。何伟觉得为了提高筹资能力，中型组织可能需要通过合并来增加其在债务市场中更具吸引力和影响力。2通过下面的讨论，我们会发现哪种负债融资的类型才可以帮助医院最大限度地发挥其筹资能力。负债融资有效的六个步骤负责融资对于医院是可行的、有效的。运营成本是整修、扩建和技术收购得以实施的基础。作为免税组织，而不是营利性的医院，虽
4、然没有获得股权资本市场的资格，但可以从慈善事业中产生股权资本，经营现金流转、现金储备和出售资产。然而，资金需求通常超过这些来源所产生的收入，所以医院必须通过债券市场获得额外的资金。债务融资可以利用各种债券发行以支持组织的成长和发展。这些措施包括免税或应税债券的发行和参与债券交易，如非传统债券发行。健全的财务计划应该包括保持一个强大的股票投资组合和管理债务，最大限度地降低成本，最大限度地获得资金。下面的步骤可以有效的使医院把负债融资纳入其战略和财务规划。建立一个融资的团队建设一个知识渊博的融资团队，是财务总监的主要职责之一。该小组应在金融市场变化时作出反应，其中包括利率变化、监管要求和评级活动。
5、除其他事项外，该小组应包括律师、承销商、审计师、财务顾问、债券发行和债券受托人等成员。积极管理债务和股票投资组合医院财务领导人必须积极地管理债务和股票投资组合，并关注金融市场的动态和医院的财务状况。高层领导人和董事会应该了解该组织的财务表现和资本前景。评估债务的能力债务的能力是一个机构用来反映其信用评级的债务情况；是这个机构财务实力的标志。理想的情况下，一个企业的债务能力需要逐年增长来帮助维持和改善其财务状况。明确债务的能力，将帮助企业战略性地分配资金。而且，这有助于企业预测他们还需要从其他来源获取多少资金。确定债务和股权融资的适当组合确定债务和股权融资的适当组合，是一个复杂的过程。在过去，医
6、疗保健机构往往依靠固定利率债券，基金的资本支出。现在，他们积极组织管理债务3和股权，以增加灵活性，并以最低的成本获得资本。金融领袖必须确定合适的股权和债务融资，包括适当的传统和非传统混合债务资本的最高金额，以确保其最优惠利率。计算适当的负债速率组合计算合适的固定利率、浮动利率组合是医院的战略财务计划的一项重要内容。一直以来，浮动利率比固定利率较低，这造成了机构的积蓄，但不能保证随着时间的推移不作改变。浮息债券受利率变动、监管活动和机构信用评级的影响。可变利率债务的多元化浮动利率债务可以采取不同的形式，它们包括浮息债券、投保和未投保的证券，其中每一个带有不同的风险水平。浮息债务多样化可以降低企业
7、面临的风险。信用评级是如何的重要信用评级是一个机构的信用评估。这个机构的借贷历史、现有的资产和负债都会影响信贷评级。机构通常会在其债券定价日期之前几个月接触信用评级机构。这个评级能够影响债券的利率、公约和投资者所需求的证券。因此，良好的信贷评级能确保医院能进行筹集资本基金的重点项目，如建设新设施，扩大或增加服务项目和掌握最新的临床信息技术。这些关键指标可作为一项提高医院信誉的战略举措。惠誉国际评级JOHNWELLS说“在确定医院的评级时，公司需要认真地研究其平均年龄。”评级机构所使用的主要指标包括应收账款年度还本付息覆盖比率坏账资本支出比率资产债务率库存现金债务覆盖比率债务资本比率营业利润率4
8、资产收益率非传统债券的类型非传统的债务是医院获取资金的另一种途径。大多数医院转向非传统的债务，并试图保持其传统的债券发行或债务的能力。非传统的债务可以免税。资产负债表选项医院通常在建筑物和设备投入了大量的资产。通过销售和售后租回，合资企业和主租赁，经营租赁，所有权转让给第三方投资者。协议的条款，允许医院离开关闭其资产负债表的资产。例如，售后租回交易，允许医院出售建筑物第三方租赁。参与债券交易PBTS可以被用来促进合资医院和医生群体的发展。医院可以获得收益，因为能够保持他们的资产和最大限度地减少风险。医院的利益对于合资医院治理和管理的影响更大。直接贷款如果医院是筹集的资金比较少，或者是在主要的债
9、券发行之间，则直接贷款是不错的途径。他们通常涉及投资者可以购买并持有的债券。虽然利率高于公共债券市场，但交易成本较低。房地产投资信托基金房地产投资信托基金投资于不同类型的房地产，包括写字楼，医院，商场，不同的运营商和租赁的空间实体。投资者租赁款项及物业销售收益，销售建设，房地产投资信托基金，可以给医院带来现金流入，并可能有助于实现售后租回的OBS。应收账款融资应收账款融资能够给医院提供现金。医院利用应收账款作为抵押的融资协议。对于降低价格的欠款，医院可以出售或质押其应收款。传统债务的类型公开招股传统的结构性债务产品，通常是免税的。传统公共产品涉及的债务，是由一个组织或拥有债券的承销商购买和出售
10、。产品CON拥有固定或浮动利率。私募5私募类似与公开募股，他们是应课税或免税，进行固定或浮动利率。私人产品不同，因为它们没有向公众披露。债务提供给借贷者的数量有限的。私募比公开招股有更高的回报率和摊销期限较短。6外文文献原文TITLEDEBTFINANCINGMATERIALSOURCEHOSPITALHEALTHNETWORKSAUTHORLEEANNRUNYDEBTFINANCINGISAMAJORSOURCEDOFCAPITALFORHEALTHCAREORGANIZATIONSACCESSTOCAPITALISCRITICALTOKEEPFACILITIESCURRENT,ADDMAJ
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41、HOLDTHEBONDSALTHOUGHTHERATESAREHIGHERTHANTHEPUBLICBONDMARKET,THETRANSACTIONCOSTSARELOWERREALESTATEINVESTMENTTRUSTSREITSAREENTITIESTHATINVESTINVARIOUSTYPESOFREALESTATE,INCLUDINGOFFICEBUILDINGS,HOSPITALSANDSHOPPINGCENTERS,ANDLEASETHESPACETODIFFERENTOPERATORSINVESTORSEARNINGSCOMEFROMLEASEPAYMENTSANDPRO
42、PERTYSALESSELLINGABUILDINGTOAREITCANGIVEHOSPITALSANINFLUXOFCASHANDMAYHELPTHEREACHIEVEOBSTHROUGHLEASEBACKSRECEIVABLEFINANCINGRECEIVABLESFINANCINGCANPROVIDEAHOSPITALACCESSTOCASHTHATITISOWEDHOSPITALSCANUSEACCOUNTSRECEIVABLESASCOLLATERALINAFINANCINGAGREEMENTHOSPITALSCANSELLORPLEDGETHEIRRECEIVABLESATARED
43、UCEDPRICEOFTHEAMOUNTOWEDTYPESOFTRADITIONALDEBTPUBLICOFFERINGSTRADITIONALPUBLICOFFERINGSARESTRUCTUREDDEBTOFFERINGSANDARETYPICALLYTAXEXEMPTTRADITIONALPUBLICOFFERINGSINVOLVEDEBTTHATISBOUGHTANDSOLDBYANUNDERWRITERTOORGANIZATIONSORINDIVIDUALSWHOAREINTERESTEDINOWNINGTHEBONDSTHEOFFERINGSCONHAVEFIXEDORVARIAB
44、LERATESPRIVATEPLACEMENTSPRIVATEPLACEMENTSARESIMILARTOPUBLICOFFERINGSINTHATTHEYARETAXABLEORTAXEXEMPTANDCARRYFIXEDORVARIABLEINTERESTRATESPRIVATEOFFERINGSDIFFERBECAUSE12THEYARENOTPUBLICLYDISCLOSEDTHEDEBTISOFFEREDTOALIMITEDNUMBEROFLENDERSPRIVATEPLACEMENTSUSUALLYHAVEAHIGHERRATEOFRETURNANDASHORTERAMORTIZATIONPERIODTHANPUBLICOFFERINGS
