Аңдатпа
In the context of limited financial resources and rising costs in the healthcare system, the problem of increasing the efficiency and transparency of medical organizations, especially those operating on a commercial basis, is of particular relevance. Increased competition, the need to ensure the quality of medical services, and financial sustainability requirements necessitate improved cost management and internal audit mechanisms. The purpose of this study is a comprehensive assessment of the effectiveness and transparency of expenses in a commercial healthcare enterprise based on the development and application of a system of integrated indicators. The methodological basis of the research is based on the methods of financial, structural, comparative and coefficient analysis, as well as approaches to the normalization of indicators and the construction of an integral efficiency index. The empirical base is represented by data from the company's internal financial and management reports for the period 2021-2025, including revenue figures, cost structures, and internal audit data. The study revealed structural changes in the distribution of costs, characterized by an increase in administrative and IT costs while reducing the share of direct medical expenses. There has been a deterioration in performance indicators, including a decrease in profitability, cost efficiency, and an increase in costs per patient with less significant revenue growth. Additionally, institutional limitations in the internal control system have been identified, which are reflected in the lack of transparency of individual financial transactions. At the same time, the positive impact of audit digitalization on improving the quality of control and reducing deviations from budget targets has been proven. The practical significance of the research lies in the development of methodological tools for a comprehensive assessment of the effectiveness and transparency of expenses, which can be used in the system of internal audit, financial control and strategic management of medical organizations.