Cost accounting in public hospitals has great significance for the hospital to make scientific management decisions and the government to make policies on a reasonable price of medical services, compensation mechanism and medicare payment and so on. However, the progress of cost accounting in public hospitals has been slow for many years. Practices has proved that the effective implementation of cost accounting in public hospitals needs active promotion and effective management of government. The author puts forward some suggestions from the perspective of government management, hoping to provide a reference for the government to perform the system design and industry management of cost accounting in public hospitals in the future.