By analyzing the common and regular problems in the audit problems of public hospitals, taking the high-risk and emerging outstanding problems in the field of economic management of public hospitals as the starting point, the causes of the prob- lems are explored, the institutional obstacles, mechanism defects and institutional loopholes behind the problems are analyzed. Based on the risk management theory and the current situation of public hospital management, a targeted audit rectification and improvement mechanism and risk prevention strategy are proposed, so as to further improve the quality of internal audit and promote the risk manage- ment capability of public hospitals, improve the governance mechanism to promote the high-quality development of public hospitals.