This research studied the nature of operations and organizational structure of the private hospitals business to include financial accounting system of private hospitals with an emphasis on methods of recording and classifying data, chart of accounts as well as form to record various transactions. The conduct research sample was selected private hospital in Bangkok with minimum of 100 beds the 5 selected from the group divided by the size of the number of hospital beds is 1 of 5 groups each with data from focus interviews. Which is divided into 2 parts with part 1 is general information regarding the nature of operations, organizational structure , corporate management to assign tasks and responsibilities and part 2 is all about accounting systems and internal controls, the process of accounting practices and financial reports.The outcomes of the research reveal nature of operations and organizational structure of private hospitals are generally divided management into 2 parts management is the work on direct medical care such as medical department, etc, and the work on the general management such as accounting and finance, etc., which define the role and authority required of employees at all levels. In addition, management has focused on the accounting system such as documentation, methods of recording and classifying data, chart of accounts in order to be used as evidence of the audit and internal control as other general business. The accounting system of the hospital business, including revenue accounting system and control accounts receivable, cash accounting system, payroll and wage systems, accounting system on procurement and control inventory and fixed assets accounting system. These made executives receive accurate information and just in times. In addition to report financial reliably. Today private hospitals, most computer systems will help to create an account. The program has finished some of the health care system associated with a complete accounting system that allows commercial competitive advantage.Private hospitals business are efficient capital investment business and utilization of people with specialized skill. Obviously the right business decisions have to rely on good financial planning and accurate information concerned, which to be survival of such enterprise in the long run. With emphasis on methods of recording and classifying data, chart of accounts as well as form to record various transaction. Appropriate internal control procedures were examined so that an efficient way of preparing significant and timely. Which is used in planning and control decisions.