融合政策规范与运营情境的DRG成本核算"边际贡献法"研究
Study on the Marginal Contribution Approach to DRG Costing by Integrating Policy Norms and Operational Contexts
谢世堂1
作者信息
- 1. 首都医科大学附属北京天坛医院运营管理办公室 北京 100070
- 折叠
摘要
目的:探索DRG成本核算新方法,完善医院在DRG支付政策背景下的内部成本管控体系.方法:在核算方法探索方面,开展专家访谈、案例医院现场调研,组织专家论证核算方法;在方法验证方面,基于案例医院运营数据开展核算,验证核算方法.结果:基于《关于印发公立医院成本核算规范的通知》提出DRG成本核算"边际贡献法"及其分层核算框架.通过案例呈现核算实践路径,核算病例成本及其构成、DRG成本,分析了运营管理应用.结论:基于"边际贡献法"医院在科室成本核算基础上便可简易开展DRG成本的"一级核算",满足医院在DRG支付背景下运营管理的主要需求;也可匹配医院成本核算基础与信息化程度"逐级细化",以进一步提升核算精度.
Abstract
Objective:To explore new methods of Diagnosis Related Growp(DRG)cost accounting and improve the internal cost control system of hospitals in the context of DRG payment policy.Methods:In terms of exploring accounting methods,expert interviews and on-site research in case hospitals were carried out,and experts were organized to validate the accounting methods;in terms of method validation,accounting was carried out based on the operational data of the case hospitals,and the accounting meth-ods were validated.In terms of the method,the interviews,observation,and the expert brain storm were used to study DRG cost ac-counting method;in terms of method application,the DRG data of the case hospital was used to verify the accounting method.Re-sults:Based on the policy of"Issuing the Notice on Public Hospitals Cost Accounting Standards",it put forward the DRG cost ac-counting"marginal contribution method"and its hierarchical accounting framework.It presented the accounting path through cases,calculated the case cost and its composition,DRG cost,and analyzed the application of operation management.Conclusion:Based on the"marginal contribution method",hospitals can easily carry out"first-level accounting"for DRG costs on the basis of depart-mental cost accounting,which meets the main demand of hospitals"operation and management in the context of DRG payments;it can also match the basis of hospital costing with the degree of informatization."Level-by-level refinement"to further improve the ac-curacy of accounting.
关键词
边际贡献/DRG/成本核算/运营管理Key words
marginal contribution/Diagnosis Related Group(DRG)/cost accounting/performance management引用本文复制引用
基金项目
首都医科大学附属北京天坛医院院科研基金管理专项(TYGL202318)
出版年
2024
NETL
NSTL
万方数据