Study on the Marginal Contribution Approach to DRG Costing by Integrating Policy Norms and Operational Contexts
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.
marginal contributionDiagnosis Related Group(DRG)cost accountingperformance management
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