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医保付费方式变革下作业成本法用于医院成本管理的探索

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目的:探究医保付费方式变革下作业成本法用于医院成本管理的价值.方法:构建基于作业成本法的医院成本管理方案,通过对比分析传统成本法与作业成本法下案例医院管理成本明细应用的差异,在全院数据累计基础上进行病种权重计算,明确医保付费方式变革下作业成本法相比传统成本法在医院成本管理中的应用优势,提出医保付费方式变革下开展作业成本法医院成本管理的操作建议.结果:通过分析发现,传统成本法核算研究对象成本为173181.73万元,作业成本法测算结果为192513.88万元,高于前者19332.15万元,差异率为11.16%.产生差异的项目主要在于作业成本法中人员经费、卫生材料成本比传统成本法各多出5437.12万元和6881.02万元,固定资产及折旧、无形资产及摊销和水电费、物业成本较传统成本法分别减少1614.06万元和2421.71万元.结论:在医保付费方式变革下运用作业成本法进行医院成本管理较传统成本法具有先进性,可从项目层面综合分析不同项目和不同医疗服务的成本构成和效益,为促进医院成本精细化管理方案提供了现实可行的参考依据.
Application of Activity-Based Costing in Hospital Cost Management under the Reform of Medical Insurance Payment Mode
Objective:To explore the application value of Activity-Based Costing (ABC) in hospital cost management under the reform of medical insurance payment mode. Methods:Hospital cost management scheme based on ABC was constructed. The application differences between traditional cost method and ABC were compared and analyzed to determine application advantages of ABC in hospital cost management compared with traditional costing method under the reform of medical insurance payment mode. Taking hospital cost management based on activity-based costing was proposed under the reform of medical insurance payment mode. Results:According to analysis,the cost by traditional costing method was 1731.8173 million yuan,and the cost by ABC was 1925.1388 million yuan,193.3215 million yuan more than that of the former,and the difference rate was 11.16%. The items that gave rise to the differences were mainly due to the fact that the cost of personnel and sanitary materials in the operation cost method were 54.371200 million yuan and 68.810200 million yuan more than the traditional cost method,and that fixed assets and depreciation,intangible assets and amortization,and utilities and property costs were 16.140600 million yuan and 24.217100 million yuan less than the traditional cost method. Conclusion:Compared with traditional costing method,application of ABC in hospital cost management under the reform of medical insurance payment mode is more advanced. It can comprehensively analyze cost compositions and benefits in different projects and medical services at the project level,and thus provide feasible reference basis for promoting hospital cost fine management scheme.

medical insurance payment mode reformActivity-Based Costinghospital cost management

唐昭华、薛勇、朱婕

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南京市中医院财务处 江苏 南京 210000

医保付费方式变革 作业成本法 医院成本管理

2024

中国卫生经济
中国卫生经济学会,卫生部卫生经济研究所

中国卫生经济

CSTPCDCHSSCD北大核心
影响因子:1.524
ISSN:1003-0743
年,卷(期):2024.43(12)