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随着医改逐步推进,国家对公立医院的成本管理、成本控制提出了明确的要求。标准成本法在企业中已得到广泛的应用。笔者主要结合管理会计的理论,以某大型三甲综合医院的门诊标准成本实践作为案例,探讨在现阶段医院管理需求不断变化的情况下实施标准成本的意义及方法。 相似文献
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为控制医疗费用,降低病人负担,医院应加强成本管理。实行标准成本控制,就是使医院步入"优质、高效、低耗"的道路,即:通过标准成本的制定、成本差异的分析和成本差异的控制,从而实施成本领先战略,实现医院快速、健康发展。 相似文献
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医院的成本控制与管理是医院经济管理的重要手段,开展成本控制可以降低医疗服务成本,减少浪费,增强医院的竞争能力。同时,为科学制定医疗服务价格和完善补偿机制提供重要依据。2004年我院着重在不可控成本控制上进行了积极的尝试和探索,取得了一定的成效。 1 传统成本核算存在的问题 相似文献
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标准化在医院成本控制中的应用 总被引:7,自引:1,他引:6
降低成本 ,提高效益 ,是医院经济管理的首要目标。如何实施有效的成本控制是医院经济管理者所面临的一个重要课题。目前大部分医院一直以来所采取的“收入减支出 ,结余提奖”的分配方法使医院成本控制仅停留在事后控制阶段 ,至于实际发生的成本是否合理 ,如何能从成本发生前和成本发生中就开始控制和降低成本 ,却没有相应的配套措施 ,致使医院成本控制一直难以取得显著成效。本文将标准化的有关原理和方法应用于医院成本控制中 ,从建立医院成本控制标准、成本控制差异分析和医院成本控制业绩考核 3个方面对这一问题作具体深入的探讨。医院成… 相似文献
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医疗机构如何进行成本控制 总被引:2,自引:0,他引:2
医院成本控制是医院经济管理过程中一项重要工作 ,由于医院是一个技术密集、知识密集、劳动密集的部门 ,其各项经济指标各不相同 ,因此在制定成本控制时必须使其标准化 ,即实行目标管理。一般来说 ,大体分为以下几个方面。1.制定目标成本目前成本的制定必须通过预测、决策和试算平衡才能确定。(1)根据医院目标收益 ,求得目标成本。一般用医院总收入减去目标收益即为医院目标成本。(2)根据成本降低的任务 ,求得目标成本。目标成本也可根据医疗服务量的扩大 ,各项费用消耗定额降低 ,及劳动生产率的提高 ,平均工资的提高 ,管理费用的节约等… 相似文献
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对医院目标成本管理的探讨 总被引:4,自引:0,他引:4
医院目标成本管理是指根据医院总的规划和发展目标 ,对医院经营成本进行预测、计划、分解、控制、核算、分析和考核 ,以达到用最小的成本开支获得最佳效益的成本管理体系和方法 ,具有全程性、全员性、技术经济性、经济责任性等特点 ,是医院目标管理的重要内容。笔者就医院如何推行目标成本管理谈一些看法。一、加强医院基础工作是有效实施目标成本管理的先决条件1.建立和健全定额制度。定额管理是科学管理医院的重要手段。所谓定额 ,是指在一定条件下 ,医院进行医疗等活动时 ,在资源的利用和消耗方面应该遵循和达到的标准。搞好医院定额管理… 相似文献
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浅谈医院工程建设造价管理与控制方法 总被引:1,自引:0,他引:1
王卫群 《中国医院建筑与装备》2008,9(9):36-42
结合医院工程建设管理实践,论述了和分析医院工程建设造价管理与控制的不同方法,强调不同性质的项目应采用不同管理与控制办法,既要做到医院投资合理使用,又要使工程造价反映实物量的真实价值。 相似文献
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医院内部审计部门参与成本管理探讨 总被引:1,自引:0,他引:1
李兵 《解放军医院管理杂志》2010,17(4):371-372
本文根据军队医院成本管理的现状和内部审计的发展趋势,提出内部审计部门参与医疗成本控制是保持医院和自身可持续发展的必然要求。应着重解决三个突出问题:一是针对科室成本这个医院成本管理体系的基础单元开展审计,为改进医院成本管理制度体系提供可靠依据,提高成本管理意识和完善成本管理机制。二是针对采购成本这个医院成本的重要组成部分开展审计,促进落实采购管理制度和严密采购管理程序。三是对成本信息实施审计,保证成本管理的基础数据真实完整,完善医院成本管理体系。总结了相关的审计重点和审计方法。 相似文献
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Objectives. To estimate hospital cost changes associated with a behavioral intervention designed to increase the use of evidence-based acute pain management practices in an inpatient setting and to estimate the direct effect that changes in evidence-based acute pain management practices have on inpatient cost.
Data Sources/Study Setting. Data from a randomized "translating research into practice" (TRIP) behavioral intervention designed to increase the use of evidence-based acute pain management practices for patients hospitalized with hip fractures.
Study Design. Experimental design and observational "as-treated" and instrumental variable (IV) methods.
Data Collection/Extraction Methods. Abstraction from medical records and Uniform Billing 1992 (UB92) discharge abstracts.
Principal Findings. The TRIP intervention cost on average $17,714 to implement within a hospital but led to cost savings per inpatient stay of more than $1,500. The intervention increased the cost of nursing services, special operating rooms, and therapy services per inpatient stay, but these costs were more than offset by cost reductions within other cost categories. "As-treated" estimates of the effect of changes in evidence-based acute pain management practices on inpatient cost appear significantly underestimated, whereas IV estimates are statistically significant and are distinct from, but consistent with, estimates associated with the intervention.
Conclusions. A hospital treating more that 12 patients with acute hip fractures can expect to lower overall cost by implementing the TRIP intervention. We also demonstrated the advantages of using IV methods over "as-treated" methods to assess the direct effect of practice changes on cost. 相似文献
Data Sources/Study Setting. Data from a randomized "translating research into practice" (TRIP) behavioral intervention designed to increase the use of evidence-based acute pain management practices for patients hospitalized with hip fractures.
Study Design. Experimental design and observational "as-treated" and instrumental variable (IV) methods.
Data Collection/Extraction Methods. Abstraction from medical records and Uniform Billing 1992 (UB92) discharge abstracts.
Principal Findings. The TRIP intervention cost on average $17,714 to implement within a hospital but led to cost savings per inpatient stay of more than $1,500. The intervention increased the cost of nursing services, special operating rooms, and therapy services per inpatient stay, but these costs were more than offset by cost reductions within other cost categories. "As-treated" estimates of the effect of changes in evidence-based acute pain management practices on inpatient cost appear significantly underestimated, whereas IV estimates are statistically significant and are distinct from, but consistent with, estimates associated with the intervention.
Conclusions. A hospital treating more that 12 patients with acute hip fractures can expect to lower overall cost by implementing the TRIP intervention. We also demonstrated the advantages of using IV methods over "as-treated" methods to assess the direct effect of practice changes on cost. 相似文献
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随着成本核算工作的发展和管理需求的不断提出,各种分析手段正广泛地应用于当前医院成本分析中。其中本量利方法较早地被应用到成本核算与分析中,并对医院未来保本点与经营状况进行预测。为了更可靠地建立本量利分析模型,有必要引入成本预测方程。本文介绍了三种常用的建立预测方程的方法并通过对比,提出各方法的优劣,供医院在实际建立本量利模型和预测成本时进行选择和参考。 相似文献
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Michael G. Trisolini Sharon Stanton Russell Gretchen Gwynne Dieter K. Zschock 《The International journal of health planning and management》1992,7(2):103-132
International attention has focused in recent years on methods for analysing costs of public hospitals in developing countries, with the goal of reducing the financial burden on governments by enabling improved resource allocation, by identifying areas for cost recovery and cost control, and by developing management systems to facilitate these efforts. A range of methods for cost analysis, cost recovery, and cost control are reviewed in this article, with illustrations of applications of the methods at Victoria Hospital, the national hospital in St. Lucia. Comparisons are made to similar studies in Belize, Lesotho, and the Dominican Republic. Cost-analysis methods focus on a detailed cost accounting effort which identifies the full financial costs of hospital operations and the unit costs of individual hospital services. Cost-recovery methods include an analysis of cost-related and other issues involved in setting fee levels for hospital services, determination of exemptions for certain population groups, and management of fee collection systems. Cost-control methods include analysing the degree of managerial authority exercised by hospital managers in relation to the central Ministry of Health and other government departments, identifying opportunities and incentives for cost control by individual departments within the hospital, and evaluating methods for involving physicians and other clinical decision-makers in cost control efforts. A diagnosis-independent method for utilization review of clinical decisions, the Appropriateness Evaluation Protocol, is pilot-tested and alternatives, including Diagnosis Related Groups, are discussed. Implementation issues related to long-term systems development efforts are reviewed. 相似文献