共查询到18条相似文献,搜索用时 187 毫秒
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目的:将2016年某科室DRG成本核算结果与已获得的支付额作对比,得出DRG病种的收益或亏损情况。通过DRG病种核算,找出成本精细化管理的途径和思路。方法:医院利用CN-DRGs医院绩效平台、成本核算系统和数据透视表,分析内分泌科DRGs病种成本。结果:对比DRGs病种成本和已获得支付金额,研究存在的差异,当医院面临实际成本高于病人的DRGs支付价格,医院产生损失;反之,实际成本低于病人的DRGs支付价格,医院获利。结论:医院利用DRG加快完善内部财务管理制度,加强成本核算、分析和控制,降低医疗成本,提高运行效率,同时为政府合理确定DRGs收付费标准提供参考依据。 相似文献
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吴镝娅张丽华刘艳蔡林 《中国卫生质量管理》2023,(1):039-43
分析DRG病种成本,可进一步优化医院成本管控。通过建立项目叠加法联合作业成本法的DRG病种成本核算方式,充分运用DRG病种成本核算结果进行同一病种不同学科间、同一病种不同治疗方式、临床路径入径和未入径、病种盈亏平衡等比较分析,以挖掘DRG成本管控难点。经实践,病案首页质量提高,DRG相关运营指标得以改善,医院运行效率和患者满意度进一步提高。为优化医院资源配置,帮助科室明确学科发展方向,提升医疗效率,建议制定临床科室个性化DRG管理方案,合理规避成本管控风险点,完善成本管理考核机制。 相似文献
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随着医疗体制改革的逐步深入 ,搞好医院经济管理的核心———医疗成本核算就显得尤为重要 ,它是适应医改、更好地提供积累资金 ,不断提高“医院收入、职工收入”两个增长 ,促进医院发展的重要途径。一、成本核算的做法1996年 ,我院成本核算开始运作 ,经过几年来的反复测算、论证 ,我院成本核算逐步完善并进入全成本核算管理 ,取得了较为显著的社会效益和经济效益。我们的做法是 :(一 )以科室为二级核算单位 ,按每个单位来核定收入项目、成本项目1.科室收入核算临床科室收入由直接收入和间接收入两部分组成。直接收入 (全额计入临床科… 相似文献
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随着我国 DRG付费方式改革进程的推进,有条件的公立医院陆续开展 DRG成本核算,不断加强医院的成本管理。但在实践中,医院成本核算结果,往往会因为选择了不同的分摊方式而不够准确。本文以医院中心供应室成本分摊为例,探索更加合理的分摊方式,产出更加可信可运用的成本核算结果,提供医院在DRG成本核算实施过程中一些新的思路和方法。 相似文献
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医院成本费用的正确划归 总被引:2,自引:1,他引:2
重点从收入与支出的配比性原则,权责发生制原则,重要性原则等医院成本核算原则出发,论述了在医院成本核算中,正确划归成本费用的必要性与一些原则性做法。同时,对药品收入与成本进入科室成本核算的必要性进行了阐述。提出在医院成本核算中,直接收入与直接成本、共同收入与共同成本和间接收入与间接成本之间的配比关系是成本费用正确划归的基础,权责发生制是其分期划分的准则。同时,对间接收入的一部分直接进入临床门诊科室收入的做法提出不同意见,认为只有在进行辅助收入与成本分配时,间接收入才能进入临床科室,以完成全成本核算的整个程序。 相似文献
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目的:测算样本医院儿科 109个 DRG病种组成本,根据核算结果开展病种组比价研究,以期理顺病种组比价关系。方法:收集儿科2020年病种费用与成本相关数据,利用费用成本转换法测算儿科病种成本,采用统计描述方法分析儿科病种组费用、成本及比价关系。结果:58.71%的儿科DRG病种组呈现不同程度亏损;儿科DRG病种组费用与成本之间存在偏离;儿科DRG病种组比价关系尚未理顺。结论:建议有针对性地调整儿科医疗服务价格,突显儿童医疗服务价值,同时秉持比价合理的原则,推行以成本为基础的DRG病种组定价制度。 相似文献
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目的:探索基于时间驱动作业成本法(TDABC)医疗服务项目成本核算方法,并与传统作业成本法的计算结果进行比较,为国内医院项目成本核算的方法选择提供参考依据。方法:采用TDABC对样本医院超声科9项医疗服务项目进行成本核算,采用Wilcoxon配对符号秩和检验对TDABC与传统作业成本法结果进行分析,比较不同方法核算出的医疗服务项目成本结果之间是否具有差异性。结果:TDABC方法可以通过时间动因将科室成本分摊至项目成本,其核算过程简便,符合医院的实际成本•与传统作业成本法相比核算结果无统计学差异。结论:TDABC方法是一种便捷准确的项目成本核算方法,依据其核算过程的特点,建立医院成本管理及核算制度方案,加强监督管理并合理分配各职能岗位,确保医疗项目成本核算的各个环节均有章可循。 相似文献
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目的:为适应医改变化,提升医院精细化管理水平,进一步强化业财融合,为医院病种结构优化和专科发展方向提供参数依据,为DRG预付费改革提供数据参考。方法:运用作业成本法、项目叠加法和象限分析法,开展基于DRG病组的成本核算与效益分析。结果:生成院、科两级DRG病组及相关医疗、财务关键数据;通过院级专科和DRG病组的象限划分区别优劣类型,实施战略分析;随着病种并发症和伴随症的发生以及严重程度加深,住院平均天数、CMI升高,病种效益下降。结论:典型病组(专病)专科专治,效益更具优势;现行医疗服务项目价格与国家病种付费及分级诊疗改革方向存在差距;对DRG病组效益分析、象限分析和收支来源进行解读,呼吁杜绝医疗浪费、控制成本消耗,促进临床诊疗与经济运营的结合,获得临床科室的认可,起到了为临床提示病种结构优劣调整和专科建设发展方向的作用。 相似文献
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Xavier Colin Dr Gilles Berdeaux Antoine Lafuma Annie Salvanet-Bouchara Laurent Kodjikian 《Applied health economics and health policy》2010,8(1):53-60
Background
Endophthalmitis is a severe condition that requires hospitalization with at least day care. Information on the incidence rate, costs and consequences of endophthalmitis is scarce.Objective
To estimate the number of patients with endophthalmitis hospitalized in France, as well as the average costs and hospital budget consequences.Methods
French Programme de Médicalisation des Systèmes d’Information (PMSI) data for 2006, derived from the official DRG classification, were analysed. Data were extracted concerning the following primary diagnoses: ‘purulent endophthalmitis’, ‘other endophthalmitis’ and ‘endophthalmitis associated with another disease’. Two durations of hospitalization were compared: the actual duration and a weighted DRG duration. The cost of hospitalization was weighted by the average DRG cost + daily hospital costs × the difference between the actual and weighted DRG days in hospital. All costs are presented in €, year 2007 values.Results
A total of 1518 patients (mean age 68.7 years; 47.1% male) experienced 1725 hospitalizations for endophthalmitis, including 1416 cases (82.1%) admitted to public hospitals. The majority of patients (79.1%) were classified by DRG codes that did not specify endophthalmitis (DRG 02M03Z). Most patients (1342) were given a drug injection and 510 underwent vitrectomy. Four patients died in hospital and 75 were transferred to other hospitals. The actual duration of hospitalization for endophthalmitis in public hospitals was 8.1 days (mean), whereas the average weighted DRG duration was 5.1 days, which underestimated the actual duration by 3 days. The average hospital cost was €3688 per patient, totalling €6 361 119 per annum for all public and private hospitalizations in France, including €223 723 as day care. If hospital funding was wholly based on DRG tariffs, the budget for endophthalmitis would be severely underestimated. The DRG inclusion of ’severe acute ocular infections’ as a proxy for endophthalmitis dramatically underestimated its true cost by approximately 30%.Conclusion
For health economic evaluations, it is inappropriate to use DRG classifications as proxies for endophthalmitis. Expressed more generally, hospitalization cost analyses should not be based on any specific DRG, but always on the clinically relevant primary diagnosis. The PMSI clustering algorithm underestimates the hospital budgets required for endophthalmitis. Lastly, the PMSI (exhaustively reporting all hospitalizations) is best suited to capturing yearly endophthalmitis incidence rates, average costs and national health expenditure. 相似文献15.
Comparison of cost accounting methods from different DRG systems and their effect on health care quality 总被引:5,自引:0,他引:5
BACKGROUND: Diagnosis related groups (DRGs) are a well-established provider payment system. Because of their imminent potential of cost reduction, they have been widely introduced. In addition to cost cutting, several social objectives - e.g., improving overall health care quality - feed into the DRG system. OBJECTIVES: The WHO compared different provider payment systems with regard to the following objectives: prevention of further health problems, providing services and solving health problems, and responsiveness to people's legitimate expectations. However, no study has been published which takes the impact of different cost accounting systems across the DRG systems into account. METHODS:We compared the impact of different cost accounting methods within DRG-like systems by developing six criteria: integration of patients' health risk into pricing practice, incentives for quality improvement and innovation, availability of high class evidence based therapy, prohibition of economically founded exclusions, reduction of fragmentation incentives, and improvement of patient oriented treatment. RESULTS: We set up a first overview of potential and actual impacts of the pricing practices within Yale-DRGs, AR-DRGs, G-DRGs, Swiss AP-DRGs adoption and Swiss MIPP. It could be demonstrated that DRGs are not only a 'homogenous' group of similar provider payment systems but quite different by fulfilling major health care objectives connected with the used cost accounting methods. CONCLUSIONS: If not only the possible cost reduction is used to put in a good word for DRG-based provider payment systems, maximum accurateness concerning the method of cost accounting should prevail when implementing a new DRG-based provider payment system. 相似文献
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Saint S Rose J Lichter AS Forrest S McMahon LF 《Evaluation & the health professions》2002,25(3):259-269
Hospitals are commonly compared with each other within diagnosis-related group (DRG) categories. Administrators infer that hospitals with a higher cost per case within a DRG are less efficient than hospitals with a lower cost per case after case mix and severity adjustment. The authors assess whether hospitals that carry a heavy load of high-cost DRGs potentially distribute the added expenses of treating these patients onto their lower cost DRGs using data gathered from the 47 hospitals in the University Hospital Consortium database between January 1994 and December 1995. The results indicate that given standard hospital allocation practices, some of the costs associated with high-cost patients were likely shifted downward, thereby inflating the cost per case for less expensive patients. As researchers adopt more benchmarking methodologies, it is important to recognize that standard accounting practices in which cost shifting from one class of patient to another may impair the ability to understand the actual cost structure for classes of patients. 相似文献
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医院卫生技术评估(HB-HTA)是专门针对医院实际情况进行评估的方法学工具,可辅助医院进行卫生技术管理与决策。HB-HTA与DRG均是医院管理的工具,二者价值理念相同、现实作用相近,可推动医院向精细化管理和高质量服务提供的发展方向迈进。在DRG改革中,HB-HTA可通过对卫生技术安全性、有效性和经济性评估,对同一病种的不同诊疗过程、技术和相应的配套措施进行分析和比较,帮助医院进行成本核算,优化"服务包"的安全有效性和成本效益,促进医院对DRG改革进行战略性回应。此外,HB-HTA还可覆盖到DRG短时间无法覆盖和不适宜以DRG支付的医疗服务,辅助医院对多元复合式医保支付方式进行整体性探索。未来,应在医院内部重点打造"HB-HTA+DRG"式医院精细化管理模式,同时要理顺组织体制、注重大数据开发和使用、加快HB-HTA试点工作并建立动态监管机制。 相似文献