飞利浦MX8000双层螺旋CT机应用故障计量分析

目的：通过二甲医院放射科MX8000双层螺旋CT机应用过程中故障及维修费用的计量分析,使维修费用应用更趋理性。方法：对2002．04～2008．08期间MX8000双层螺旋CT机发生的故障进行系统性计量分析．并对发生的保修、未保修和其他维修等费用进行核算对比。结果：换件维修故障共76次,费用约586万元;不换件维修故障（含软故障）共184次,费用约44万元。购买保修的费用远远低于保修（换件维修）实际发生的费用;阶段性不买保修的费用略低于买保修的费用。但不买保修的实际潜在风险非常高。结论：中小医院CT机购买保修与实际维修费用之间存在很大的差异。对于没有CT维修能力的中小医院．给CT机购买保修可能更为合理。     

GE16排螺旋CT故障维修三例

CT对于现代医院而言一直是必备的大型诊疗设备,其维修费用昂贵。掌握自行保养维护技能,不仅能大大降低维修成本,而且可以延长CT设备使用寿命,提高工作效率。     

CT维修:从器件级到芯片级

芯片级维修属于深层次维修,技术性含量高,要求具备一定条件。其对于拓展CT维修技术层面,降低维修费用支出或减少用户维护费用负担具有积极的意义。     

可靠性维修理论在64排螺旋CT维修决策中的应用

为了将可靠性维修（RCM）理论应用于64排螺旋CT的维修决策中达到改进CT维修的目的,该研究依据RCM理论实施流程,首先选定64排螺旋CT的重要功能单元,然后进行功能单元的故障模式及影响分析（FMEA）,最后采用改进后的逻辑决断图来确定维修方式,以制定维修计划;实践证明,采用RCM理论后,64排螺旋CT的故障率、停机时间和维修费用均有显著下降,RCM理论在64排螺旋CT的维修决策中,能够有效地提高设备的使用可靠性并降低运行成本。     

CT设备电路板芯片级维修

芯片级维修属于深层次维修，技术性含量高，要求具备一定条件。其对于拓展CT维修技术层面，降低维修费用支出或减少用户维护费用负担具有积极的意义。     

CT机故障判别与维修三例

Synergy CT灯丝板故障原因的经验判别目的:Synergy CT灯丝板故障的加快判别,就灯丝板故障现象进行经验分享并探讨,以期有效降低用户维修费用。     

GE Lightspeed Ultra 多层螺旋CT故障维修体会

螺旋CT机使用过程中，会遇到各种各样的故障，在熟练掌握CT机的基本原理、工作结构及有熟练电脑维护知识的基础上，自己可维修CT机较多的常见故障，达到快速修复、节省费用的目的，更好地发挥CT机的作用。     

CT球管打火故障的分析及维修措施研究

为了全面了解CT球管的故障原因以及维修方法，就需要了解CT球管的结构和工作原理，知道CT球管故障的工作条件及原因，掌握CT球管损坏的故障判断方法，同时由于CT机已成为现代医院门诊不可或缺的常规诊断设备，具有良好的社会效益和经济效益，并且CT机本身价格高，使用频率高，主要耗材为CT球管，所以维修保养费用高。因此只有合理使用CT球管，减少CT球管更换次数，延长CT球管使用寿命，才能减少CT机的维修成本。本文对CT球管概述、CT仪器常见故障介绍、原因以及CT机球管的日常维护进行阐述。     

GE8800型CT阵列处理器AP故障检修

CT机属医院大型贵重医疗设备,一般无可替用设备,一旦停机,即便设备厂商做出最快响应,其工程师赶到现场也需要耗费相当长的时间,更不用说设备已过保修期的情况下繁琐报修手续所耽误的时间以及使用多年后的配件供应问题,购置所需配件价格昂贵自不必说,而因停机时间稍长给医院带来的间接损失更可观.因此探索CT设备电路板芯片级维修,对拓展CT维修技术层面,减少维修费用开支具有积极的意义.     

医疗设备维修费用的现状与管理

分析了目前医疗设备维修费用的意义和现状,分别从讨论维修费用的意义、医院维修费用支出的现状、设备科控制维修费用的要点难点以及如何降低维修费用等方面,探讨如何合理控制维修成本,促进医院设备效益管理、保证临床设备正常开展,强调了对设备维修费用科学管理的重要性,给出了如何科学管理维修费用的几点思路。     

设备成本构成分析

在对全国10个城市31所医院的CT等8种设备进行现场调查的基础上,分析了1993～1995年三年的资料,对3年间8种诊疗设备的固定和变动成本、直接和间接成本以及成本构成比例进行比较和分析,结果将有助于了解3年以来医院诊疗设备成本构成的变化情况。     

公共卫生机构成本核算的思路、模型和应用

文章介绍了公共卫生机构成本核算的现况及背景 ,并对成本核算的层次、内容和目的进行了探讨 ,提出了成本核算的思路和理论模型 ,探讨了成本核算在微观和宏观两个层面的应用以及如何在公共卫生机构内组织和实施成本核算工作     

从人力成本看成本核算方法一致性问题

由于医院成本项目较多且医疗服务具有特殊性,在实际工作中成本分摊成为医院成本核算的难点和重点,成本分摊参数的选择影响成本核算数据的准确性和可靠性,参数一旦选定,在以后的成本期间就保持一致性,随意变更分摊参数将会严重影响成本核算数据的可比性.     

Assessment of cost sharing in the Pima County Marketplace

The Patient Protection and Affordable Care Act established health insurance marketplaces to allow consumers to make educated decisions about their health care coverage. During the first open enrollment period in 2013, the federally facilitated marketplace in Pima County, Arizona listed 119 plans, making it one of the most competitive markets in the country. This study compares these plans based on differences in consumer cost sharing, including deductibles, co-pays and premiums. Consumer costs were reviewed using specific cases including a normal delivery pregnancy, the management of Type II Diabetes, and the utilization of specialty drugs to treat Hepatitis C. Total cost of care was calculated as the cost of managing the condition or event plus the cost of monthly premiums, evaluated as a single individual age 27. Evaluating a plan on premium alone is not sufficient as cost sharing can dramatically raise the cost of care. A rating system and better cost transparency tools could provider easier access to pertinent information for consumers.     

作业成本法在MRI及CT成本测算中的应用研究

目的:建立基于作业成本法下的间接成本分摊模型,探索运用作业成本法测算项目与病种成本,为按病种付费方式改革提供方法指导。方法:运用作业成本法理论与方法,以某医院影像中心业务项目MRI及CT为成本对象,通过项目作业链、成本库、成本动因分析,建立成本测算模型。结果:得出MRI、CT两项目在作业成本法和传统成本法的平均成本值及比较。结论:作业成本法在医疗服务成本核算中具有广阔的应用前景。     

Cost of school-based drug treatment in Tanzania

It has been argued that targeting delivery of anthelmintics to school-children by taking advantage of the existing education infrastructure and administrative system can be one of the most cost-effective approaches in minimizing the intensity of infections with both schistosomiasis and major intestinal nematodes in many developing countries.The study was conducted in January 1997, shortly after the completion of the drug intervention programme. This paper provides an analysis of the costs of providing age-targeted treatment of school children for urinary schistosomiasis using praziquantel and for intestinal nematodes using albendazole as an integral part of the School Health Programme in Tanga Region, Tanzania.The analysis shows that the total financial cost of the intervention programme in 1996 prices was US$54 252.28 (exchange rate: TSH 573 = US$1). Of this amount, the cost of drugs constitutes 80.6%, while the delivery cost appears relatively low, representing just below 20%. Even when the opportunity cost of unpaid days of labour input is included, the cost of drugs still remains the highest cost component of the intervention (55.8%). In the current epidemiological and logistic setting of Tanzania, the financial cost per child treated using praziquantel, which involved prior screening at the school level, was US$0.79, while treatment using albendazole was as low as US$0.23, of which US$0.20 was drug purchase cost.It is concluded that the base cost of delivering a universal, standard, school-based health intervention such as albendazole can be as low as US$0.03 per child treated, but even a very slight increase in the complexity of delivery can have a very significant impact on the cost of intervention.      

作业成本法在医院成本核算中的应用探讨(上)

分3部分对作业成本法在医院的应用进行了探讨,从理论上提出了包括划分作业、确定作业代表动因、分摊作业成本、计算单元成本、建立成本账户、制定账务处理程序和编制成本表等步骤在内的一整套具体的、可操作的成本核算方法,该方法集科室成本核算和医疗服务单元成本核算于一体,能够为医院管理和宏观决策提供丰富翔实的成本核算资料。该方法较好地解决了目前医院成本核算中对间接成本分摊不合理的问题以及医疗服务成本核算对象过于笼统的问题。     

论成本核算在医院管理中的作用

本文介绍医院成本核算的现状，并对成本核算的内容和日的进行r探讨：提出成本核算的思路。     

糖尿病预防治疗的费用效益分析

目的 了解患者在糖耐量异常阶段进行药物治疗预防糖尿病的经济学意义。方法 以国际公认的两项大型临床研究DPP和STOP-NIDDM为基础,计算每预防1例糖尿病发生所需要的费用,与现有的糖尿病治疗费用相比较。结果 如果以合资二甲双胍治疗,在3年中预防1例糖尿病发生的费用为69 122.95元;以阿卡波糖治疗,3.3年中预防1例糖尿病发生的费用为154 116.05元;以国产二甲双胍进行治疗,3年预防1例糖尿病发生的费用为21666.63元。现有状况下上海市糖尿病患者的年均治疗费用为9143.70元。结论 对糖耐量异常患者进行药物预防治疗,总体医疗费用较大。药物费用在治疗的总体费用中所占比例较大。选用经济、有效的药物是节省费用的关键。深入的临床研究尤其是预防糖尿病及其并发症作用将进一步揭示糖尿病预防治疗的经济学意义。     

Drivers of cost system development in hospitals: results of a survey

While many hospitals are under pressure to become more cost efficient, new costing systems such as activity-based costing (ABC) may form a solution. However, the factors that may facilitate (or inhibit) cost system changes towards ABC have not yet been disentangled in a specific hospital context. Via a survey study of hospitals, we discovered that cost system development in hospitals could largely be explained by hospital specific factors. Issues such as the support of the medical parties towards cost system use, the awareness of problems with the existing legal cost system, the type of contract for the physician's internal financial agreement, should be considered if hospitals refine their cost system. Conversely, ABC-adoption issues that were found to be crucial in other industries are less important. Apparently, installing a cost system requires a different approach in hospital settings. Especially, results suggest that hospital management should not underestimate the interest of the physician in the process of redesigning cost systems.