作业成本法实施中作业成本核算研究

作业成本核算是通过对作业进行动态的追踪、分析，从而计量作业和医疗服务(产品)成本，评价作业业绩和资源利用情况的一种核算方法。作业成本核算是作业成本法实施的基础和关键。     

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。     

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。     

不同核算方法下的公立医院病种成本测算比较分析

目的:揭示不同核算方法下的病种成本差异程度,为改进病种成本测算方法,提高成本信息精度、加强病种成本控制,提升医院运营能力以及推进病种支付方式改革提供信息支持和决策参考。方法:运用项目成本法和作业成本法对4个病种进行成本核算。结果:作业成本法核算病种间接成本高于项目成本法,且两种方法核算的病种成本均高于单病种限价收费水平。结论:项目成本核算病种简单易行,作业成本法核算较为精准但对成本精细化要求较高,应根据病种成本管理控制的要求可以选择适宜的病种成本核算方法。     

作业成本法在医院中心供应室成本核算中的应用

目的 通过作业成本法在医院中心供应室成本核算中的应用分析,提高医院成本信息准确性,改善和优化医院作业流程.方法 以医院中心供应室为例,对作业内容、作业流程进行分析,对成本费用发生、分配和归集利用作业成本法进行研究探讨.结果 作业成本法能提供更为准确的成本核算信息,在业务流程复杂、间接费用占全部成本费用中比例较高的医疗行业更为适用.采用作业成本法可得到更为精准的成本信息,有利于医院进行成本管理和成本控制.结论 作业成本法在医院成本管理、成本核算、成本控制和成本分析中应用是切实可行的,值得推广.     

作业成本法在项目成本核算中的应用

与传统的成本核算方法相比,作业成本法提供了一种全新的成本理念,可更有效归集和分配间接成本,该方法通过分析成本动因,使医院成本管理重心深入到作业层次,优化作业流程,提高医院成本管理效益。以作业成本法为核心构建医院作业成本核算系统核算医疗项目成本,设计作业链,确定成本动因,进行成本分析,为医院管理和宏观决策提供更准确合理的成本核算资料。     

基于改进作业成本法的医疗服务项目成本核算研究

根据公立医院开展医疗服务项目成本核算的现状，结合医疗服务的特点，将改进的模糊估时成本核算模型应用在样本医院功能检查科，计算其医疗服务项目成本，并与传统作业成本法核算结果比较。结果显示，两者的核算结果趋势一致，但模糊估时作业成本法工作量小、数据可比，更具有科学性和实用性。     

基于时间驱动作业成本法的病理项目成本核算

目的将时间驱动作业成本法应用于医疗项目成本核算。方法以医院现行成本核算方法为基础,结合时间驱动作业成本法原理,建立医疗项目成本核算模型,选择某医院病理科作为研究对象,计算出病理科医疗项目成本并进行服务效率分析。结果大部分医疗项目亏损,病理科处于超负荷工作状态,应增加工作人员。结论时间驱动作业成法能够用于医疗项目成本核算及管理,并能为制定和调整医疗服务项目收费标准提供科学的参考和依据。     

医改背景下项目成本核算问题研究

作业成本法由于在分配间接费用方面的优势而被引入项目成本核算中.通过实证分析,进一步揭示了作业成本法下的项目成本核算在解决医院成本控制、医改财政补偿、医疗服务定价改革中将发挥的积极作用及重大现实意义.     

基于时间驱动作业成本法的超声室服务项目成本核算

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。     

The impact of activity based cost accounting on health care capital investment decisions.

For the future survival of the rural hospitals in the U.S., there is a need to make sound financial decisions. The Activity Based Cost Accounting (ABC) provides more accurate and detailed cost information to make an informed capital investment decision taking into consideration all the costs and revenue reimbursement from third party payors. The paper analyzes, evaluates and compares two scenarios of acquiring capital equipment and attempts to show the importance of utilizing the ABC method in making a sound financial decision as compared to the traditional cost method.     

Costes de las terapias de las enfermedades neurodegenerativas: aplicación de un sistema de costes basado en las actividades

Objective

To apply the activity based costing (ABC) model to calculate the cost of therapy for neurodegenerative disorders in order to improve hospital management and allocate resources more efficiently.

Method

We used the case study method in the Francolí long-term care day center. We applied all phases of an ABC system to quantify the cost of the activities developed in the center. We identified 60 activities; the information was collected in June 2009.

Results

The ABC system allowed us to calculate the average cost per patient with respect to the therapies received. The most costly and commonly applied technique was psycho-stimulation therapy. Focusing on this therapy and on others related to the admissions process could lead to significant cost savings.

Conclusions

ABC costing is a viable method for costing activities and therapies in long-term day care centers because it can be adapted to their structure and standard practice. This type of costing allows the costs of each activity and therapy, or combination of therapies, to be determined and aids measures to improve management.     

Applying activity-based costing to the nuclear medicine unit.

Previous studies have shown the feasibility of using activity-based costing (ABC) in hospital environments. However, many of these studies discuss the general applications of ABC in health-care organizations. This research explores the potential application of ABC to the nuclear medicine unit (NMU) at a teaching hospital. The finding indicates that the current cost averages 236.11 US dollars for all procedures, which is quite different from the costs computed by using ABC. The difference is most significant with positron emission tomography scan, 463 US dollars (an increase of 96%), as well as bone scan and thyroid scan, 114 US dollars (a decrease of 52%). The result of ABC analysis demonstrates that the operational time (machine time and direct labour time) and the cost of drugs have the most influence on cost per procedure. Clearly, to reduce the cost per procedure for the NMU, the reduction in operational time and cost of drugs should be analysed. The result also indicates that ABC can be used to improve resource allocation and management. It can be an important aid in making management decisions, particularly for improving pricing practices by making costing more accurate. It also facilitates the identification of underutilized resources and related costs, leading to cost reduction. The ABC system will also help hospitals control costs, improve the quality and efficiency of the care they provide, and manage their resources better.     

以时间驱动作业成本法核算病人护理成本方法探索

以科室内核算任意病人的护理成本为例,讨论传统作业成本法与时间驱动作业成本法的区别,介绍时间驱动作业成本法在医疗领域的应用。重点提出了辅助作业的计算和分摊方法,同时提出了病人的主要作业护理成本数据可代表消耗的护理服务水平并用于比较,以及医疗护理服务不适宜使用资源能力实际使用量这一概念的观点。     

作业成本模式的运用——以中国台湾某医学中心手术室为例

随着作业成本法（Activity-based costing，简称ABC）在企业的普及，ABC被引入作为医院财务管理．这种制度能更加精确地计算医院成本。以中国台湾某医学中心手术室为例，实证作业成本法对医院财务管理的帮助。结果显示作业成本法除可由作业活动的归纳计算出更精彩的成本之外，还可为许多管理决策提供帮助。     

基于作业成本法测算艾滋病防治成本的探讨

成本估计是艾滋病防治费用测算的主要内容。传统艾滋病防治成本测算方法存在测算内容不全面,测算结果不太符合实际,不利于控制艾滋病防治费用等不足。本文介绍了运用作业成本法测算艾滋病防治成本的优势,如可以促使艾滋病防治成本测算更加合理,提高艾滋病防治工作效率,控制不合理的艾滋病防治费用支出以及提供艾滋病防治管理决策信息等;阐述了实施该方法具备良好的硬件设备和实践基础;列举了作业成本法测算艾滋病防治成本四个基本步骤：作业分析,归集成本,成本或资源分配到各个作业中心的成本库,作业中心的成本分配到服务项目。目的在于测算合理的艾滋病防治工作成本,为测算艾滋病防治工作费用和控制成本,提高资金使用效益服务。     

Application of activity-based costing (ABC) for a Peruvian NGO healthcare provider

This article describes the application of activity-based costing (ABC) to calculate the unit costs of the services for a health care provider in Peru. While traditional costing allocates overhead and indirect costs in proportion to production volume or to direct costs, ABC assigns costs through activities within an organization. ABC uses personnel interviews to determine principal activities and the distribution of individual's time among these activities. Indirect costs are linked to services through time allocation and other tracing methods, and the result is a more accurate estimate of unit costs. The study concludes that applying ABC in a developing country setting is feasible, yielding results that are directly applicable to pricing and management. ABC determines costs for individual clinics, departments and services according to the activities that originate these costs, showing where an organization spends its money. With this information, it is possible to identify services that are generating extra revenue and those operating at a loss, and to calculate cross subsidies across services. ABC also highlights areas in the health care process where efficiency improvements are possible. Conclusions about the ultimate impact of the methodology are not drawn here, since the study was not repeated and changes in utilization patterns and the addition of new clinics affected applicability of the results. A potential constraint to implementing ABC is the availability and organization of cost information. Applying ABC efficiently requires information to be readily available, by cost category and department, since the greatest benefits of ABC come from frequent, systematic application of the methodology in order to monitor efficiency and provide feedback for management. The article concludes with a discussion of the potential applications of ABC in the health sector in developing countries.     

作业成本法在医院流程管理中的应用研究

流程成本管理是医院流程管理的重要内容之一,主要包括流程成本的汇集及成本分析.作者对作业成本法应用于医院流程管理进行了理论探讨,并基于医院组织结构建立了医院流程作业成本模型,对医院医疗服务项目及其活动成本归集进行了论述.之后,通过实例分析,验证了医院业务流程成本分析和计算方法具有一定的实践意义.     

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.