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目的:针对医院两院区运营模式下的人力成本精细化核算困难的问题找到优化方法,以提高人力成本精细化核算水平.方法:通过案例分析,以南京市儿童医院呼吸科为例,根据人力成本在两院区分摊中存在的问题,结合单位实际情况提出人力成本核算方法.结果:两院区运营模式下的医院人力成本能够更准确分摊,人力成本分摊方式得到了优化,医院人力成本... 相似文献
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新医改下高质量的成本核算是增强公立医院经济运行效能的重要抓手和有效手段,相较于单一院区,单体多院区的成本核算工作更加复杂和具有挑战性。作者分析了单体多院区医院成本核算中存在的问题及其产生的原因,如构建精细化的多院区成本核算体系缺乏顶层设计、各类成本难以合理归集和分摊、缺乏强有力的信息支撑、项目成本核算调研方式陈旧等,并... 相似文献
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针对多院区一体化管理难点,杭州市中医院在两院区一体化管理实践中从党建引领、医疗质量、业务流程等方面进行探索并取得良好成效,可为公立医院优化多院区管理提供参考。 相似文献
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吴牡丹谭剑 《中国卫生质量管理》2021,(4):092-94
多院区医院已发展成为医疗卫生资源合理配置的重要途径,而同质化管理是多院区发展亟待解决的问题。多院区医院可分为垂直化、扁平化及混合型管理模式,在推进多院区医院同质化管理过程中,各院区之间管理权责、文化融合、学科设置、医疗服务水平、信息化建设方面等存在难点。针对这些问题,提出在制定总体战略规划、制度及标准流程基础上,统筹安排人、财、物等各项资源要素,以实现多院区同质化发展。 相似文献
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目的 分析医院一院三区医疗服务同质化水平,为多院区提高医疗同质化管理提供参考。方法 调查某院多院区住院患者对医疗服务质量的期望与实际感受之间的差距,运用SERVQUAL量表从5个维度对医院一院三区住院患者进行问卷调查并对调查结果进行统计学分析。结果 患者个体特征对满意度评价没有影响,医院三院区医疗服务质量总体上无差异,5个维度无差异,22个具体指标中存在差异的仅有两项。从象限分析结果得出三院区都做得比较好的方面包括有形性、可靠性和保证性3个维度。结论 SERVQUAL量表适用于医院多院区医疗服务质量的评价研究,可以为医院改进医疗服务的薄弱环节和提高多院区同质化管理提供帮助。 相似文献
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通过对三级传染病分院院区运营进行分析,梳理总结院区运营中的各种问题,协调各个相关部门,探讨科学高效的解决方案并落实,实现了多院区的同质化服务,各项持续发展的数据指标均有提高,促进了传染病医院“一院多区”的稳步发展,为目前一院多区设置的医院尤其是传染病医院提供建议。 相似文献
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段亚梅 《中华现代医院管理杂志》2006,4(3):19-20
通过成本核算在医院管理中的应用,总结医院开展成本核算的意义,分析开展成本核算过程中遇到的难点,寻找解决难点的方法,从而更好地发挥成本分析评价和成本控制的职能,达到降低医疗服务成本和医院运营成本的目的。构建低成本经营优势。 相似文献
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徐峥杨中浩张天黄玲萍 《中国卫生质量管理》2023,(1):008-11
目的 从办医主体视角,提出促进公立医院财务管理数字化转型的路径和建议。方法 梳理公立医院财务管理面临问题及原因,以上海市级医院为例,从财务数字化转型切入,总结提升公立医院运营管理效能的举措。结果 集中统一建立会计核算、成本核算和智能分析平台,从而规范医院会计基础核算、规范成本核算路径、强化运营分析评价和加强数据质量控制,强化预算管理、提升成本效率、增强业财融合。结论 办医主体推动公立医院财务管理转型中,需要兼顾不同管理层级和医院业务特点选择系统建设模式,还需从持续加强数据质量控制,构建具有实效的指标评价体系等方面继续努力。 相似文献
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目的:探索时间驱动作业成本法在医院成本核算中的应用效果及可行性。方法:通过分析时间驱动作业成本法的原理及测算模型,选取某三级甲等公立医院产科主要医疗服务项目成本核算为对象,利用样本医院2019年1-6月的财务数据,将时间作为成本动因,应用时间驱动作业成本法来核算各医疗服务项目成本,结合现行的项目收费标准,进行医疗服务项目成本和服务效率对比分析。结果:在22项产科主要的医疗服务项目中,12项医疗项目亏损,8项盈利,且差异较大,其中收益率最差的项目是入院护理,依次术前准备、肌肉注射、皮下注射、皮内注射、胎心监护、吸氧、出院护理、静脉注射、产科检查、挂号、就诊登记检查、常规护理、疑难病例会诊。通过计算得出的有效产能为1553256元,其中450666元是闲置产能,服务效率为70.99%。结论:时间驱动作业成本法可用于医疗服务项目成本核算及管理中,利用时间因素将资源分配到医疗项目,能够简化核算步骤提高成本核算的准确性,测算的成本更符合实际成本,也为医院开展医疗服务项目定价和成本管理提供数据支撑和参考。 相似文献
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医院开展全成本核算工作的难点与对策 总被引:25,自引:6,他引:19
目的,我院注重经济管理,实施成本核算,在实践中遇到的问题:①成本核算机构设置的问题;②医院成本核算级次的划分问题;③管理费用的分摊问题;④成本核算数据与财务核算数据间的匹配问题。⑤内部定价规则的制定问题。就其原因:一医疗保障体制,二是医疗管理体制,三是如何降低医疗成本定位不够等。为此,应当针对成本核算中的难点,采取相应解决措施,以保证成本核算顺利推行。 相似文献
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浅谈护理成本核算在护理管理中的引用 总被引:5,自引:0,他引:5
护理服务是医疗卫生保健中不可缺少的组成部分,也存在着护理服务价值和服务成本问题。在认识护理成本核算的基本概念及研究进展的基础上,了解护理成本核算管理的现状及问题,并提出在护理管理中引用护理成本核算的设想。 相似文献
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Hanson K Kikumbih N Armstrong Schellenberg J Mponda H Nathan R Lake S Mills A Tanner M Lengeler C 《Bulletin of the World Health Organization》2003,81(4):269-276
OBJECTIVE: To assess the costs and consequences of a social marketing approach to malaria control in children by means of insecticide-treated nets in two rural districts of the United Republic of Tanzania, compared with no net use. METHODS: Project cost data were collected prospectively from accounting records. Community effectiveness was estimated on the basis of a nested case-control study and a cross-sectional cluster sample survey. FINDINGS: The social marketing approach to the distribution of insecticide-treated nets was estimated to cost 1560 US dollars per death averted and 57 US dollars per disability-adjusted life year averted. These figures fell to 1018 US dollars and 37 US dollars, respectively, when the costs and consequences of untreated nets were taken into account. CONCLUSION: The social marketing of insecticide-treated nets is an attractive intervention for preventing childhood deaths from malaria. 相似文献
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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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不同成本核算方法具有不同的优缺点及不同的适应性,与地方医院相比,军队医院因为行政编制和服务性质的不同,决定了军队医院成本核算的特殊性。通过对其特殊性分析,研究适合军队医院成本核算的具体方法 ,有助于提升医院的经济管理水平。 相似文献
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Estimates of cost and cost-effectiveness are typically based on a limited number of small-scale studies with no investigation of the existence of economies to scale or intra-country variation in cost and cost-effectiveness. This information gap hinders the efficient allocation of health care resources and the ability to generalize estimates to other settings. The current study investigates the intra-country variation in the cost and cost-effectiveness of nationwide school-based treatment of helminth (worm) infection in Uganda. Programme cost data were collected through semi-structured interviews with district officials and from accounting records in six of the 23 intervention districts. Both financial and economic costs were assessed. Costs were estimated on the basis of cost in US$ per schoolchild treated, and an incremental cost-effectiveness ratio (cost in US$ per case of anaemia averted) was used to evaluate programme cost-effectiveness. Sensitivity analysis was performed to assess the effect of discount rate and drug price. The overall economic cost per child treated in the six districts was US$0.54 and the cost-effectiveness was US$3.19 per case of anaemia averted. Analysis indicated that estimates of both cost and cost-effectiveness differ markedly with the total number of children who received treatment, indicating economies of scale. There was also substantial variation between districts in the cost per individual treated (US$0.41-0.91) and cost per anaemia case averted (US$1.70-9.51). Independent variables were shown to be statistically associated with both sets of estimates. This study highlights the potential bias in transferring data across settings without understanding the nature of observed variations. 相似文献