静脉输液实际消耗成本核算研究

目的:准确核算滨州市公立医疗机构静脉输液实际消耗成本,为制定合理的护理项目收费标准提供数据支持。方法:采用便利抽样方法,分别选取滨州市一、二、三级公立医疗机构各一家,收集其2010年的相关资料;运用项目成本核算法测算样本公立医疗机构不同途径静脉输液的实际消耗成本,分析成本构成并比较与政府定价的差异。结果:样本公立医疗机构静脉输液实际消耗成本为:三级普通钢针途径为25.46元、留置针途径为24.54元、PICC途径为36.87元、CVC途径为35.88元;二级普通钢针途径为19.80元、留置针途径为19.39元;一级普通钢针途径为15.55元。与政府定价之间的差距为12.60～30.87元,成本补偿率为11.78%～30.94%;分析其成本构成,占总成本比例最高的是护理人力成本,为39.05%～53.25%。结论:静脉输液实际消耗成本与现行收费标准差距悬殊,建议相关部门在项目成本科学核算的基础上,合理调整静脉输液收费标准。

Actual cost consumption accounting of venous transfusion in public medical institutions

Objectives：To calculate the actual cost consumption of venous transfusion accurately in public medical institutions in Binzhou and to provide data evidence for formulating reasonable charging standard of nursing projects. Methods：Three public medical institutions in Binzhou,each one from First-Grade, Second-Grade and Third-Grade public medical institutions respectively, were selected by representative sampling.We collected the related data in 2010 of each institution, calculated the actual cost consumption of different infusion methods using the project cost accounting, method, analyzed cost construction, and compared the difference between actual cost and current valorization. Results： The actual cost consumption of normal steel needle method, indwelling needle method, PICC method. and Central Venous Catheter（CVC） method of venous transfusion in Third-Grade public medical institution were 25.46, 24.54, 36.87, and 35.88 yuan respectively. The actual cost consumption of normal steel needle method and indwelling needle method in Second-Grade institution were 19.80 and 19.39 yuan respectively.. The actual cost consumption of normal steel needle method in First-Grade institution was 15.55 yuan. The price gaps between actual cost consumption and valorization were 12.60-30.87 yuan and the cost compensation rates were only 11.78-30.94%. The highest proportion of total venous transfusion cost was the nursing human costs which ranged from 39.05% to 53.25%. Conclusion： There are enormous gaps between actual cost consumption of venous transfusion and current valorization. The government should adjust current charging standard based on scientific project cost accounting of venous transfusion.