基于三种方法的医疗服务病种成本测算比较研究

文章以宁夏某县级医院为样本,选取15种代表性疾病,采取了以项目平均成本、临床路径和床日成本与费用3种方法进行成本测算。方法一,发现15个主要病种平均病种费用为4 129.65元,平均成本为4 597.74元,平均例均费用低于成本405.09元;方法二,研究表明15个主要病种平均成本为3 456.17元,平均例均费用高于成本为673.48元;方法三,病种费用普遍低于成本,但费用与成本相差不大,费用低于成本平均为553.23元。建议,在完善信息系统的基础上,实施以临床路径和成本测算为基础的单病种支付方式,以提高医院管理水平。

The Comparison Study on the Hospital Cost Reckoning based on three methods

The study chooses 15 representative diseases in one county hospital of Ningxia,and gives cost reckoning by three methods of average unit cost,clinical pathway and per bed cost.The results found that,for the first method,average expenditure of 15 diseases is 4 129.65 yuan whereas the average cost is 4 597.74 yuan,and the former is lower than the latter with 405.09 yuan;for the second method,the average expenditure is higher than the costs with 673.48 yuan;but the third methods found the average expenditure is lower than average cost with 553.23 yuan.At last,it is suggested that payment of per disease based on the cost reckoning and clinical pathway be implemented in the hospital reform with the strengthening management of information system.