基于TD-ABC的医疗服务项目标准成本核算体系构建  

Construction and Thinking of Standard Cost Accounting System for Medical Service Items

作　　者：赵要军 谢双保 蒋帅 李利平 史展 娄鹿 靳科 王翔宇 郑丽[1] 穆子涵 ZHAO Yao-jun;XIE Shuang-bao;JIANG Shuai;LI Li-ping(China Fuwai Hospital/Central China Fuwai Hospital of Zhengzhou University,Zhengzhou,451460,China;不详)

机构地区：[1]华中阜外医院郑州大学华中阜外医院运营管理部,郑州451460 [2]河南省卫生健康委员会财务处,郑州450000 [3]郑州大学第一附属医院财务处,郑州450052 [4]河南中医药大学第一附属医院医疗价格管理办公室,郑州450099 [5]河南省第二人民医院财务科,郑州451191 [6]郑州市第一人民医院医务科,郑州450004 [7]中国人寿保险股份有限公司河南省分公司,郑州450002 [8]北京朝阳医院党委办公室,北京100020 [9]郑州大学公共卫生学院,郑州450001

出　　处：《中国卫生经济》2022年第6期31-34,37,共5页Chinese Health Economics

基　　金：河南省重点研发与推广专项(软科学研究)(222400410559);河南省卫生健康委重点项目(20200801A);河南省医学科技攻关计划联合共建项目(LHGJ20190813,LHGJ20200347)。

摘　　要：建立以临床价值为导向、以成本为基础、以科学方法为依托的医疗服务价格动态调整机制已成为价格改革的新遵循。针对当前医疗服务项目成本核算方法不统一、成本要素最小计价单元缺乏核算标准、技术劳务价值体现不充分等问题,以河南省省管8家代表性医院现行医疗服务项目为研究对象,借鉴估时作业成本法、标准成本法和临床专家咨询等方法,通过对2019年、2020年连续两年项目标准成本核算过程的探索性研究,从全流程管理角度构建了数据采集、数据处理、作业字典库、作业资源消耗、成本要素核算和成本核算平台等“六位一体”的医疗服务项目标准成本核算体系,以期为深化医疗服务价格改革提供参考借鉴。A new principle of price reform relying on scientific methods has reached based on clinical value and cost of medical services.In view of the current problems such as inconsistent cost accounting methods of medical service items,lack of accounting standards for the smallest unit of cost elements,and insufficient reflection of the value of technical labor,it takes the current medical service items of 8 representative hospitals managed by Henan Province as the research object,and comprehensively draws lessons from the methods of time-driven activity-based costing and clinical expert consultation based on the exploration of item standard cost accounting in 2019 and 2020.The"six in one"medical service item standard cost accounting system including data collection,data processing,activity dictionary library,activity resource consumption,cost item accounting and cost accounting platform has been constructed,in order to provide references for deepening the reform of medical service price.

关 键 词：估时作业成本法 医疗服务项目 作业资源消耗 标准成本 成本要素最小计价单元 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F224.5[经济管理—国民经济]