基于RBRVS的产妇顺产分娩护理成本核算研究  

Study on nursing cost accounting of vaginal delivery in puerpera based on RBRVS

作　　者：汪次曼 于秀荣[1] 黄俊芝[1] 孙礼鹃 WANG Ciman;YU Xiurong;HUANG Junzhi;SUN Lijuan(Obstetrics Department,Binzhou Medical University Hospital,Binzhou 256600,China)

机构地区：[1]滨州医学院附属医院产科,山东滨州256600

出　　处：《中国临床护理》2023年第6期378-382,共5页Chinese Clinical Nursing

摘　　要：目的基于以资源为基础的相对价值系数(resource based relative value scale,RBRVS),核算产妇顺产分娩的护理成本,为制定合理的产房助产分娩收费标准提供科学依据。方法选取2021年11月-12月在山东省某三甲医院采用顺产方式分娩的126例产妇作为研究对象,借鉴RBRVS对其顺产护理项目的人力成本进行分析,确定人力成本相对价值比率,采用工时测定法对顺产实际操作时间进行测定,应用项目成本阶梯分摊法核算顺产项目实际护理成本。结果顺产护理操作总时间为(404.10±115.87)min,其中观察产程及宫缩耗费时间最长。顺产分娩服务项目总成本为(1216.61±357.68)元,其中人力成本为(759.92±219.62)元,占主要部分。结论产房顺产护理项目收费标准与实际成本有一定差距,建议顺产护理项目收费适时调整,充分体现助产人员的劳动价值。Objective To calculate the nursing cost of vaginal delivery based on the resource based relative value scale(RBRVS),so as to provide a scientific basis for the formulation of a reasonable charge standard for midwifery delivery.Methods A total of 126 parturients underwent the vaginal delivery in a grade-3 class A hospital in Shandong province in November and December of 2021 were selected as the research object.The labor cost of the nursing was analyzed by referring to RBRVS,and the ratio of labor cost to value was determined.Meanwhile,the actual operating time of vaginal delivery was measured by the man-hour measurement method.The project cost ladder allocation method was applied to calculate the actual cost of the natural delivery project.Results The total nursing operation time of vaginal delivery was(404.10±115.87)minutes,and the observation of labor and contractions took the longest time.The total cost of delivery services was(1216.61±357.68)yuan,among which the labor cost was(759.92±219.62)yuan,make up the bulk.Conclusion There is a certain gap between the fee standard and the actual cost of the vaginal delivery.It is suggested to adjust the fee of such nursing project in time to fully reflect the labor value of midwifery personnel.

关 键 词：产妇 顺产 护理项目 RBRVS 成本核算 价格 工时测定 

分 类 号：R473.71[医药卫生—护理学]