CN103942651A - Assessment method of hospital management cost control - Google Patents

Abstract

The invention discloses an assessment method of hospital management cost control. The assessment method comprises an assessment method of same-disease treatment cost control, an assessment method of clinical department cost control and an assessment method of hospital cost control. By means of the assessment method of the hospital management cost control, accuracy of the assessment method of the same-disease treatment cost control, the clinical department cost control and the hospital cost control is improved, and a novel practical method for improving profits of hospital management is provided.

Description

A kind of appraisal procedure of cost control of hospital management

Technical field

The invention belongs to the data processing method technical field that is applicable to public health medical industry, relate in particular to a kind of appraisal procedure of cost control of hospital management.

Background technology

Region or national medical conditions are determined jointly by factors such as health care policy, hospital services level, social economy's level, patient (or government provide) paying ability.The Major Function of hospital is for patient provides diagnosis and treatment service, and in medical services flow process, hospital realizes the direct link of serving patient.The diagnosis and treatment service (being product) of hospital directly offers patient's (being client), and patient has directly embodied the common people to the even evaluation of national health medical conditions of region to the satisfaction of service that hospital provides.Hospital services level is made up of Level of Hospital Management, medical technique level, medical worker's attitude, hospital's safeguards system etc., wherein Level of Hospital Management plays material impact effect to other factors, so can think that hospital management plays decisive role to hospital services level, and cost control in Operation of Hospitals process is to realize one of important means that Level of Hospital Management improves.The hospital that does not carry out cost control, its efficiency is difficult to reach optimum condition, is also just difficult to reach high-caliber hospital management state.

In economics and health economics works, " consumption philosophy " matrix formulation of famous Friedman ' s is: (1) can reach maximum saving and best effects by the thing that the money of oneself is done oneself, and the thing of doing oneself with others' money is effective best but saves not good; (2) can reach maximum saving by the thing that own money is done others but effect is uncertain, save with effect and be all not enough to maximum by the thing that others' money is done others.In Friedman ' s " consumption philosophy " matrix, the product correspondence of different qualities different prices, consumer, buying when product, can ownly determine press valency completely and do shopping, and reaches the expection object of saving and effect.But in Medical Consumption, medical services (product) can be fixed a price, but its quality cannot be unified (affected by medical condition, doctor's level, severity extent etc.); Suppose that medical service quality is consistent, medical outcome also cannot reach precognition completely.The determinative of medical procedure is the rule of disease, and disease cannot be comparable with other consumer goods in patient's complicacy.Medical procedure is subject to country medical service system, hospital's situation, medical worker's level etc. many factors simultaneously.Above-mentioned situation makes in Medical Consumption process, there is following feature: (1) spends the disease of the money treatment oneself of oneself, its effect and saving degree be subject to the external world (as, hospital, doctor, policy etc.) impact, can not necessarily reach maximum and save and best effects; (2) in like manner, spend others' money treatment oneself disease, spend the money of oneself treat others' disease and spend others' money to treat others' disease, also might not meet the statement of Friedman ' s " consumption philosophy " matrix, " Medical Consumption philosophy " matrix lost efficacy.

Summary of the invention

In view of the defect that above-mentioned prior art exists, the object of the invention is the appraisal procedure of the cost control that proposes a kind of hospital management.

Object of the present invention will be achieved by the following technical programs:

A kind of appraisal procedure of cost control of hospital management, comprise appraisal procedure, the appraisal procedure of cost control of clinical department and the appraisal procedure of the cost control of hospital of the cost control to same disease treatment, wherein, the appraisal procedure of the described cost control to same disease treatment comprises the following steps:

The expense Ii of the various medical items to same disease treatment and the rate of profit Pi of medical item carry out data collection, gather;

Calculate total expenses TC, gross profit SP, gross profit ratio P and medical item expense accounting R _i, wherein i=1,2 ..., n-1, n, I _ifor the expense of medical item, P _ifor the rate of profit of medical item, TC is total expenses, and SP is gross profit, R _ifor medical item expense accounting, the following formula of computing method:

Total expenses $\mathrm{TC}=\underset{i=1}{\overset{n}{\mathrm{\Σ}}}{I}_i,$

Gross profit $\mathrm{SP}=\underset{i=1}{\overset{n}{\mathrm{\Σ}}}{I}_i{P}_i,$

Gross profit ratio $P=\frac{\underset{i=1}{\overset{n}{\mathrm{\Σ}}}{I}_i{P}_i}{\underset{i=1}{\overset{n}{\mathrm{\Σ}}}{I}_i},$

Medical item expense accounting $R_i=\frac{I_i}{\underset{i=1}{\overset{n}{\mathrm{\Σ}}}{I}_i};$

Taking cost control as core, according to gross profit ratio P and medical item expense accounting R _icost control is assessed, and gross profit ratio P is higher, rate of profit P _ihigh medical item expense accounting R _ilarger, the assessment result of cost control is better.

Preferably, the appraisal procedure of the cost control of above-mentioned a kind of hospital management, the appraisal procedure of the cost control of wherein said clinical department comprises the following steps:

To the medical expense per capita of a clinical department gross profit ratio P, accepts patient for medical treatment and counts N, the basic cost d of section office, staff's unsteady bonus x carry out data collection, gather;

Calculate the profit PD of section office, wherein c is the medical profit of accepting each patient for medical treatment, and computing method are public as follows

Formula:

Accept each patient's medical profit for medical treatment

The profit PD=cN-x-d of section office;

Taking cost control as core, according to the profit PD of section office, cost control is assessed, profit PD is higher in section office, and the assessment result of cost control is better.

Preferably, the appraisal procedure of the cost control of above-mentioned a kind of hospital management, the appraisal procedure of the cost control of wherein said hospital comprises the following steps:

The Outpatient personal medication cost of a hospital is used outpatient service person-time N _o, the average medical expense of being in hospital , person-time N is in hospital _i, cost of drugs C _d, high-value consumables cost C _c, other medical treatment costs C _o, the basic remuneration P of personnel _b, the unsteady bonus X changing with workload, non-medical treatment cost C _ncarry out data collection, gather;

Calculate the profit PH of hospital, wherein k is constant, the following formula of computing method:

Hospital's profit $\mathrm{PH}=(N_o\stackrel{\‾}{m}+N_i\stackrel{\‾}{m})-(C_d+C_c)-k,$

k＝C _o+P _b+C _n+X；

Taking cost control as core, according to the profit PH of hospital, cost control is assessed, profit PH is higher in hospital, and the assessment result of cost control is better.

Outstanding effect of the present invention is: the appraisal procedure of the cost control of a kind of hospital management that the present invention proposes, improving the accuracy of the appraisal procedure of the cost control to same disease treatment, clinical department and hospital, providing a kind of new hands-on approach for how improving the profit of hospital management.

Below just accompanying drawing in conjunction with the embodiments, is described in further detail the specific embodiment of the present invention, so that technical solution of the present invention is easier to understand, grasp.

Brief description of the drawings

Fig. 1 is that the section office of the embodiment of the present invention 2 accept number and the profit relation schema figure of section office for medical treatment;

Fig. 2 is medical worker's remuneration and the profit relation schema figure of section office of the embodiment of the present invention 2.

Embodiment

Below by specific embodiment, method of the present invention is described, but the present invention is not limited thereto.Experimental technique described in following embodiment, if no special instructions, is conventional method; Described reagent and material, if no special instructions, all can obtain from commercial channels.

Embodiment 1

The present embodiment provides 2 Different hospitals to carry out severed finger reunion (1 finger) operation, and the expense Ii of its various medical items sees the following form 1:

Table 1

In table 1, Operation Fee, anesthesia and custody fee, the rate of profit P of berth and diagnosis and treatment expense _n=100%, the rate of profit P of auxiliary consultation fee _n=40%, the rate of profit P that medicine takes _n=15%; The rate of profit of fee of material is P _n=5%.

According to formula: gross profit ratio the gross profit ratio that calculates hospital 1 is 44.4%, and the gross profit ratio of hospital 2 is 79.5%; According to formula: medical item expense accounting result of calculation is presented at the numerical value in the bracket in table 1.

Taking cost control as core, according to gross profit ratio P and medical item expense accounting Ri, cost control is assessed, hospital 1 is by anesthesia and custody fee use, drug expenditure, Master Cost etc., reaches that medical total expenses increases and source of profit increase, but gross profit ratio decline; Hospital 2, surgery cost ratio increases and other fees reduce, and reach and reduce medical total expenses, but gross profit ratio increases.Can obtain thus, hospital 2 is better than the assessment result of the cost control of hospital 1.

Embodiment 2

Section office's gross income of the present embodiment if medical expense is per capita : n is for accepting patient's quantity for medical treatment.

Medical department cost comprises: medical treatment cost (medicine, medical material, consumptive material etc.), medical worker's remuneration (wage, bonus, subsidy, welfare and social insurance), hospital's overhead cost (depreciation of fixed assets, non-medical material, operating cost, other).

Suppose: hospital's overhead cost is constant a, medical worker's remuneration is P ₀+ x, medical treatment cost is :

Section office's profit $(\mathrm{profit\; of\; Dep}.,\mathrm{pD})=N\stackrel{\‾}{M}P-x-(a+P_0),$

P ₀for the basic remuneration of medical worker, medical worker's income variation is mainly reflected in the unsteady bonus x changing with workload.Order c is the medical profit of accepting a routine patient for medical treatment, the basic cost that d is section office.:

PD＝cN-x-d，

That is: section office's profit (PD) by accepting patient's number (N) for medical treatment, medical profit (c), the basic cost (d) of section office and medical worker's the unsteady bonus (x) of accepting each patient for medical treatment determine jointly.

In medical control practice, to establish: over a period to come, medical expense is constant per capita, section office's basic cost is fixed, and section office's profit is by accepting patient's quantity for medical treatment and unsteady bonus determines _.

Generally, work as N=0, PD=-d, works as N=N ₀, PD=0, works as N=N _x, PD=cN _x-d, as N≤N _x: x=0:: medical worker's remuneration is P ₀as N > N _x: x > 0:: medical worker's remuneration is P ₀+ x, works as N=N _maxtime, PD=PDmax: medical worker's remuneration is P ₀+ x _max.

Set: N _maxstate is that section office's maximum is accepted capacity for medical treatment, is now setting the each side such as staff's number, working effect and efficiency, economic benefit in optimum condition; Exceed this limit, need to newly increase section office and arrange.Accept number for medical treatment while being 0 when section office, the cost of bearing is d, and section office's profit is-d; Accept number for medical treatment and reach N ₀, section office realize balance between revenue and expenditure, and section office's profit is 0; When accepting number for medical treatment for N _xtime, section office's profit is cN _x-d, now, medical worker's workload reaches some, then while increasing workload (increase and accept number for medical treatment), should increase medical worker's remuneration, and section office's rate of profit changes; Reach N when accepting number for medical treatment _max, section office's profit reaches PD _max; After this, increase and accept number for medical treatment, because needs increase personnel, increase risk etc., occur that section office's profit declines, as shown in Figure 1.Section office manage the initial stage, and profit is at-d～cD _xbetween-d time, medical worker's remuneration is basis income P ₀; Along with section office's profit increases, medical worker's remuneration increases gradually, reaches mxm. P ₀+ x _max; Section office's profit declines, and declining appears again in medical worker's remuneration.As shown in Figure 2.

Embodiment 3

The gross income (gross income, GI) of hospital comprises government subsidy, the society's contribution etc. that medical income, social responsibility obtain.If medical income comprises clinic income (income from out-patients, I _o) and the income (income from patients in hospital, Ii) of being in hospital:

$I_o=N_o\stackrel{\‾}{m},$

for Outpatient personal medication cost use, N _ofor outpatient service person-time, for the average medical expense of being in hospital, N _ifor be in hospital person-time.

The government subsidy that social responsibility obtains and society's contribution are expressed as B:

$\mathrm{GI}=N_o\stackrel{\‾}{m}+N_i\stackrel{\‾}{m}+B,$

The cost (cost of hospital, CH) of hospital comprises: medical treatment cost (medicine, medical material, consumptive material etc.), staff's remuneration (wage, bonus, subsidy, welfare and social insurance), non-medical treatment cost (depreciation of fixed assets, non-medical material, operating cost, Development of Hospital fund, other).

Medical treatment cost (medical treatment cost, C _m) comprise cost of drugs (C _d), high-value consumables cost (C _c) and other medical treatment costs (C _o); Personnel's remuneration comprises basic remuneration (P _b) (as wage, welfare, social insurance etc.) and with workload change unsteady bonus (X) (as subsidy, bonus); Non-medical treatment cost (C _n) comprise two parts, i.e. non-medical fixed cost (depreciation, expansion funds etc.) and non-medical flotation costs (non-medical material, operating cost, other), the latter can be by strict budget, effectively management be controlled, so we are C _nregard constant as.

:

CH＝C _d+C _c+C _o+P _b+X+C _n， (4.1)

Make A=C _o+ P _b+ C _n:

CH＝A+(C _d+C _c+X)， (4.2)

Can be obtained by formula (4.1), (4.2), hospital's profit (profit of hospital, PH) can be expressed as:

PH＝GI-CH，

That is:

$\mathrm{PH}=(N_o\stackrel{\‾}{m}+N_i\stackrel{\‾}{m}+B)-[A+(C_d+C_c+X)],$ (4.3)

In China, many hospitals obtain government subsidy and society's contribution is very limited, B ≈ 0 in formula (4.3), that is:

$\mathrm{PH}=(N_o\stackrel{\‾}{m}+N_i\stackrel{\‾}{m})-[A+X+(C_d+C_c)]$ (4.4)

Carry out in cost control process non-medical treatment cost C in some hospitals _n, the basic remuneration P of personnel _ball can regard constant as, bonus X and other medical treatment costs C float ₀increase to some extent with portfolio increase, but change not quite, can regard constant as with respect to the gross income of hospital, can establish: A+X is constant k.Formula (4.4) can be expressed as:

$\mathrm{PH}=(N_o\stackrel{\‾}{m}+N_i\stackrel{\‾}{m})-(C_d+C_c)-k.$

As can be seen here, in the situation that business income is certain, the profit PH of hospital is affected by high-value consumables and medicine mainly, and the cost of controlling high-value consumables and medicine can effectively reduce medical expense or increase hospital's profit.

The present invention still has numerous embodiments, and all employing equivalents or equivalent transformation and all technical schemes of forming, within all dropping on protection scope of the present invention.

Claims (3)

1. the appraisal procedure of the cost control of a hospital management, comprise appraisal procedure, the appraisal procedure of cost control of clinical department and the appraisal procedure of the cost control of hospital of the cost control to same disease treatment, wherein, the appraisal procedure of the described cost control to same disease treatment comprises the following steps:

The expense I of the various medical items to same disease treatment _irate of profit P with medical item _icarry out data collection, gather;

Calculate total expenses TC, gross profit SP, gross profit ratio P and medical item expense accounting R _i, wherein i=1,2 ..., n-1, n, I _ifor the expense of medical item, P _ifor the rate of profit of medical item, TC is total expenses, and SP is gross profit, R _ifor medical item expense accounting, the following formula of computing method:

Total expenses $\mathrm{TC}=\underset{i=1}{\overset{n}{\mathrm{\Σ}}}{I}_i,$

Gross profit $\mathrm{SP}=\underset{i=1}{\overset{n}{\mathrm{\Σ}}}{I}_i{P}_i,$

Gross profit ratio $P=\frac{\underset{i=1}{\overset{n}{\mathrm{\Σ}}}{I}_i{P}_i}{\underset{i=1}{\overset{n}{\mathrm{\Σ}}}{I}_i},$

Medical item expense accounting $R_i=\frac{I_i}{\underset{i=1}{\overset{n}{\mathrm{\Σ}}}{I}_i};$

Taking cost control as core, according to gross profit ratio P and medical item expense accounting R _icost control is assessed, and gross profit ratio P is higher, rate of profit P _ihigh medical item expense accounting R _ilarger, the assessment result of cost control is better.

2. the appraisal procedure of the cost control of a kind of hospital management according to claim 1, is characterized in that the appraisal procedure of the cost control of described clinical department comprises the following steps:

To the medical expense per capita of a clinical department gross profit ratio P, accepts patient for medical treatment and counts N, the basic cost d of section office, staff's unsteady bonus x carry out data collection, gather;

Calculate the profit PD of section office, wherein c is the medical profit of accepting each patient for medical treatment, the following formula of computing method:

Accept each patient's medical profit for medical treatment

The profit PD=cN-x-d of section office;

Taking cost control as core, according to the profit PD of section office, cost control is assessed, profit PD is higher in section office, and the assessment result of cost control is better.

3. the appraisal procedure of the cost control of a kind of hospital management according to claim 1, is characterized in that the appraisal procedure of the cost control of described hospital comprises the following steps:

The Outpatient personal medication cost of a hospital is used outpatient service person-time No, the average medical expense of being in hospital person-time N is in hospital _i, cost of drugs C _d, high-value consumables cost C _c, other medical treatment costs C _o, the basic remuneration P of personnel _b, the unsteady bonus X changing with workload, non-medical treatment cost C _ncarry out data collection, gather;

Calculate the profit PH of hospital, wherein k is constant, the following formula of computing method:

Hospital's profit $\mathrm{PH}=(N_o\stackrel{\‾}{m}+N_i\stackrel{\‾}{m})-(C_d+C_c)-k,$

k＝C _o+P _b+C _n+X；

Taking cost control as core, according to the profit PH of hospital, cost control is assessed, profit PH is higher in hospital, and the assessment result of cost control is better.