社区卫生服务站作业成本核算应用研究

Activity-Based Cost Accounting in Community Health Service Institutions

目的探讨作业成本法在社区卫生服务站成本核算中的适用性及社区卫生服务站存在的问题。方法选取北京市某区功能较齐全、数据基础较完善的1家社区卫生服务站,通过定性访谈和直接观察相关信息,2006年6-8月按作业成本核算步骤进行成本核算。结果社区卫生服务站平均每人次诊疗服务(含出诊)成本为25.03元,次均诊疗收入为11.32元;次均口腔诊疗成本为169.11元,而次均口腔诊疗收入为97.99元;收不抵支部分和健康档案等成本消耗,依赖药品结余补偿。结论用作业成本法核算结果更准确,但程序复杂,结果可以为建立社区卫生服务站新的补偿机制提供依据。

Objective To apply activity -based costing in cost accounting in community health service institutions （ CHSI）, and to analyze the existing problems in CHSI and the feasibility of this method. Methods A community health service institution in a district of Beijing whose functions are complete and datum basis is perfect was selected. Its relative information was collected through qualitative interview and direct observation, and the cost accounting from June to August 2006 was performed according to activity -based cost accounting. Results The average cost of medical care per person was 25. 03 Yuan, while the average revenue was 11. 32 Yuan. The average cost of dentistry care per person was 169. 11 Yuan, while the average revenue was 97. 99 Yuan. The financial deficit and the cost in health record were compensated by balance of pharmaceuticals. Conclusion The result of activity - based cost accounting is more accurate but its procedure is complex, however it can provide evidence for community health service institution to set up new compensatory mechanism.