国外医院成本控制研究概况

Current status in research for hospital cost control in abroad

目的学习和借鉴国外医院在成本控制研究上的经验。方法查阅国外期刊上公开发表的有关医院成本核算(控制)管理方面的论文,介绍他们在医院成本核算研究上的先进理念和方法。结果在国外医院成本控制研究中应用较多且具有代表性的有:ISO9000簇标准,侧重于过程质量控制以降低成本;作业成本法应用病种标准(计划)成本,从源头上减少无效或低效作业以控制成本;平衡计分卡综合分析医院外部环境与内部资源,利用一套"平衡"指标体系,超越传统(仅从财务)角度测评组织绩效全貌的方法,以提高效率控制成本。结论先进的成本控制(管理)理念主要是:培养全员成本意识;实施高质量低成本战略;实施管理职能、采用先进核算方法;改革传统付费方式、引入第三方监督机制等,达到了有效控制医院成本的目的。

Objective To learn and use the experience in research for hospital cost control from other countries. Methods The published papers in research for hospital cost control in abroad were reviewed. The advanced theories and methods were also introduced. Results The more used research tools for hospital cost control were as followed. The standard of ISO 9000 was emphasized to decrease the cost by performance quality control. The activity based costing （ABC） calculated the hospital cost based on the kind of sickness. It controls the cost from the source by reducing invalid and low efficiency work. The balanced score card （BSC） was designed to analysis hospital external environment and in hospital resources. It enhances the efficiency control cost by using a set of balanced indicator system,surmounting traditional method evaluated the complete picture of the organization s achievements and efficiency. Conclusion The mainly advanced cost control idea is training the cost awareness of full staff,implementing the high-quality and low-cost strategy, strengthening management function by using the advanced cost accounting method, reforming traditional payment way,introducing a third party supervising mechanism and so on. It has achieved the active function for hospital cost control.