作业成本法在医院调剂服务成本测算中的应用

Application of Activity-based Costing in Cost Accounting of Inpatient Pharmacy Dispensing Service

目的:测算医院住院药房调剂服务的项目成本,为我国开展相关调查以及合理设定药事服务费提供依据。方法:采用作业成本法,在样本医院住院药房中测算不同调剂项目的单位医嘱成本,以获得病区医嘱调剂的单项服务总成本,并进行敏感度分析。结果:住院药房不同调剂项目单位医嘱成本单剂量摆药为0.68元,病区非单剂量摆药为0.31元,处方调配为1.99元,静脉输液冲配为3.41元。敏感度分析结果表明,相比固定资产成本等其他方面成本,人力成本对调剂总成本的影响最大。结论:作业成本法在调剂服务成本测算中具有可行性,可以更科学地分配间接成本。不同调剂项目之间的单位成本有显著差异,不能单纯以处方费或医嘱数量来计算药事服务费。

OBJECTIVE：To measure the item cost of dispensing service of inpatient pharmacy using Activity-Based Costing（ABC） . METHODS：According to the ABC method,the total cost of single-item service was calculated through measuring unit-costs among the different methods of dispensing in the model of inpatient pharmacy. Sensitivity analysis was conducted. RESULTS：The costs per medical order dispensed by different ways were：single-dose dispensing was 0.68 yuan,dispensing for ward was 0.31 yuan,prescription dispensing was 1.99 yuan,intravenous admixture was 3.41 yuan. Results of sensitivity analysis showed human cost influenced the total cost of dispensing significantly,compared with the others of fixed assets cost. CONCLUSIONS：The application of the ABC method in dispensing service accounting is feasible,and it distributes the indirect costs scientifically. The unit costs of different dispensing item have significant difference,and it is unscientific to calculate pharmaceutical care fees only by prescription fees or the number of medical order.