我国公立医院成本核算影响因素分析及制度建设

Analysis of cost accounting influencing factors for public hospitals in China and the institutional building

医院成本核算系统的影响因素可归为3类：驱动与激励因素、影响真实性与准确性的因素以及影响医院选择与应用的因素。随着DRG支付的广泛使用，成本核算得到前所未有的发展。在我国支付制度改革和公立医院补偿机制转换趋势下，精确支付、合理补偿以及公立医院内部成本绩效管理对成本核算提出新需求，公立医院成本核算制度亟待建立。需从宏观、微观目标同时出发，满足不同层级的需求，配合联动，才能最大化实现成本核算制度的作用。

The factors influencing cost accounting fall into such three categories as drivers and incentives, factors affecting authenticity and accuracy,and factors affecting application and selection. DRG payment, as it is getting more popular than before, is pushing forward cost accounting at an unprecedented pace. Thanks to the current payment system reform and the transition of public hospital reimbursement regime, such needs as exact payment, just compensation and cost/performance management of such hospitals are challenging the present cost accounting system, calling for the birth of a cost accounting system for these hospitals. To build such a system, micro- and macro-level goals need to be considered simultaneously, while needs of different levels should be designed, integrated and interacted with each other. Only in this way,goals can be reached for such a system.