临床路径下病种人力成本核算模型初探

Manpower cost accounting model for diseases in clinical pathway

目的了解临床路径下病种人力成本核算研究进展,为今后开展病种人力成本核算的研究提供参考。方法通过文献回顾法,总结病种人力成本核算的研究现状。结果①医疗收费价格与成本间存在一定程度的背离;②病种成本中人力成本占比较低,医务人员劳务价值没有得到充分体现;③缺乏对病种人力成本核算模型的专项研究。结论基于临床路径的病种成本核算能有效规范药品耗材使用与诊疗流程,但在病种人力成本数据标化方面仍存在空缺。通过构建以医务工作人员工资绩效水平、区域经济调整系数、医院经济效益调整系数与病种风险难度调整系数为核心的病种人力成本核算模型,计算标准化的病种人力成本,能够使病种成本核算结果以及基于其定价的收费更趋合理。

Objective To review the literature on human cost accounting of diseases in clinical pathway and provide reference for the research in human cost accounting of diseases in the future. Methods Literature review was used to summarize the research status of manpower cost accounting of diseases. Results There is,in certain level,a deviation between medical charges and costs;The manpower cost is relatively low in disease costs,and the service value of medical staff is not fully demonstrated;Special research on the human cost accounting model of diseases is rare. Conclusion While the cost accounting of diseases based on clinical pathway can effectively regulate the use of medical consumables and the diagnosis-treatment process,the standardization of human cost data of diseases is rarely covered. The construction of a disease cost accounting model focusing on the wage and performance of medical staff,adjustment coefficient of regional economy,adjustment coefficient of hospital economic benefit and adjustment coefficient of disease risks for calculation of standardized disease manpower costs can make the disease cost accounting and charging based on fixed prices more rational and reasonable.