基于估时作业成本法的医院超声造影诊断肝占位的成本研究

Cost Analysis of Imaging Diagnosis of Focal Liver Lesions by Contrast-enhanced Ultrasound From a Hospital Perspective Based on Time-driven Activity-based Costing

目的:立足医院视角测算超声造影诊断肝脏占位性病变的资源消耗及成本结构,旨在验证测算方法的可操作性,准确量化该项目在医院中的实际运行情况,为项目定价和医院成本管理提供参考依据。方法:选择技术运用较为成熟的8家三甲医院为样本,采用估时作业成本法(time-driven activity-based costing,TDABC)以时间为单位对不可直接追溯成本进行分摊。结果:使用SonoVue的肝脏占位性病变超声造影总成本为748.30元/例,其中药费占70.19%,人力和设备资源占28.40%。结论:在肝占位领域选择超声造影进行病灶定性的成本较低。在现有基础上,医疗机构可以通过流程重组与人员培训等进一步降低资源消耗。研究证明,在医疗卫生领域应用TDABC可以更准确地梳理医院实际运行情况,更有效地配置各种资源,对公立医院内外部成本控制有积极意义。

Objective:To estimate the cost of imaging diagnosis of focal liver lesions(FLLs)by contrast-enhanced ultrasound(CEUS)from a hospital perspective,aiming to validate the applicability of the measurement methodology,accurately quantify the actual operation of the CEUS,so as to provide a reference basis for project pricing and hospital cost management.Methods:Eight tertiary hospitals with mature technology use were selected as a sample and a survey was implemented.Based on time,the time-driven activity-based costing(TDABC)was used to apportion non-directly traceable cost.Results:The total cost of diagnosing FLLs by CEUS with SonoVue was￥748.30 per case,of which the drug cost accounted for 70.19%,and human and equipment resources accounted for 28.40%.Conclusion:The cost of choosing CEUS for FLLs is low,based on which hospitals can further reduce resource consumption through process reorganization and staff training.The study proves that the application of TDABC in the healthcare field can not only describe the actual operation of service in hospitals more accurately but also enable more effective allocation of various resources,which has positive implications for internal and external cost control in public hospitals.