基于估时作业成本法的增强MRI诊断肝脏占位性病变成本核算研究

Study on Cost Accounting of Focal Liver Lesions Diagnosed by Contrast-enhanced MRI Based on Time-driven Activity-based Costing

目的:基于估时作业成本法,对增强MRI诊断肝脏占位性病变的资源消耗成本进行核算。方法:选取东、中、西部的5家三甲医院影像科作为成本核算的对象,现场调研样本医院的设备服务利用情况、运行成本以及医务人员进行检查时主要环节操作的作业时间等信息。采用估时作业成本法,测算2018-2020年增强MRI诊断肝脏占位性病变的成本。结果:经测算,2018-2020年增强MRI诊断肝脏占位性病变的单位成本分别为994.83元、976.69元和958.81元。其中,人力资源和设备相关的成本所占比例较高,2018-2020年分别占整个项目成本的52.46%、53.67%和54.28%。结论:采用估时作业成本法进行成本核算,能清楚地反映医院及科室相应资源的利用情况,可为医院服务项目定价、医院运营精益化管理及以价值为导向的医保支付方式发展提供相应的数据信息、决策依据及相关建议。

Objective:To measure the cost of resource consumption in contrast-enhanced MRI for diagnosing focal liver lesions based on time-driven activity-based costing.Methods:The imaging departments of five grade-A tertiary hospitals in the east,central and west were selected as the target of cost accounting.The information on the utilization of equipment services,operating costs,and the operating time of the primary operations performed by medical staff in the sample hospitals were investigated on-site.Time-driven activity-based costing was used to measure the cost of contrast-enhanced MRI for diagnosing focal liver lesions from 2018 to 2020.Results:The unit costs of contrast-enhanced MRI for diagnosing focal liver lesions were measured to be 994.83 yuan,976.69 yuan and 958.81 yuan in 2018-2020,respectively.Among them,the human resources and equipment-related costs were high,accounting for 52.46%,53.67%and 54.28%of the overall project costs from 2018 to 2020 respectively.Conclusion:The application of time-driven activity-based costing in cost accounting can clearly reflect the utilization of related resources in hospitals and departments.It can provide corresponding data information,decision basis,and relevant suggestions for the pricing of hospital services,lean management of hospital operations,and the development of health insurance value-based payment.