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论文编号：	849
作者编号：	2220060646
上传时间：	2008/6/27 10:00:07
中文题目：	医院全成本管理研究
英文题目：	The researching on total cost
指导老师：	黄菊姗 副教授
中文关键字：	医院管理 全成本管理 成本分摊
英文关键字：	Hospital management Total cos
中文摘要：	随着社会主义市场经济体制的不断完善和医疗服务竞争的日益激烈，医院作为由政府实行一定福利政策的社会公益性卫生事业的组成部分，其经济管理也越来越受到医院管理者的重视。如何控制医疗卫生支出，降低医疗费用的增长速度，已成为国内外卫生经济专家和医院管理者研究的焦点问题。因此，作者提出引进和借鉴企业管理的成功经验，在医院内部推行全成本核算，运用成本管理，努力降低医疗成本，减轻患者的负担，有效占领医疗市场，获得相应的经济效益，提高医院的生存与发展能力。 本文文献综述部分概括评述了国外政府部门在加强成本管理方面的种种举措，同时也介绍了国内医院成本核算发展的阶段及理论研究成果。第二部分是全文的理论基础，在对非营利组织理论的基础上，引入管理会计中相关理论，如成本习性、标准成本的理论，结合医院成本核算的特点，初步构建了医院全成本概念体系，并从成本核算与医院管理的角度，尝试提出一些成本管理的改革思路。 论文的主体部分，提出采取四级分摊方法，逐级逐项分摊到直接医疗科室。将各科室直接发生的成本直接计入到该科室。然后按顺序进行四级分摊：第一级管理成本分摊；第二级医疗辅助成本分摊；第三级医技科室成本分摊，第四级药品成本分摊。并通过对各级分摊的方法、分摊参数的设定，分别将全院的各项成本逐级分步骤的分摊到直接医疗科室中，充分披露各级各类科室的全部成本。案例分析中，作者将该研究方法应用到TICH医院中，结合其全成本核算实施过程，分析它的成本情况和运营现状，建立了“门诊人均费用”、“住院床日成本”等一系列业绩评价指标，通过指标的相互可比，为科学衡量医院管理水平提供依据，对于改进医院财务管理工作，提高医院竞争力具有重要作用，并从医院管理学的角度提出：医院实施全成本核算后，“优质、高效、低耗”的现代医院管理模式具有了更丰富的内涵。最后，本研究归纳了试点医院成本核算过程中遇到的一些问题并提出几点浅显的建议，希望能够为今后其他医院顺利开展全成本核算有所裨益。
英文摘要：	Hospital is taken as a composing of the welfare policy and social nonprofit health service, which is executed by the government. Along with the deepening of the medical system reform and the competition among the medical services, the governors of the hospital regard its management economy more and more. So how to control the payout of medical service and how to depress the increasing speed of medical cost becomes the focus issue of both domestic and foreign medical economists’ and hospital governors’ study. Therefore, the author presents that we should introduce and learn the successful experience from enterprises; we should execute the total cost management in the hospital, in order to reduce medical cost, lighten the burden of patients, occupy the medical market to gain the corresponding economic benefit, and then promote the ability of existence and development. This thesis document summary part briefly commentates foreign governments’ kinds of acts of strengthening the cost management, and also introduces the domestic theory researching results of cost management of hospital. The second part introduces the related theories of nonprofit organizations, administrative accounting and cost management, which establishes the theoretic basis of further research. The third part tries to present some new reforming trains of thought based on the analysis of disadvantages of hospital’s current cost management, therefrom presents the concept of total cost management, initially frames hospital’s total cost concept system, and evaluates and analyzes its effects. The main part of this thesis presents that to use the four-class distribution method, which means to distribute to the direct medical departments by level. The direct cost of this department will be charged to this department, and then allocates by four levels by steps: the first level is management cost allocation, the second level is medical assistance cost, the third level is medical and technical department cost allocation, the forth level is medicine cost allocation. By setting up the methods and parameters of allocation, the whole hospital’s kinds of cost will be distributed into direct medical departments by levels and by steps, the total cost of every level and every category will be showed clearly. In the case analysis, the author uses this research method on the TICH, combines with implementation of the total cost management the author analyzes its cost situation and operation actuality. The author builds series of performance evaluation index such as “average cost of out-patient department”, “days of hospitalizations cost” and so on, and then provides the basis for measuring the management level of the hospital scientifically. The author also presents the idea from the hospital management point of view: to execute the total cost management will enrich the “high-quality, effective, low-cost” modern hospital management model. At the end, this research summarizes the problems came out from the process of hospital’s cost management, and gives some simple advices. The author hopes the research will help other hospitals to develop total cost management.
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