【作者】 潘爱斌；

【导师】 江启成；

【作者基本信息】 安徽医科大学 ， 社会医学与卫生事业管理， 2004， 硕士

【摘要】 目的：本研究通过对某一试点医院的工资成本、医疗消耗和管理及科教费用等全部成本项目进行归集和分摊，从而确定科学合理的材料消耗定额、工资成本比例和管理费用标准。方法c以铜陵市第四人民医院作为研究对象，采用医疗服务调查表的方式获取医院的基本信息、概况资料、科室基本支出以及管理和后勤费用等财政资料，进行院科两级的成本核算，分别将管理成本、医疗辅助科室成本、医疗技术科室成本和药品经营成本分三个等次分摊到各临床科室。结果：报告期内的医院总成本为25，393，427元，其中医疗服务成本为15，174，119元，占总成本的59.76％；药品经营成本为10，219，308元，占总成本的40.24％；药品经营收益占医院总收益的68.26％，医疗服务部门当期收益为负值，差额靠政府财政补助和药品经营收入来填补；医院管理人员占全院职工总人数的14.8％，管理经营成本是5，429，414元，占全院总支出的21.42％；报告期内人员经费为7，197，345元，比上年度增加642，141元，占全院总支出的26％。结论：医院的大型医疗设备和固定资产的使用统一走全院后勤和管理费用划账，掩盖了科室之间成本的真实区别；根据科室每阶段利润分配奖金有利于奖金分配的公平性，真实反映创收大户和利润大户的差别；药品经营部门按照当期收益占全院总收益的百分比来承担相应的管理费用，可以平衡药品和医疗部门收益之间的巨大差别，同时实行药品收入定额管理来降低药品经营在医院经营中的比重；单独设立医院管理帐户，实行管理成本的定额管理可望降低过高的管理成本。更多还原

【Abstract】 Objective: To definite the scientific and reasonable medicine material expenditure ration, pay-cost portion and management expenditures standards, all cost items , including pay-cost, medical expenditures, management costs, and scientific study and training costs ,were returned and apportioned in a experimental unit hospital in this study. Methods: Basic information, general situation and the fundamental expenditures of all section offices were obtained from the designed medical questionnaires, and the management and logistics costs were divided by three ranks and apportioned to the different clinical section offices respectively in the selected top-two-level hospital. Results: All clinical section offices’ apportioned costs were reported. In reporting period, the dealing-in medicament costs were 10,219,307.56 Yuan, which was 68.26% in the total benefits of the hospital, while the total medicine benefits were negative value. The income of the departments of pediatrics and internal medicine ranked third and fourth among all clinical departments’ income, but the benefits of the departments of pediatrics exceeded that of the departments of internal medicine; the benefit of the departments of stomatology owed to 12,002 Yuan. The number of the manager accounted 14.8% in total hospital employees. The management costs, which were 20, 033, 480, 000 Yuan, were 21.42% in the hospital total expenditures. In reporting period, the employees’ costs were 7, 197, 345 Yuan, which was 26% in the hospital total expenditures and increased by 642.121 Yuan compared with that of last reporting period. Conclusion: The expenditures of the advanced medical treatment equipments and fixed assets were expended from the logistics and management costs, which revealed the difference of the costs of all section offices. The departments’ bonuses were allocated in term of every period profits, which in favored of the equality of the allocated and reflected thedifference between the most income section office and the most profit section office. The department of medicament dealing-in afforded the management costs by the percentage of accounting in the total benefits in the period, which balanced the difference between medicament benefits and medicine benefits. Carrying out ration management of medicament income could lower the percentage of medicament dealing-in in the hospital management. Establishing the hospital management account separately and carrying out ration management of management costs were expected to lower the very high management costs.更多还原