基于作业成本法的A医院成本管理研究

发布时间：2018-03-04 21:19

本文选题：医疗项目成本　切入点：成本管理　出处：《西南交通大学》2017年硕士论文　论文类型：学位论文

【摘要】：近年来,我国老百姓面临着"看病贵、看病难"的问题,针对这样的现象,我国在医疗体制上也进行了深入的改革,医疗服务行业之间的竞争逐渐交由市场去平衡,现如今私立医院迅速崛起,部分私立医院甚至纳入了医保的范围,我国公立医院面临的竞争和挑战进一步加剧,政府对医院的财政投入近年来虽有所提高但占比仍旧较低,因此,如何在激烈的市场竞争中保障医院自身的经营运作,从开源节流中的节流角度来看,对医院的成本管控有了更高的要求。在资源相对有限的情况下可以通过自身良好的成本管理来获得同行业中的成本优势,保障自身的可持续性发展。2012年,随着新医改的全面推进,国家对医疗行业成本控制管理的决心也进一步表明。当前我国的大部分公立医院在成本上依照新的《医院会计制度》进行成本核算,这种核算方法在操作上比较简便,但存在着核算结果并不能完全反应真实耗费的情况。对A医院而言,公立医院成本管理上的缺陷也同样存在,因此,就目前医疗行业面临的新形势以及A医院在成本核算方面所面临的挑战来说,都有必要去探索一种更科学合理的成本管理模式来应对现今的状况。作业成本法最先是制造业根据其行业特点探索出的先进成本管理方法,国外学者较早的做出了将作业成本法应用到医疗领域的研究,并随后成功的进行了实践,表明了作业成本法在医疗行业中的实施相较于现行的成本方法而言更加科学合理。因此,本文以大量的文献研究为基础,借鉴国内外学者在医院中应用作业成本法的理论与实践经验,设计出基于作业成本法的A医院超声科室的成本管理案例,并通过分析作业成本法对A医院的成本管控现状的改善情况,来表明实施作业成本法可以改善医院的成本管理情况。本文在具体操作上主要是以A医院的医技科室代表——超声科室为例,在其医疗项目成本测算上分别运用医院现行的成本方法和作业成本法来进行成本核算,对比和分析测算结果的差异以及差异形成的原因,从中明确作业成本法的具体操作程序和其在医疗项目成本中核算的优势,旨在优化超声科室的工作流程,对A医院在成本管理和控制上提供参考价值。经过对比分析表明,A医院运用作业成本法进行成本核算更具有优势,可以使A医院成本核算结果更准确和客观,可以依据接近实际耗用的全面成本信息进行良好的成本控制,优化工作流程来提高A医院成本管理水平,保持竞争优势。
[Abstract]:In recent years, the common people in our country are faced with the problem of "expensive and difficult to see a doctor." in view of this phenomenon, China has also carried out in-depth reforms in the medical system, and the competition among the medical service industries has been gradually handed over to the market to balance. Nowadays, private hospitals are rising rapidly, and some private hospitals are even included in the scope of medical insurance. The competition and challenges faced by public hospitals in China are further intensified. Although the government's financial investment on hospitals has increased in recent years, the proportion of public hospitals is still relatively low. Therefore, how to ensure the management and operation of the hospital itself in the fierce market competition, from the angle of reducing expenditure in the process of increasing revenue and reducing expenditure, The cost control of the hospital has higher requirements. In the case of relatively limited resources, we can gain the cost advantage in the same industry through its own good cost management, and ensure its sustainable development. In 2012, With the comprehensive promotion of the new medical reform, the determination of the state to the cost control and management of the medical profession further indicates that most of the public hospitals in our country carry out cost accounting in accordance with the new Hospital Accounting system at present. This accounting method is relatively simple in operation, but the accounting results do not fully reflect the true cost. For Hospital A, the defects in cost management of public hospitals also exist, so, In terms of the new situation facing the medical industry and the challenges that hospitals A face in terms of cost accounting, It is necessary to explore a more scientific and reasonable cost management model to deal with the current situation. Activity-based costing is the first advanced cost management method explored by the manufacturing industry according to its characteristics. Foreign scholars made earlier research on the application of activity-based costing to the medical field, and then successfully carried out the practice. It shows that the implementation of ABC in medical industry is more scientific and reasonable than the current cost method. Therefore, this paper is based on a large number of literature studies. Referring to the theory and practice experience of applying Activity-based costing to hospitals at home and abroad, the cost management case of ultrasonic department in Hospital A based on ABC is designed. And through the analysis of ABC to improve the current situation of cost control in hospital A, In order to show that the implementation of activity-based costing can improve the cost management of the hospital. This paper mainly takes the representative of the Department of Medical Technology of Hospital A-ultrasonic department as an example. In the cost calculation of the medical project, the current cost method and the activity-based costing method of the hospital are used to carry out the cost accounting, and the differences between the results of calculation and the reasons for the differences are compared and analyzed. In order to optimize the work flow of ultrasonic department, we should clarify the specific operating procedure of Activity-Based costing (ABC) and its advantages in the cost accounting of medical project. This paper provides reference value for A hospital in cost management and control. The comparative analysis shows that Activity-Based costing has more advantages, which can make the results of A Hospital cost accounting more accurate and objective. According to the total cost information which is close to the actual consumption, we can carry on good cost control, optimize the work flow to improve the cost management level of A hospital and keep the competitive advantage.
【学位授予单位】：西南交通大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.322

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