Rigby E
Department of Commerce, Australian National University, Canberra.
Aust Health Rev. 1993;16(1):89-102.
Cost accounting describes that aspect of accounting which collects, allocates and controls the cost of producing a service. Costing information is primarily reported to management to enable control of costs and to ensure the financial viability of units, departments and divisions. As costing studies continue to produce estimates of Diagnosis Related Group (DRG) costs in New South Wales hospitals, as well as in other states, costs for different hospitals are being externally compared, using a tool which is usually related to internal management and reporting. Comparability of costs is assumed even though accounting systems differ. This paper examines the cost centre structures at five major teaching hospitals in Sydney. It describes the similarities and differences in how the cost centres were constituted, and then details the line items of expenditure that are charged to each cost centre. The results of a comparative study of a medical specialty are included as evidence of different costing methodologies in the hospitals. The picture that emerged from the study is that the hospitals are constituting their cost centres to meet their internal management needs, that is, to know the cost of running a ward or nursing unit, a medical specialty, department and so on. The rationale for the particular cost centre construction was that cost centre managers could manage and control costs and assign responsibility. There are variations in procedures for assigning costs to cost centres, and the question is asked 'Do these variations in procedures make a material difference to our ability to compare costs per Diagnosis Related Group at the various hospitals?' It is contended that the accounting information, which is produced as a result of different practices, is primarily for internal management, not external comparison. It would be better for hospitals to compare their estimated costs per Diagnosis Related Group to an internal standard cost rather than the costs from other hospitals. This is because there are differences in cost centre construction and standardisation of cost centre definitions will not meet the information needs of internal management. Also capabilities and capacities of accounting systems vary greatly and uniformity will take a long time to achieve, if ever.
成本会计描述了会计工作中收集、分配和控制服务生产成本的那一方面。成本核算信息主要报告给管理层，以便进行成本控制，并确保各单位、部门和科室的财务可行性。随着成本核算研究不断得出新南威尔士州医院以及其他州的诊断相关组（DRG）成本估计数，不同医院的成本正在通过一种通常与内部管理和报告相关的工具进行外部比较。尽管会计系统不同，但仍假定成本具有可比性。本文研究了悉尼五家主要教学医院的成本中心结构。它描述了成本中心构成方式的异同，然后详细说明了每个成本中心所承担的支出项目。一项医学专科比较研究的结果作为各医院不同成本核算方法的证据被纳入其中。该研究得出的情况是，各医院构建其成本中心是为了满足内部管理需求，即了解运营一个病房或护理单元、一个医学专科、一个科室等的成本。构建特定成本中心的基本原理是成本中心经理能够管理和控制成本并明确责任。在将成本分配到成本中心的程序方面存在差异，有人提出疑问：“这些程序上的差异是否会对我们比较各医院每个诊断相关组成本的能力产生重大影响？”有人认为，由于不同做法而产生的会计信息主要用于内部管理，而非外部比较。医院将其每个诊断相关组的估计成本与内部标准成本进行比较，而不是与其他医院的成本进行比较会更好。这是因为成本中心的构建存在差异，成本中心定义的标准化无法满足内部管理的信息需求。此外，会计系统的能力和容量差异很大，即使有可能实现统一也需要很长时间。
