McKay Niccie L, Gapenski Louis C
Department of Health Services Research, Management and Policy, University of Florida, Gainesville, USA.
Health Care Manage Rev. 2009 Jul-Sep;34(3):234-41. doi: 10.1097/HMR.0b013e3181a16bbc.
Health management studies of hospital revenues have tended to focus on patient-service revenues, with little attention to the magnitude and the nature of nonpatient revenues.
This study (a) examines the size and sources of nonpatient revenues in hospitals, (b) analyzes the impact of nonpatient revenues on hospital profit margins, and (c) investigates variations in nonpatient revenues by ownership and bed size.
The data source for this study is the Florida Hospital Uniform Reporting System. The unit of observation is a private, acute care hospital, with the data being averaged over the period 2003-2005 (n = 143). Descriptive statistics and nonparametric tests of differences between groups are the primary methods of analysis.
During the period 2003-2005, on average, other operating revenues accounted for 1.3% and nonoperating revenues accounted for 4.1% of total revenues, although there was considerable variation across hospitals. Nonpatient activities contributed importantly to hospital profit margins. The average patient care margin was 3.1%, and the average total margin before tax was 4.8%. Thus, without nonpatient activities, total margin before tax would have been 1.7 percentage points lower. Nonpatient revenues tended to be more important for not-for-profit compared with for-profit hospitals, with little differences by bed size.
The key practice implication is that because nonpatient activities contribute importantly to hospital profit margins, they should constitute a core element in the organization's financial and operational planning. In particular, hospitals should consider treating nonpatient activities as profit centers.
医院收入的健康管理研究往往侧重于患者服务收入，而很少关注非患者收入的规模和性质。
本研究（a）考察医院非患者收入的规模和来源，（b）分析非患者收入对医院利润率的影响，（c）调查不同所有制和床位规模医院非患者收入的差异。
本研究的数据来源是佛罗里达医院统一报告系统。观察单位是一家私立急症护理医院，数据为2003 - 2005年期间的平均值（n = 143）。描述性统计和组间差异的非参数检验是主要分析方法。
在2003 - 2005年期间，平均而言，其他营业收入占总收入的1.3%，非营业收入占4.1%，尽管不同医院之间存在相当大的差异。非患者活动对医院利润率有重要贡献。平均患者护理利润率为3.1%，平均税前总利润率为4.8%。因此，如果没有非患者活动，税前总利润率将降低1.7个百分点。与营利性医院相比，非患者收入对非营利性医院往往更为重要，不同床位规模的差异不大。
关键的实践意义在于，由于非患者活动对医院利润率有重要贡献，它们应构成组织财务和运营规划的核心要素。特别是，医院应考虑将非患者活动视为利润中心。
