Brzović Z, Richter D, Simunić S, Bozić R, Hadjina N, Piacun D, Harcet B
Kliníki bolnicki centar Zagreb.
Lijec Vjesn. 1998 Dec;120(12):363-5.
The periodic income and expenditure accounts produced at the hospital and departmental level enable successful short term management, but, in the long run do not help remove tensions between health care demand and limited resources, nor do they enable optimal medical planning within the limited financial resources. We are trying to estabilish disease category costs based on case mixing according to diagnostic categories (diagnosis related groups, DRG, or health care resource groups, HRG) and calculation of hospital standard product costs, e.g., radiology cost, preoperative nursing cost etc. The average DRG cost is composed of standard product costs plus any costs specific to a diagnostic category. As an example, current costing procedure for hip artheroplasty in the University Hospital Center Zagreb is compared to the management accounting approach based on British Health Care Resource experience. The knowledge of disease category costs based on management accounting requirements facilitates the implementation of medical programs within the given financial resources and devolves managerial responsibility closer to the clinical level where medical decisions take place.
医院和科室层面编制的定期收支账目有助于成功进行短期管理，但从长远来看，无助于消除医疗需求与有限资源之间的紧张关系，也无法在有限的财政资源范围内实现最佳医疗规划。我们正试图根据诊断类别（诊断相关组，DRG，或医疗资源组，HRG）的病例组合以及医院标准产品成本（如放射科成本、术前护理成本等）的计算来确定疾病类别成本。平均DRG成本由标准产品成本加上特定诊断类别的任何成本组成。例如，将萨格勒布大学医院中心目前髋关节置换术的成本核算程序与基于英国医疗资源经验的管理会计方法进行比较。基于管理会计要求的疾病类别成本知识有助于在给定的财政资源范围内实施医疗项目，并将管理责任下放至更接近做出医疗决策的临床层面。
