Canto-Torán Esther, Vivas-Consuelo David, Barrachina-Martinez Isabel, Escudero-Torrella Joaquín
Centro de Ingenieria Economica, Unidad de Investigacion en, Economia y Gestion de la Salud.
Rev Neurol. 2011 Nov 16;53(10):599-606.
The steady growth of spending on healthcare and the limited availability of resources make it necessary to include cost analysis among the tools used for hospital management. AIMS. To obtain the hospitalisation operating statement of a neurology service and to analyse the differences with regard to costs per process.
The study involved an analysis of costs per process in the neurology service of a referral hospital in the Valencian Community (400,000 inhabitants). The data used were those concerning health care activity in 2008 according to the information registered by the Economic Information System of the Valencian Regional Ministry of Health; ABC and top-down methods were applied to calculate the cost per process. The results thus obtained were compared with the fees established for hospital production in the Valencian Regional Government's Law on Fees.
For a production of 1092 hospital discharges, with a case-mix index of 0.96 and a mean length of stay of 9.2 days with a case mix of 1.91, hospitalisation costs came to 4,411,643.45 euros, with a mean cost per process of 2,111.46 euros. Taking into account the fees that were applied, the difference between income and expenditure was -12,770.39 euros. The diagnosis-related groups with the greatest difference were numbers 14 (-246,392.49 euros), 533 (-90,292.49 euros) and 15 (-55,139.66 euros).
The hospitalisation profit and loss account obtained is negative due to the fact that the mean length of stay in the service is longer than expected, above all in diagnosis-related groups 14, 533 and 15, which are the most inefficient.
医疗保健支出的稳步增长以及资源的有限可用性使得有必要将成本分析纳入医院管理工具之中。目的：获取神经科服务的住院运营报表，并分析各流程成本之间的差异。
该研究对瓦伦西亚自治区（40万居民）一家转诊医院的神经科服务各流程成本进行了分析。所使用的数据是2008年根据瓦伦西亚地区卫生部经济信息系统登记的医疗保健活动信息；采用作业成本法（ABC）和自上而下的方法来计算各流程成本。将由此获得的结果与瓦伦西亚地区政府费用法中规定的医院生产费用进行比较。
对于1092例出院病例，病例组合指数为0.96，平均住院天数为9.2天，病例组合为1.91，住院成本达到4,411,643.45欧元，每个流程的平均成本为2,111.46欧元。考虑到所应用的费用，收支差额为-12,770.39欧元。差异最大的诊断相关组是第14组（-246,392.49欧元）、第533组（-90,292.49欧元）和第15组（-55,139.66欧元）。
由于该服务的平均住院天数长于预期，尤其是在效率最低的诊断相关组14、533和15中，所获得的住院损益账户为负数。
