Boronat F, Barrachina I, Budia A, Vivas Consuelo D, Criado M C
Servicio de Urología, Hospital Universitario y Politécnico La Fe, Valencia, España.
Unidad de Investigación en Economía y Gestión de la Salud, Centro de Ingeniería Económica, Universidad Politécnica de Valencia, Valencia, España.
Actas Urol Esp. 2017 Jul-Aug;41(6):400-408. doi: 10.1016/j.acuro.2016.10.003. Epub 2016 Dec 7.
The health care system has management tools available in hospitals that facilitate the assessment of efficiency through the study of costs and management control in order to make a better use of the resources.
The aim of the study was the calculation and analysis of the total cost of a urology department, including ambulatory, hospitalization and surgery activity and the drafting of an income statement where service costs are compared with income earned from the Government fees during 2014.
From the information recorded by the Economic Information System of the Department of Health, ABC and top-down method of cost calculation was applied by process care activity. The cost results obtained were compared with the rates established for ambulatory and hospital production in the Tax Law of the Generalitat Valenciana. The production was structured into outpatient (external and technical consultations) and hospital stays and surgeries (inpatient).
A total of 32,510 outpatient consultations, 7,527 techniques, 2,860 interventions and 4,855 hospital stays were made during 2014. The total cost was 7,579,327€; the cost for outpatient consultations was 1,748,145€, 1,229,836 Euros for technical consultations, 2,621,036€ for surgery procedures and 1,980,310€ for hospital admissions. Considered as income the current rates applied in 2014 (a total of 15,035,843€), the difference between income and expenditure was 7,456,516€.
The economic balance was positive with savings over 50% and a mean adjusted hospitalization stay rate (IEMAC) rate of 0.67 (33% better than the standard). CMA had a favorable impact on cost control.
医疗保健系统在医院中有管理工具,可通过成本研究和管理控制来促进效率评估,以便更好地利用资源。
本研究的目的是计算和分析泌尿外科的总成本,包括门诊、住院和手术活动,并编制一份损益表,将2014年的服务成本与政府收费所得收入进行比较。
根据卫生部经济信息系统记录的信息,采用作业成本法和自上而下的成本计算方法,按诊疗活动进行计算。将获得的成本结果与瓦伦西亚自治区税法规定的门诊和医院生产费率进行比较。生产分为门诊(外部和技术咨询)以及住院和手术(住院患者)。
2014年共进行了32,510次门诊咨询、7,527项技术操作、2,860例干预和4,855次住院。总成本为7,579,327欧元;门诊咨询成本为1,748,145欧元,技术咨询成本为1,229,836欧元,手术程序成本为2,621,036欧元,住院成本为1,980,310欧元。将2014年适用的现行费率视为收入(总计15,035,843欧元),收入与支出之间的差额为7,456,516欧元。
经济平衡为正,节省超过50%,平均调整住院天数率(IEMAC)为0.67(比标准好33%)。作业成本法对成本控制有积极影响。