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作业成本法

Activity-Based Costing.

作者信息

Jalalabadi Faryan, Milewicz Allen L, Shah Sohail R, Hollier Larry H, Reece Edward M

机构信息

Division of Plastic Surgery, Jamail Specialty Care Center, Baylor College of Medicine, Houston, Texas.

Department of Surgery, Baylor College of Medicine, Houston, Texas.

出版信息

Semin Plast Surg. 2018 Nov;32(4):182-186. doi: 10.1055/s-0038-1672208. Epub 2018 Oct 22.

Abstract

Cost allocation for health care professionals can be an enigma within the health care system. Activity-based costing (ABC) is an accounting tool that allocates costs incurred through a company's practice of providing goods and services to the consumer. ABC can provide insight into inefficiencies across the supply chain and unlock excess capacity. This, in turn, can drive services provided toward generating more value for the hospital system. ABC can be tailored to focus upon a unit of measurement that holds value as it pertains to production. With time-driven ABC (Td-ABC), we look to use the advantages of both the fee-for-service and capitation model to transition to a value-based system. Providers are rewarded based on efficiencies and successful outcomes in patient care while disincentivizing poor outcomes and superfluous volume/expenditures. ABC, however, does not come without its own risks and disadvantages, and the user must exercise caution in applying this cost-allocating tool to avoid detriment to its practice. A review of the literature was conducted to analyze the implementation, medical application, and advantages and disadvantages of Td-ABC.

摘要

医疗保健专业人员的成本分配可能是医疗保健系统中的一个谜。作业成本法(ABC)是一种会计工具,用于分配公司在向消费者提供商品和服务的过程中产生的成本。ABC可以洞察供应链中的低效率问题,并释放过剩产能。反过来,这可以推动所提供的服务为医院系统创造更多价值。ABC可以进行调整,以专注于与生产相关且具有价值的计量单位。通过时间驱动作业成本法(Td-ABC),我们希望利用按服务收费和按人头收费模式的优势,向基于价值的系统过渡。根据医疗效率和成功结果对提供者进行奖励,同时抑制不良结果和多余的工作量/支出。然而,ABC并非没有自身的风险和缺点,使用者在应用这种成本分配工具时必须谨慎,以免对其实践造成损害。我们对文献进行了综述,以分析Td-ABC的实施、医学应用以及优缺点。

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本文引用的文献

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Time-Driven Activity-Based Costing for Surgical Episodes.手术阶段的时间驱动作业成本法
JAMA Surg. 2017 Jan 1;152(1):96-97. doi: 10.1001/jamasurg.2016.3356.
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How to Pay for Health Care.如何支付医疗费用。
Harv Bus Rev. 2016 Jul-Aug;94(7-8):88-98, 100, 134.
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From volume to value: better ways to pay for health care.从量到值:更好的医疗保健支付方式。
Health Aff (Millwood). 2009 Sep-Oct;28(5):1418-28. doi: 10.1377/hlthaff.28.5.1418.
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