Carroll Nathan, Lord Justin C
Department of Health Services Administration University of Alabama at Birmingham USA.
J Health Care Finance. 2016 Fall;43(2):172-185.
Management scholars have identified several cost accounting methods that provide organizations with accurate estimates of the costs they incur in producing output. However, little is known about which of these methods are most commonly used by hospitals. This article examines the literature on the relative costs and benefits of different accounting methods and the scant literature describing which of these methods are most commonly used by hospitals. It goes on to suggest that hospitals have not adopted sophisticated cost accounting systems because characteristics of the hospital industry make the costs of doing so high and the benefits of service-level cost information relatively low. However, changes in insurance benefit design are creating incentives for patients to compare hospital prices. If these changes continue, hospitals' patient volumes and revenues may increasingly be dictated by the decisions of individual patients shopping for low-cost services and as a result, providers could see increasing pressure to set prices at levels that reflect the costs of providing care. If these changes materialize, cost accounting information will become a much more important part of hospital management than it has been in the past.
管理学者已经确定了几种成本核算方法，这些方法能为组织提供其在产出过程中所产生成本的准确估计。然而，对于医院最常用的是这些方法中的哪一种，人们却知之甚少。本文考察了关于不同会计方法的相对成本和收益的文献，以及描述医院最常用这些方法中哪一种的稀少文献。文章进而指出，医院尚未采用复杂的成本核算系统，因为医院行业的特点使得这样做的成本高昂，而服务水平成本信息的收益相对较低。然而，保险福利设计的变化正在促使患者比较医院价格。如果这些变化持续下去，医院的患者数量和收入可能越来越多地由寻求低成本服务的个体患者的决策所决定，结果，医疗服务提供者可能会面临越来越大的压力，要将价格设定在反映提供护理成本的水平上。如果这些变化成为现实，成本核算信息将比过去在医院管理中变得重要得多。
