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[医疗技术活动的融资。以法国一台扫描仪为例(1986年)]

[The financing of medico-technical activities. The example of a scanner in France (1986)].

作者信息

Meyer C, Lefaure C, Fagnani F

机构信息

INSERM U 240, Fontenay-aux-Roses.

出版信息

J Radiol. 1988 Oct;69(10):587-95.

PMID:3199347
Abstract

To analyse the french methods for financing technical-medical activities as CT scanners, and to assess if they can face, or not, the management constraints of such activities a financial simulation has been executed. First, current expenditures are totalized (including depreciations and financial charges) with variations according to the number of examinations per year. Costs are classified especially according to fixed and variable charges: the weight of fixed charges, especially equipment charges, is the most significant. It's very high in yearly expenditures. Most, that involves a very fast decreasing cost with increasing number of procedures. Second, consequences of such accounts are analyzed: on private CT scanners, Payed with a charge per examination whatever would be the factor's cost; on public CT scanners, payed with an annual allowance; in this case charges equal receipts whatever would be the cost for a procedure. Third, a break point is defined; either the annual activity is higher: there would be an excedent; either it is lower: there would be a deficit. Then, those results are reported to CT-scanners activity's data in France (1986). After all, we discuss about financing systems themselves, and suggest a few hypothesis to explain those desadjustments between charges and their financing way.

摘要

为分析法国为计算机断层扫描(CT)扫描仪等技术医疗活动融资的方法,并评估它们是否能够应对此类活动的管理限制,我们进行了一次财务模拟。首先,汇总当前支出(包括折旧和财务费用),并根据每年的检查次数进行变动。成本特别按照固定费用和可变费用进行分类:固定费用的比重,尤其是设备费用,最为显著。它在年度支出中占比很高。大多数情况下,随着检查次数的增加,成本会迅速下降。其次,分析此类账目产生的后果:对于私立CT扫描仪,按每次检查收费,无论设备成本如何;对于公立CT扫描仪,按年度津贴支付;在这种情况下,无论一次检查的成本如何,收费都等于收入。第三,定义一个断点;要么年度活动量较高:会有盈余;要么较低:会有赤字。然后,将这些结果应用于法国CT扫描仪活动的数据(1986年)。最后,我们讨论融资系统本身,并提出一些假设来解释收费与其融资方式之间的这些失调情况。

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