LVIV POLYTECHNIC NATIONAL UNIVERSITY, LVIV, UKRAINE.
IVAN FRANKO NATIONAL UNIVERSITY OF LVIV, LVIV, UKRAINE.
Wiad Lek. 2023;76(12):2679-2686. doi: 10.36740/WLek202312118.
The aim: This paper is an analytical and descriptive study of the use of the Activity Based Costing (ABC) system in mental healthcare institutions for the allo¬cation of overhead costs of auxiliary units that provide non-medical services. The realistic estimates obtained using this costing system will help improve the allocation of resources, especially in the conditions of increased number of patients, and to control overhead costs, ensuring the reduction of non-productive expenses, increasing the efficiency and effectiveness of the mental health and psychosocial support institution.
Materials and methods: The study describes and uses ABC as a system and method for calculating inpatient care costs in 2022. The cost of medical services will be calculated as the sum of direct and overhead costs. Overhead costs into inpatient care consist of medical support units overhead costs and non-medical support units overhead costs. Overhead costs in non-medical support units were allocated to the cost of services within the cost centers:hospital departments that specialize in the treatment of specific mental health conditions. Expert opinion regarding the alignment of the cost allocation base with the factors identified for the allocation of each group of overhead costs in the mental health and psychosocial support facility was taken into account .
Results: Calculations showed the impracticality of using a single tariff for psychiatric care medical services for adults and children in inpatient conditions, since there are cost centers, namely, clinical departments of health care institutions, which consume a larger amount of resources. In particular, these are the departments providing the treatment of psychotic disorders caused by taking psychoactive substances, as well as schizophrenic, organic disorders, including symptomatic, mental disorders). Accordingly, the tariff for such medical services should be higher.
Conclusions: ABC is applicable in mental health care institutions and can help to efficiently cost processes, and thereby overcome a key challenge: to overesti¬mation or underestimation of costs into a medical services. Cost assignment through ABC generated more accurate cost estimates, which suggests that model of cost calculation ABC is more able to address complexity in mental health care institutions. ABC should be gradually incorporated into an estimated approach to costing leads, to progressively bring reliable cost-accounting practices to mental health care institutions.
本文旨在分析和描述在提供非医疗服务的辅助单位的间接成本分配方面，使用作业成本法（ABC）系统在精神保健机构中的应用。使用这种成本核算系统获得的现实估计将有助于改善资源分配，特别是在患者数量增加的情况下，并控制间接成本，确保减少非生产性支出，提高精神卫生和心理社会支持机构的效率和效果。
本研究描述并使用 ABC 作为 2022 年计算住院护理成本的系统和方法。医疗服务成本将计算为直接成本和间接成本的总和。住院护理的间接成本包括医疗支持单位的间接成本和非医疗支持单位的间接成本。非医疗支持单位的间接成本分配给成本中心的服务成本：专门治疗特定精神健康状况的医院科室。在考虑到精神卫生和心理社会支持机构中每个组别的间接成本分配因素的情况下，专家意见考虑了成本分配基础的一致性。
计算结果表明，对于在住院条件下的成人和儿童的精神病护理医疗服务，使用单一的收费标准是不切实际的，因为有成本中心，即医疗机构的临床科室，它们消耗了更多的资源。特别是，这些科室提供治疗因使用精神活性物质引起的精神病性障碍，以及精神分裂症、器质性障碍，包括症状性、精神障碍）。因此，这种医疗服务的收费标准应该更高。
ABC 适用于精神保健机构，可以帮助有效地计算成本，从而克服一个关键挑战：对医疗服务的成本过高或过低估计。通过 ABC 进行的成本分配生成了更准确的成本估计，这表明 ABC 成本计算模型更能够应对精神保健机构的复杂性。ABC 应逐步纳入成本估算方法，逐步为精神保健机构带来可靠的成本核算实践。
