Williams S V, Finkler S A, Murphy C M, Eisenberg J M
Med Care. 1982 May;20(5):450-9. doi: 10.1097/00005650-198205000-00002.
Traditionally, many hospital costs have been allocated to patients using indirect measures that do not always reflect the value of the resources used to provide care. When, for example, costs are allocated by multiplying the patient's charges by the hospital's ratio of costs to charges, the allocated cost does not reflect actual cost because the hospital does not uniformly charge for services in proportion to their cost. The choice of method for cost allocation will be as important for the newly developed case-mix cost-accounting systems as it has been for traditional cost-accounting systems. To illustrate how the use of an indirect cost-allocation method might affect the output of a case-mix cost-accounting system, operating room, radiology and clinical laboratory costs were assigned to 106 hospitalized inguinal hernia patients in two diagnosis-related groups (DRGs) using both the hospital's existing cost-allocation method and a method that measures costs directly. Total costs and the costs in each department were significantly lower in each DRG using the direct method. It was concluded that patients in these two DRGs were being assigned more than the actual cost of their care with the existing cost-allocation method and, therefore, that the existing method prevented the case-mix accounting system from providing accurate management information.
传统上，许多医院成本是通过间接方法分配给患者的，这些方法并不总是能反映用于提供护理的资源价值。例如，当通过将患者的收费乘以医院成本与收费的比率来分配成本时，分配的成本并不能反映实际成本，因为医院对服务的收费并非与其成本成比例。成本分配方法的选择对于新开发的病例组合成本核算系统将如同对传统成本核算系统一样重要。为了说明间接成本分配方法的使用可能如何影响病例组合成本核算系统的输出，使用医院现有的成本分配方法和直接计量成本的方法，将手术室、放射科和临床实验室成本分配给两个诊断相关组（DRG）中的106名住院腹股沟疝患者。使用直接方法时，每个DRG中的总成本和各科室成本显著更低。得出的结论是，采用现有成本分配方法时，这两个DRG中的患者被分配的护理成本超过了实际成本，因此，现有方法阻碍了病例组合核算系统提供准确的管理信息。
