Pink G H, Bolley H B, Cockerill R W
Department of Health Administration, Faculty of Medicine, University of Toronto (UT), Ontario, Canada.
Am J Hosp Pharm. 1994 May 15;51(10):1331-4.
The consequences of two different methods of allocating pharmacy costs per patient case were studied. The study was conducted using cost data from Sunnybrook Health Science Centre (SHSC), a 1205-bed teaching hospital in Toronto, Canada. A sample of the 1991-1992 cases for the three case mix groups (CMGs) with the highest total pharmacy cost and the three CMGs with the highest pharmacy cost per case were examined. Information was obtained from patient records and used to produce two sets of data: pharmacy prescription unit costs and pharmacy costs per case using the relative value unit (RVU) method, and pharmacy prescription unit costs and pharmacy costs per case using the workload measurement system (WMS) method. For each case, the difference between the RVU and WMS pharmacy costs was determined. The RVU method consistently produced higher pharmacy costs per case for the CMGs with the highest pharmacy cost per case. If these CMGs are typical of other CMGs with high pharmacy costs per case, then case reimbursement based on the WMS method of cost allocation would result in underfunding of hospitals whose case mix has a high proportion of CMGs with high pharmacy costs per case and overfunding of hospitals whose case mix has a high proportion of CMGs with low pharmacy costs per case. However, the RVU method of cost allocation, although it appears to be more accurate, places a greater data collection burden on pharmacy managers. The RVU and WMS methods of pharmacy cost allocation gave significantly different pharmacy costs per case for the six CMGs studied.
研究了两种不同的按患者病例分配药房成本方法的后果。该研究使用了加拿大多伦多一家拥有1205张床位的教学医院——桑尼布鲁克健康科学中心（SHSC）的成本数据进行。对1991 - 1992年药房总成本最高的三个病例组合组（CMG）以及每个病例药房成本最高的三个CMG的样本进行了检查。从患者记录中获取信息并用于生成两组数据：使用相对价值单位（RVU）方法的药房处方单位成本和每个病例的药房成本，以及使用工作量测量系统（WMS）方法的药房处方单位成本和每个病例的药房成本。对于每个病例，确定RVU和WMS药房成本之间的差异。对于每个病例药房成本最高的CMG，RVU方法始终产生更高的每个病例药房成本。如果这些CMG是其他每个病例药房成本高的CMG的典型代表，那么基于WMS成本分配方法的病例报销将导致每个病例药房成本高的CMG比例高的医院资金不足，而每个病例药房成本低的CMG比例高的医院资金过剩。然而，RVU成本分配方法虽然似乎更准确，但给药房管理人员带来了更大的数据收集负担。对于所研究的六个CMG，RVU和WMS药房成本分配方法得出的每个病例药房成本有显著差异。
