Cockerill R, Scott E, Wright M
Department of Health Administration, University of Toronto, Ontario, Canada.
Am J Occup Ther. 1996 Jun;50(6):447-51. doi: 10.5014/ajot.50.6.447.
Interest in costing health care delivery on an individual case basis has increased in recent years as concern with overall health care costs has heightened. Costing exercises have been largely oriented around medical classification systems. Measures to incorporate the contributions of allied health activities such as occupational therapy are relatively recent. The objective of this study was to examine the attitudes and opinions of senior occupational therapy managers toward workload measurement on the basis of case mix.
A survey was sent to all 198 senior occupational therapy managers in accredited Canadian facilities, which was completed by 182 respondents for a response rate of 92%. The questionnaire asked about workload measurement system(s) currently used, satisfaction with the system(s), and needs and expectations of workload systems in general.
The majority of respondents were using a time recording workload measurement system and expressed relatively low levels of satisfaction with it. Current systems were unable to provide costing data, which respondents ranked as very important for themselves as managers. The majority of respondents believed that it would be useful or very useful to be able to cost occupational therapy services by a diagnostic grouping system and to establish standard protocols per diagnosis, standard times per procedure per institution, and standard times per procedure for the profession.
There is support for developing or expanding current methods of measuring workload. Senior occupational therapy managers would like to be able to predict their workload prospectively, a step that will accommodate the move toward case costing and program management.
近年来，随着对整体医疗保健成本的关注度提高，基于个体病例的医疗保健服务成本核算受到了更多关注。成本核算工作主要围绕医疗分类系统展开。纳入诸如职业治疗等辅助医疗活动贡献的措施相对较新。本研究的目的是考察高级职业治疗经理对基于病例组合的工作量测量的态度和看法。
向加拿大所有经认可机构的198名高级职业治疗经理发送了一份调查问卷，182名受访者完成了调查，回复率为92%。问卷询问了当前使用的工作量测量系统、对该系统的满意度以及一般工作量系统的需求和期望。
大多数受访者使用的是时间记录工作量测量系统，且对其满意度相对较低。当前系统无法提供成本核算数据，而受访者认为这对他们作为管理人员来说非常重要。大多数受访者认为，能够通过诊断分组系统对职业治疗服务进行成本核算，并为每个诊断制定标准方案、为每个机构的每个程序制定标准时间以及为该专业的每个程序制定标准时间会很有用或非常有用。
支持开发或扩展当前的工作量测量方法。高级职业治疗经理希望能够前瞻性地预测他们的工作量，这是朝着病例成本核算和项目管理迈进的一步。
