The monetary expression of the value of materialized labor expended in the process of healthcare operations (C) and the value created by the necessary labor consumed in the labor consumption (V); that is, the sum of funds expended by the hospital in the process of healthcare operations
.
This is the economic essence of healthcare costs.
The scope of medical cost expenditure includes:
. The actual consumption of medical materials, auxiliary materials and fuel at their original cost, transportation, loading and unloading
and other costs
. Power consumed for medical activities
. Salaries, bonuses, allowances, subsidies and other wage expenses paid by the hospital to its employees
expenses; and employee welfare and subsidies to individuals and families
. Depreciation of fixed assets (drawing on the repair and purchase fund), rental fees, repair and maintenance costs and amortization of low
value consumables
. Costs of medicines consumed in the course of medical treatment
. Office expenses, heating
, utilities, travel expenses paid by the hospital for carrying out medical activities and managing the organization of medical care
Medical costs do not include:
Capital expendituresAcquisition of office equipment
Acquisition of special equipment
Acquisition of means of transportation
Acquisition of books and materials
Expenditures on external investments Expenditures Confiscated property Various fines, compensation for medical disputes, sponsorship and donation expenditures Funded scientific research and teaching project expenditures Expenses charged to various types of funds Expenditures that are not allowed to be included in the cost of the state regulations1, the types of hospital costing:
Cost accounting according to the object of the costing classification are generally Hospital total cost, department
departmental costs, medical project costs and disease costs.
Total hospital cost:
The total cost of the hospital is the sum of the money spent on medical operations. It can be summarizedreflect the medical cost situation, evaluation and assessment of the hospital's level of operation, but also for the
external and to the higher level of reporting financial costs. As reflected in the financial accounting statements of the total cost of health care.
In the total cost can be divided into outpatient total cost, hospitalization total cost, medical total cost, drugTotal cost of goods.
Formula: total hospital cost = total hospital medical cost + total hospital drug cost
Department (department) cost:
Department, departmental cost is the cost of the responsible unit according to the theoretical method of responsibility accounting,
is the responsible unit of the medical operation process of the cost of funds. Department, department cost is mainly
is the responsibility of the unit and the department's operation to make predictions and decisions, in the management of the hospital
has an important role.
Medical project cost:
Medical project cost is the cost of accounting for each medical project, reflecting the medical
project cost of funds. The main role of program cost is to assess the profit and loss of the medical program as
a basis for reimbursement and pricing.
Disease cost:
Disease cost is the total amount of money spent on treating a particular disease. It can be used as a comprehensive evaluation of the
treatment process, provide a basis for charging for the type of disease, and open up a new
way for the settlement of medical insurance.
Positioning of medical costing:
Medical costing should be positioned on the final medical results. The departments that can reflect the final
medical outcomes are the departments of outpatient care and the departments of inpatient clinical care. Only
these departments reflect the whole process of medical operation, other medical departments are only
part of the medical process rather than the final medical product.
The role of hospital costs
1, health care costs are the measure of compensation for medical expenses, but also the basis for the division of production costs and hospital
revenue.
2, medical cost is a comprehensive indicator of the quality of hospital treatment.
3, medical cost is an important factor in the development of medical prices.
4, medical cost is an important basis for hospitals to make business decisions.
Cost accounting methods
1, full cost method
2, itemized step-by-step carry forward method
3, the selection of cost items
Four levels of apportionment process and methods
The first level of apportionment: the apportionment of common costs
u Definition: for the current costs that can not be directly accounted for in the department ("common costs").
u Definition: Apportionment of current costs (hereinafter referred to as "utility costs") that cannot be directly charged to the department.
u Includes the following items:
1. Personnel costs: Retirement living costs, social security costs, contractual employee pensions, retirement
Retirement costs, welfare costs.
2. Coal, water, electricity and other costs.
3. Transportation consumption costs: vehicle fuel costs, maintenance costs, road and bridge tolls, insurance
fees, etc..
4. depreciation: depreciation of fixed assets
5. building repairs, incidental works (it is recommended that the hospital take the amortized way to deal with)
u Apportionment method:
Personnel ratio, area ratio, service equivalents
Four levels of apportionment process and methodology
Second level of apportionment: management cost sharing
u Definition: the hospital will be the whole of the hospital's fuel costs, maintenance costs, road and bridge tolls, insurance
fees. >Definition: Apportionment of the cost of the entire hospital's management department (including the cost of the management department directly
and the share of common costs)
u Scope of the department:
Administrative and management departments
u Apportionment method: according to the proportion of personnel (original or adjusted value)
Can be directed to the apportionment of the four-level apportionment process and methodology
Four levels of apportionment flow and Methodology
Third level of apportionment:Internal service cost sharing
u Definition: apportionment of medical auxiliary department costs (including the sum of the directly charged medical auxiliary department costs,
the common cost sharing portion, and the administrative cost sharing portion).
u Scope of departments:
Logistic service function departments, supply department, laundry, nutrition canteen, registration office,
charge office, etc.
u Apportionment method:
Logistic service department: whoever benefits, whoever bears the responsibility principle
Outpatient medical auxiliary departments: according to the number of outpatient visits to the outpatient clinic directed to the sharing of the various outpatient departments
Inpatient medical departments: Directed apportionment to each inpatient department according to the number of inpatient bed days
Medical departments without workload: Directed apportionment to designated medical technology or direct medical departments
Fixed costs: number of staff, area
Variable costs: number of outpatient visits, number of inpatient bed days, revenue ratio
Four levels of apportionment process and methodology
Level 4 Apportionment:Medical and technical department cost sharing
u Definition: Apportionment of medical and technical department costs (including the sum of the directly charged medical and technical department costs, the shared portion of utility costs
, the shared portion of management department costs, and the shared portion of medical support department costs
).
u Section scope:
Medical technology examination section, operating room, drug section, but the research and teaching section is no longer
participating in the apportionment.
u Apportionment method:
Medical and technical departments with income: the principle of balanced income-expenditure ratio
Medical and technical departments without income: targeted apportionment to the designated direct medical departments
Fixed costs: the number of personnel, the area
Variable costs: outpatient trips, the number of inpatient beds, the proportion of income
1, strengthening financial management And standardized accounting is a good premise of cost accounting
Property and materials to be inventoried to ensure that the accounts, accounts consistent
The hospital's housing area of each section to re-verify
Unified accounting caliber. The economic management office section accounting and cost accounting section caliber
unified, the data source should also be unified caliber, to avoid the number of doors
strict accounting period cost accounting period and accounting to maintain consistency
accounting and cost accounting adhere to the accrual system of current costs and expenses in the current period of accounting
adherence to the end of the month of the reconciliation. Accounting and property management, accounting and costing data
are to be checked to ensure that the data is consistent and error-free
Development of consumption quotas, internal service prices and other standard work
Hospital costing and financial accounting
2, costing is a complementary and perfect financial accounting
True analysis of the whole hospital The cost situation of each department, clear profit and loss of the department or project, for the adjustment of
income structure and compensation provides the basis.
Through the analysis of the cost structure and cost items, it is clear that different structures, different items on the cost of
influence, to find the cost of the control point, respectively, different situations and targeted solutions.
Changing the original only after the accounting by the hospital to do things after the control of the passive situation, so that
To enable the departments to control the cost of the formation of a comprehensive cost management situation.
The realization of medical cost accounting, reflecting the extension and strengthening of financial management functions. The realization of the responsibility
Accounting and financial accounting of the single-track system of accounting, so that financial management is also extended to the economic management of the work,
Strengthening of the assessment of the department and the control of costs, and strengthen the role of financial management.
Guiding the adjustment of revenue structure. Reducing and avoiding problems such as indiscriminate prescribing of medicines and checkups, making the increase of income
more rational.
Improves the index evaluation system. It can make the assessment and evaluation of the department more comprehensive and complete.
The association between hospital costing and financial accounting
3. Similarities and differences between hospital costing and accounting
Similarities
Hospital costing is a part of the work of financial accounting, and therefore should be kept in
consistency with the theory of accounting. Medical cost accounting also follows the Ministry of Health, the Ministry of Finance *** with the issuance of the "hospital financial system
System" and "hospital accounting system", accounting methods, accounting entries, etc. are consistent.
Cost accounting principles and accounting principles are consistent. Such as: accrual principle, accounting
accounting phasing principle, the actual cost principle, the principle of importance, the principle of relevance, the principle of proportionality and so on in
these principles of accounting organization.
The source of data is the same. Costing and accounting data sources are the same, both within the single
bit and external data sources to maintain consistency.
Output results are the same. Cost accounting output is cost indicators, accounting output is
expenditure indicators, we cost accounting to achieve the sum of the costs of each medical department and the total budget expenditure is to maintain
consistent (minus the expenditure should not be included in the cost of the project)
Hospital costing and financial accounting
3, the hospital costing and accounting of the same points and differences
Differences
Medical costing in the budgetary expenditures of capital expenditures are not included in the cost of accounting
Contents. For example, acquisition costs are not included in the cost items. What is reflected in the statement is that medical costs
costs plus excluded cost items equal total budgeted expenditures.
The method of allocating costs to be pooled is different from accounting. Accounting provides for overhead
allocation in proportion to personnel. And in cost accounting only this method of allocation obviously does not reflect
cost object benefit, so in cost accounting using a variety of different allocation methods. If
the allocation of area, according to the allocation of working hours, according to the allocation of workload, etc., better reflect
the rationality and authenticity of the cost.
Beijing Founder Zongbang Digital Medical System Co., Ltd. provided by Market Development Department
jiangopen@163.com