1, the role of nursing cost accounting:
(1) cost accounting is an effective way to reduce the cost of medical care
(2) cost accounting is the basis for the development of a reasonable price
(3) cost accounting is the basis for the rational allocation of nursing human resources
(4) nursing costing is the measure of the effectiveness of the nursing service
(5) Nursing costing is also the basis of nursing value evaluation
2, the method has:,
Project method (fee-for-service) Project method is to nursing project as the object, the collection of costs and distribution of costs to account for the cost of the method, the project method and the cost of nursing care has a direct link.
Bed day costing (per day service method/per diem) is the cost of care is included in the average cost of a bed day, the cost of care is directly related to the length of stay.
Relative intensity measures (relative intensity measures) are used to cost ICU patients
Patient classification systems (patient classification systems) is a costing method that measures nursing care needs or workload based on patient classification systems. It determines the need for nursing care based on the degree of the patient's condition, calculates the number of nursing points and nursing hours, and determines the cost of nursing care and charges.
Diagnosis-related group DRG (diagnosis-related group DRG) is a method of calculating the cost of care required for each disease by taking the disease as the object of costing, pooling and allocating costs.
The integrated method is the computer-assisted method, combined with the patient classification system and DRG classification, the application of computer technology to establish the criteria for the corresponding care needs, the implementation of care to determine the cost of care for a particular group of patients.
3. Systematic management of nursing costing:
a. Establishment of nursing costing system Combining patient assessment and classification, nursing staff deployment and scheduling with costing, analyzing and managing nursing equipments, nursing costs, nursing manpower costs, supplying items, nursing income and comprehensive costs, so that nursing costing is gradually separated from medical costs.
b. Nursing costing components Cost composition, classification can be based on different characteristics of the composition of the nursing program cost is summarized as direct costs and indirect costs. Direct costs that is: personnel costs, material consumption, equipment depreciation and maintenance; indirect costs that is, operating expenses, management costs and education expenses.
4, nursing cost accounting ideas:
Adherence to the patient-centered philosophy and the establishment of cost values, including the establishment of cost values, strengthen the sense of economic management and accurate records of charges, scientific and reasonable charges adhere to the quality of care first and reduce medical care costs, specifically to control costs, reduce waste, strengthen the cost of accounting and adhere to the highest social benefits. Concurrently contains the provision of high-priced services, improve social benefits and the establishment of a reward and punishment system, the conscious implementation of cost accounting
Specific accounting method is: the total cost of care services = direct costs + indirect costs. Among them, direct costs related to nursing time and wages, indirect costs include: management costs, operating costs, such as heating, electricity, housing costs, etc., in order to be fair, the indirect costs will be shared equally to each patient. Nursing individual costing formula:
Nursing labor cost A = (average monthly salary / monthly working hours) × working hours consumed (hours)
Nursing equipment depreciation amount B = (monthly depreciation amount / monthly usage time) × usage time (hours)
Materials used for nursing care C = material tax-inclusive unit price × usage Operating cost D = (A + B + C) / (1 - G) × G (where G=15~25%)
Administrative Expenses E = (A+B+C+D) × (3~5)% Teaching, Research and Social Expenses F = (A+B+C+D) × 5%
Total Costs = A+B+C+D +E+F Reasonable Charges = Total Costs × 1.25
Case Study - A Hospital Hospital implementation of nursing cost accounting specific practices
For the basic nursing process of three items: oral care, prevention of bedsores, change of bed linen.
The basic accounting method: 150 primary care patients were replaced sheets, oral care, prevention of decubitus ulcers care for the time, take the average value. Sub-case costs: labor costs, management costs, washing costs, depreciation costs, nursing material costs. Randomly selected two nurses, one-time average operating costs, nursing material costs (used in the nursing program), management costs (labor costs, office costs, utilities, equipment costs, etc.), washing costs, depreciation costs.
Calculation:
1) Labor cost = [total annual salary of nursing staff / (working day × daily working hours)] × one-time average operating time (minutes) 2) Material cost (nursing material costs, washing costs, equipment depreciation costs)
3) Management costs = (personnel costs + material costs) × 20% (management personnel costs, office costs, housing costs , utilities, supply room manpower costs and equipment maintenance costs, calculated at 20%.)