Pharmaceutical costing

Drug cost accounting

With the current pace of medical system reform continues to deepen, strengthen drug cost accounting, the economic interests of medical institutions as well as the future development of the crucial impact.

Abstract: The medical system reform continues to deepen, a series of reform measures have been clearly put forward to actively explore ways to separate medicine and pharmaceuticals, and hospital drugs gradually abolish the drug markup, the implementation of zero-differential price sales. In order to create conditions for the further advancement of health care reform, the Ministry of Finance, the Ministry of Health jointly issued a new "hospital financial system", the new "hospital accounting system", the accounting methods of drugs are also modified accordingly, the content, methods and means of drug accounting has changed. The article linked to some of the experience in the actual work, how to strengthen the cost of drugs under the new situation of accounting for the relevant discussions.

Keywords: new situation; pharmaceutical cost accounting

First, the new situation to strengthen the necessity of hospital pharmaceutical cost accounting

(a) the transformation of the hospital management mode of operation and management of the drug costing has become an inevitable trend

With the health care reform, the hospital's operation and management of the hospital's business model has been deepened. With the deepening of the hospital's business management model has undergone fundamental changes, medical institutions began from the previous nature of the institution began to move towards the market, self-financing, self-management, which makes the hospital to carry out cost control has become inevitable. Carrying out cost accounting, reduce the cost of related items, is conducive to enhance the competitiveness of the hospital itself, enhance the efficiency of the use of medical resources. Drugs in the entire medical process occupies an extremely important position, is a special commodity in the daily operation of medical institutions, with a large number, variety, mobility and difficult to manage the characteristics of the hospital's current drug costing method is still relatively outdated, the medical resources can not be a good configuration, resulting in a waste of resources. The current situation how to strengthen the drug costing management has become the economic management of hospitals, financial management, and even the development of the hospital key issues.

(ii) pharmaceutical costing management in the hospital overall accounting management occupies an increasingly important position

Financial management work is composed of an important part of the internal management of the hospital, financial management is not only the core of the hospital's operations, or the necessary factors for the survival and development of the hospital. Hospital drug cost accounting as an important part of the hospital's internal financial management, throughout the various aspects of the hospital's financial management, and with the implementation of the new system, drugs are added to the management of inventory, drug accounting management in the hospital's overall accounting management occupies a more and more important position, so the new hospital accounting system should be strengthened under the drug accounting management, for the new accounting system of drug accounting requirements, and actively take effective measures to continue to strengthen the drug accounting system. Requirements, actively take effective measures to continuously standardize drug accounting.

(C) the new "hospital accounting system" to strengthen the drug cost management and control put forward higher requirements

The new "hospital financial system", the new "hospital accounting system" requires hospitals to ensure the quality of hospital health care services under the premise of the establishment of a sound cost management system, to strengthen the cost of accounting and cost management, to take effective measures to control the cost of expenditure. The new system stipulates the principles to be followed in cost accounting, and makes uniform provisions for the basic methods of accounting, reflecting the scientific and superiority of the new system. Hospital cost accounting is divided into three levels of accounting: the first level of accounting is a hospital-wide cost accounting, including hospital income, expenditure and other overall economic efficiency; second level accounting is the departmental cost accounting; third level accounting is the cost of the project accounting, including clinic cost accounting, single disease accounting and so on. After the implementation of health care reform, the focus of cost control to departmental cost accounting and project cost accounting direction transfer, drug cost control from the pure total cost statistics to the secondary and tertiary accounting changes, from rough accounting to the direction of refinement.

(D) institutional reform of the compensation mechanism to promote the implementation of hospital drug costing

"Comprehensive reform of urban public hospitals," it is pointed out: ? public hospital reform, breaking the ? medicine for medicine? mechanism, in the abolition of the drug markup at the same time, the implementation of medical service price adjustment and health insurance payment, financial compensation policy adjustment.? Hospitals can be compensated through three ways: adjustment of medical service prices, health insurance payment and financial subsidies after the abolition of the drug markup. However, the financial investment in health care is decreasing, the financial subsidy income in the proportion of the whole hospital's income is getting lower and lower, hospitals due to the abolition of the drug markup and the reduction of income (including the cost of drug storage, custody, loss, etc.), in addition to through the adjustment of the price of health care services, the rest of the part of the hospital is self-consumption. In this situation, the hospital must be open source and cut costs, strengthen the drug cost management and control, reduce the cost of drug storage and storage is particularly important.

Second, the current stage of the hospital drug cost accounting dilemma

(a) hospital drug import and export price difference is difficult to visualize

The new "hospital accounting system" in the drug accounting method, whether it is the set of accounting accounts or accounting concepts than the previous big change, ? The difference between the purchase and sale of drugs? The new accounting system is a new way of accounting for medicines, and it is a new way of accounting for medicines. The new system is a new way of accounting for drugs. and? Drug Expenditures have all been eliminated, and the Drug Revenue was included in the "Medical Income" category. Medical Income The second level of detail accounts, and the second level of expenditure on pharmaceuticals were eliminated. Pharmaceutical Expenditures is classified as "Medical Expenses". Medical Expenditures A second-level line item that will be The price difference between the purchase and sale of drugs The accounting content is merged into the "Medical Income and Expenditure Balance". Balance of medical income and expenditure This indicates that the main body of hospital revenue is no longer based on charging patients for the difference in drug prices. This shows that the main body of the hospital's income is no longer based on charging patients the difference in the price of drugs, changing the traditional? The traditional concept of "medicine for medicine" has been changed. The concept of medicine to support medical care, weakening the role of drugs to compensate for medical costs. But the traditional public hospitals to abolish the price difference between the purchase and sale of drugs has a process, not in one step, drugs still need to be added to the patient after use. This makes the hospital in the complete abolition of the drug markup before the drug purchase price difference appears more hidden, can not clearly from the account processing intuitively reflected, is not conducive to the supervision.

(2) due to the difference in time or management process is not perfect and caused by the account does not match

1. Time difference

The varieties, specifications, the number of drugs, the flow of the link is more, in practice, due to the difference in time caused by the account does not match the management of the drug accounting difficulties. The new "Hospital Accounting System" clearly requires that accounting should be based on the accrual system, and medicines should be managed using the accrual principle in each circulation link. According to this principle, as long as the patient has paid regardless of whether the drug is issued, should be recognized as drug expenditure, but in fact, the patient payment and issue of drugs by the financial and pharmaceutical two different departments responsible for the time is difficult to synchronize; for hospitalized patients, the pharmacy has been issued by the patient has not been paying hospital fees and other cases often exist, these differences due to the timing of the drug revenue and expenditure will result in the caliber of the inconsistent, the drug revenue and expenditure. The drug revenues and expenditures can not be matched.

2. Drug management process is not perfect

In the pharmacy drugs to replenish the pharmacy staff failed to timely preparation of the inventory list or the transfer of the list for review and confirmation, which will result in the issuance of drugs to the patient, the pharmacy drug inventory balance of the negative; in the process of the treatment of the patient, there are often patients leave the hospital early, discharge, or allergic to medicines and other unexpected circumstances, which will lead to the ward to appear in the hospital, the patient's health and safety. This will lead to a surplus of drugs in the ward.

Hospital drug accounting, in addition to the financial management system in the account processing, often through the hospital HIS system for accounting. The new hospital accounting system for the management of drugs put forward? Material management department in accordance with the name, specifications, etc. set up quantity and amount of detailed accounts? Requirements, drugs in the hospital flow of all aspects of the implementation of all the quantity and amount of one-to-one accounting method, and all drugs should be implemented in the number and amount of dual control, to achieve the resources of the hospital network * * * * to enjoy, to maintain the same caliber of data. This puts a higher demand on the hospital's information management, and some hospitals originally lagged behind in the construction of information technology, and the lack of follow-up on the investment of the new system, affecting the implementation of the new system effect.

Three, under the new situation to strengthen the hospital drug cost accounting strategy

(a) to strengthen the process of drug flow accounting, improve the level of drug management

Hospitals in the drug accounting should pay full attention to the management of drugs and circulation process of the various differences between the problem, in order to ensure that the management of the accounts of the drug in line with the real, in the Every aspect of the flow of drugs should be managed consistently with the corresponding drug accounting. The new system provides for the use of accrual accounting, which confirms the issuance of medicines as long as the patient has paid for them or recorded them in the accounts, and eliminates the phenomenon of borrowing medicines and reporting losses without reporting them. In addition to developing normal drug entry and exit statements, a variety of management statements should be continually improved, such as statistical tables of drug breakage, drug price adjustments, statistical tables of drugs to be dispatched, and statistical tables of patient fees receivable. The establishment of a daily checking system, the discovery of differences in a timely manner to identify, timely change, to solve the problem of drug income and expenditure does not match, drug data information distortion, etc., to effectively eliminate the differences caused by time, improve the level of drug management.

(ii) Strengthen the awareness of cost management and cost control

The new "Hospital Accounting System" requires hospitals to strengthen cost accounting and cost management to reduce medical costs. The purpose of cost management is to comprehensively, truthfully and accurately reflect hospital cost information, strengthen cost awareness, improve hospital performance, and enhance the competitiveness of hospitals in the healthcare market. Drug cost accounting is an important part of cost management, according to the object of accounting can be divided into departmental drug cost accounting, patient consultation cost accounting, disease drug cost accounting, etc., effective control of drug costs and expenses, for the hospital's performance evaluation and assessment of the data base. In the accounting process, in strict accordance with the principle of accuracy and the principle of cost proportionality, the actual use of drug costs for detailed analysis, increase the accuracy of cost accounting, especially in the abolition of drug markups before the refinement of drug costing can improve the accuracy of the calculation of the difference between the price of drugs.

Hospitals should set up drug statistical reports and analytical functions, to observe the changes in various types of drug indicators and abnormal data, to provide accurate and effective information for hospital managers. In the carry-over of drug costs to strengthen the analysis of drug income and drug expenditure, set up a variety of drugs detailed statistical tables and analytical functions, the use of data from various departments for matching, so that drug income and drug expenditure in the medical process of the ` proportion of the more reasonable. The dynamic analysis table of medicines can be added, and the indicators of measuring medicines, such as the turnover rate of medicines funds, the percentage of medicines inventory and loss, the rate of medicines loss, the proportion of the use of basic medicines, the ratio of the use of medicines for outpatients and inpatients, etc. can be compared horizontally and vertically on a regular basis to quickly reflect the comparison with that of the same period of the last year.

(D) the establishment of a sound drug inventory system

The hospital's drugs need to be regularly inventoried inventory, the establishment of a sound control system for drug loss, destruction, reimbursement, etc., by the director in charge of the financial department, the audit department, the pharmacy department, and other personnel to form an inventory team, regularly on the physical inventory of drugs. The pharmacy carries out self-inventory every month, and the inventory results are reported to the financial department and the dean in charge for approval. The financial department and the audit department may participate in the inventory of drugs, or conduct random inventory of pharmacy drugs for effective accounting control. The finance department should verify in detail the difference in the quantity change of each variety, analyze the reasonableness of the change, and then adjust the book number of drugs after the approval of the dean in charge. For the inventory surplus, need to determine whether the normal surplus; for the deficit, need to identify the reasons for poor custody of the individual to be held liable for compensation, belonging to the normal wear and tear of the hospital expenditures, can not be offset by profit and loss.

(E) increase the construction of hospital accounting information

Hospital information management system must be updated to keep pace with the new situation and the pace of change in the hospital environment, and continue to meet the needs of the financial sector and the pharmacy department, and standardized drug management processes, with the new "Hospital Accounting System," the accounting guidelines match the accounting information on pharmaceuticals and pharmaceutical supplies out of the information complete The link between the drug accounting information and the information of drug materials out of the warehouse is complete, so as to realize the goal of efficient management of drugs in the hospital. Relying on the information management system, make the drugs from warehousing, storage, and the whole process of the information data can be effective statistics, the drug income, expenditure, balance of every detail of the timely management and supervision, the abnormal changes in the data for analysis and warning, in improving work efficiency at the same time, can really realize the transparent management of the drug flow process. The new "Hospital Accounting System" requires that the drug income and expenditure, the amount of money to be subdivided into the clinical departments, medical departments and auxiliary departments, the workload is large and prone to error, the financial sector can also be completed with the help of information management systems to assist in the statistics.

(F) enhance the professional quality of drug accounting staff

The new hospital accounting system for drug accounting puts forward higher requirements, drug accounting is no longer limited to simple drug accounting and inventory, should also be fully involved in the supervision and management of drugs in the process. The new hospital accounting system puts more demands on drug accounting, which is no longer limited to simple drug accounting and inventory, but should be fully involved in the process of drug supervision and management.

Four, conclusion

With the current pace of healthcare system reform continues to deepen, to strengthen the drug cost accounting, the economic interests of medical institutions and the future development of the vital impact. Medical institutions should attach great importance to the management of drug costing, face up to the problems that exist in the current work, and actively explore and seek solutions and strategies to promote the management of drug costing towards the direction of scientific and standardized development.

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