医院护理的变量和固定成本的分布
R R Roberts1, P W Frutos, G G Ciavarella
1Department of Emergency Medicine, Cook County Hospital/Rush University, Chicago, IL 60612, USA.
JAMA
|February 24, 1999
概括
大多数医疗保健成本控制策略都侧重于降低可变成本,但这项研究发现,固定成本主导着医院费用. 高的固定成本需要根据患者的消费量进行调整,以提高效率.
科学领域:
- 卫生经济学 卫生经济学
- 医院管理局 医院管理局
- 医疗保健管理的管理
背景情况:
- 控制医疗保健成本是一个重大挑战.
- 目前的战略往往针对的是可变成本,这是总体开支中较小的一部分.
- 了解固定和可变成本结构对于有效的成本管理至关重要.
研究的目的:
- 分析与住院和门诊服务相关的固定和可变成本.
- 量化一个大型城市公共教学医院的成本结构.
主要方法:
- 进行了全面的成本分析.
- 所有1993年的机构支出都被归类为固定或可变支出.
- 固定成本包括工资,福利,设施和公用事业;可变成本包括用品和药物.
主要成果:
- 1993年,医院的总预算为4.292亿美元.
- 预算中的绝大多数 (84%) 是固定成本 (360.3亿美元).
- 可变成本仅占16% (688万美元),直接工资和支持服务占固定费用的很大一部分.
结论:
- 医院服务的特点是与基础设施和劳动力相关的高短期固定成本.
- 仅仅专注于降低可变成本的策略可能不足以控制成本.
- 根据患者数量优化固定成本分配对于医院效率至关重要.
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