以时间为导向的基于活动的成本模型,以改善海地Mirebalais的医疗资源使用
Morgan Mandigo1, Kathleen O'Neill2, Bipin Mistry3
1Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA; University of Miami Miller School of Medicine, Miami, FL, USA.
Lancet (London, England)
|August 28, 2015
概括
时间驱动的基于活动的成本计算 (TDABC) 准确地确定了海地的医疗保健成本. 这种方法优化了资源的使用,改善了预算预测,并提高了低资源环境中的患者护理效率.
科学领域:
- 健康经济学
- 医疗保健管理
- 资源分配
背景情况:
- 在资源有限的环境中,效率至关重要,以最大限度地利用患者护理资源.
- 通过分析临床和管理过程,基于时间的活动成本计算 (TDABC) 提供了准确的成本估计.
- 通过将成本与资源利用时间联系起来,TDABC提供了比传统成本计算方法更大的透明度.
研究的目的:
- 在资源有限的环境中适应和应用TDABC以准确计算服务成本.
- 能够可靠地预测财务需求,并为质量改进计划提供信息.
- 在缺乏资源的环境中,最大限度地提高医疗保健的效率.
主要方法:
- 一个多学科团队使用TDABC来绘制海地Mirebalais大学医院 (HUM) 产科和乳腺癌护理的临床过程.
- 根据资源使用时间估计人员,设备和设施的直接成本.
- 间接费用按患者分组分配,人员费用按每张床位计算.
主要成果:
- 阴道分娩的直接成本为62美元;剖腹产的直接成本为249美元.
- 乳腺癌治疗的直接费用, 包括诊断和切除乳腺的费用, 总计为1393美元.
- 间接成本占总成本的26%至38%,工资占总成本的51%至72%.
结论:
- 使用TDABC准确计算医疗服务成本对于财务管理和资金决策至关重要.
- 在HUM,TDABC找到了优化资源使用和降低成本的机会,例如简化杀菌和改善团队合作.
- 应用TDABC改善了预算预测,提供了明智的融资决策,并证明了在缺乏资源的环境中改善医疗服务和医疗服务的价值.
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