project cost method public hospitals cost accounting of disease types
江苏省医院协会医院管理创新研究面上指导课题（JSYGY-3-2019-461）
目的：通过项目成本法对公立医院病种进行成本测算，为公立医院推行成本管控提供参考。方法：以某公立三甲医院为例，按照医疗服务性质不同划分医院的各服务单元，将费用和各项成本归入各服务单元，通过成本/费用计算出各单元的成本费用比值（CCR），并计算“食管癌术后化疗”的病种成本。结果：按照医疗服务分类出25个服务单元，计算每个服务单元的CCR，测算出该院的“食管癌术后化疗”病种成本为7 625元。结论：应用项目成本法计算病种成本较为准确，可操作性强，可为实施按病种付费和医院精细化管理提供参考。
Objective：To estimate the cost of diseases in public hospitals through the project cost（estimation）method，so as to provide reference for the implementation of cost control in public hospitals. Methods：Taking a certainGrade-A Tertiary GeneralHospital as an example，each service unit of the hospital was divided according to the nature of medical service，and the expenses and costs were classified into each service unit. Through the cost/charge，the cost to charge ratios（CCR）of each unit was calculated and the disease cost of “postoperative chemotherapy for esophageal cancer” was calculated. Results：According to the classification of medical services，25 service units were classified，and the CCR of each service unit was calculated. It is estimated that the disease cost of postoperative chemotherapy for esophageal cancer in this hospital is 7 625 yuan. Conclusion：The application of project cost method for calculating the cost of diseases is more accurate and operable，and can provide reference for the implementation of payment by disease and fine management of hospitals.