The Empirical Research On Fine Cost Management In A Public Hospital

Objective To analyze variable costs and establish a fine management system in a Class 3A hospital, to evaluate its feasibility and effectiveness on controlling costs in hospitals and to provide scientific guidance on reducing operating costs, adjusting income structures and optimizing the allocation resources in public hospitals on the premise of ensuring medical quality and continuing to be non-profit and welfare.Methods Take a Class 3A public hospital as the research object and analyze cost structures, development trend and causes of costs of its each department. Then taking medicines, health materials and other key cost projects and key departments with large costs as the pointcut, carry out fine cost management in sources, use and results and other segment of costs, and put forward a set of methods of fine cost management in public hospitals to compare implementation effect and evaluate its feasibility of this fine cost management system.Results This hospital has carried out the fine cost management for one year from January 2014. The total costs, total medical incomes and balance of payments have increased by 28.7%, 33.8% and 79.6% in 2014 respectively compared with those in 2013. The growth rate of total costs is slower than that of medical incomes. Among total costs, costs for hygienic materials and costs for medicines account for 17.2% and 29.7% of medical incomes, which decrease a little compared with those of 2013, and meantime the growth rates of those two costs are slower than that of medical incomes. The proportions of medicines, materials that should be paid with charges and materials that are free of charge in the hospital decrease from 35.5%, 10.1% and 8.9% in 2013 to 31.5%, 8.5% and 6.9% in 2014 respectively, while the ratio of effective income rises from 53.2% in 2013 to 57.7% in 2014 and the optimization ratio is 8.5%.Conclusions The comprehensive cost management system, taking medicines, health materials and other key cost projects and key departments with large costs as the pointcut, carrying out fine cost management in sources, use and results and other segment of costs, is proved to be effective on reducing health-care costs and optimizing income structures. However, the successful implementation of this method depends on accurate cost division, fine cost distribuiting, complete informatization construction, seasonable results of feedback.