Research On The Cost Accounting Oftreatment Services In Z City Based On "SHA2011"

Objective Health is related to personal development,family happiness and the rise and fall of the country.With the rapid development of social economy,the continuous improvement of people’s living standards,the change of disease spectrum and the aging of population,people’s demand for health and health services is increasing.The related situation of health expenditure has become one of the key issues for health economic policy makers when formulating health economic policies.Based on the "SHA2011" provided by the National Health Development Research Center,to calculates and analyses the cost of treatment services in Z city in 2016,in order to understand the scale,collection,distribution and use of treatment services in Z city,so as to provide reference for the formulation and adjustment of health economic policy in Z city.Method This paper studied the current policy environment and related theory knowledge through literature,combined with field investigation,used Excel form and Stata SE statistical software to audit,clean and build database of collected data,and used the "SHA2011" accounting method to calculate the processed data and get the corresponding accounting results.Result(1)The basic situation of recurrent health expenditure and treatment service expenditure in Z city in 2016:The total recurrent health expenditure is 11.673 billion yuan,the total treatment service expenditure is 7.561 billion yuan,and the expenditure on treatment service in Z city in 2016 is 6.5 times that of preventive service;In terms of financing composition,the main sources of financing are public financing scheme and family health expenditure,and the proportion of family health expenditure The highest rate was 49.56%.From the perspective of the functional composition of the treatment cost,the hospitalization service cost and the outpatient service cost are 4.253 billion yuan and 3.308 billion yuan respectively,and the total hospitalization service cost is relatively large;from the perspective of the structure of the organization,the treatment service cost mainly concentrates on the hospital(72.17%);(2)Financing analysis:from the financing analysis of the service function,the highest proportion of outpatient service is family health expenditure(54.17%).90%,followed by the public financing scheme(43.59%),the highest proportion of hospitalization services is the public financing scheme(51.58%),followed by family health expenditure(45.40%).From the analysis of fund-raising institutions,there are some differences in the composition of fund-raising.(3)Functional allocation analysis:from the perspective of the functional allocation of financing schemes,the treatment service costs raised by each financing scheme are mainly concentrated in hospitalization services;From the perspective of the functional allocation of institutions,hospitals mainly provide hospitalization services,grass-roots medical and health institutions and outpatient institutions mainly provide outpatient services.(4)Institutional allocation analysis:from the perspective of institutional allocation of financing schemes,public financing schemes,voluntary medical care payment schemes and family health expenditure are mainly directed to hospitals;from the perspective of institutional allocation of service functions,the institutional allocation of outpatient and inpatient services is basically consistent with the overall situation of treatment services.(5)Beneficiary population analysis:From the age distribution of treatment service fees,the age groups of 50-54 years old and 60-64 years old accounted for 8.59%and 8.74%respectively,and the treatment fees of 0-4 years old group were relatively high,accounting for 7.53%.Combined with the analysis of the proportion of sample population of each age group in the total sample population,we can consider the treatment fees of each age group,which is related to the number of population of each age group.The physical condition needs further in-depth study before a conclusion can be drawn.From the distribution of diseases,according to the classification of ICD-10 chapters,the diseases that accounted for the top five treatment service fees are circulatory system diseases(15.17%).Respiratory diseases(11.4%),digestive diseases(10.95%),urogenital diseases(10%)and factors affecting health status and contacts with health care inistitutions(8.03%).According to GBD classification,the diseases with the highest expenditure on treatment are non-communicable diseases.According to the distribution of treatment cost diseases in different age groups,the characteristics of diseases in different age groups are different.According to the matrix analysis of funding schemes,the economic burden of diseases in some age groups is heavier;from the matrix analysis of disease and financing schemes,a considerable part of the burden of medical treatment has increased.According to the age and institutional matrix analysis of treatment costs,the population of primary health care institutions are relatively concentrated in the 0-4 year-old group and the 60-79 year-old group.The proportion of medical expenditure consumed by people over 40-95 years old in hospitals is as high as 76%.Conclusion Through the analysis of the accounting results of treatment service cost in Z city in 2016,the following problems were found:(1)(1)Health service resources are more focused on treatment services;(2)insufficient government support and unbalanced financing structure of treatment service costs;(3)insufficient service capacity of primary health care institutions,the pattern of medical treatment has not changed;(4)heavy burden of treatment of key diseases and key groups;(5)low standardization of health information system.In view of the problems,the following suggestions are put forward:(1)Improving the government investment mechanism and improving the compensation for public health services;(2)Optimizing the financing structure and playing the role of the government rationally;(3)Improving the service capacity of grass-roots units and reasonably controlling the flow of treatment service costs;(4)Paying attention to the prevention and treatment of key diseases and strengthening the intervention for diseases of special-populations;(5)Strengthen the informationization of medical and health systems and improve the quality of medical records on the front page.