Construction Of Drgs Cost Accounting Model And Method System In Chinese Public Hospitals

Public hospitals are the main forces of Chinese medical services. In recent years, public hospitals mainly use the services-based payment method. Due to the information asymmetry between patients and public hospitals and lack of government budget, this payment method has changed medical behaviors, induced demands and made the unreasonable increase of medical expenses, eventually, partly lead to the serious phenomenon of "see a doctor difficultly and expensively". At this time, the DRGs introduced into foreign has achieved remarkable results in controlling medical expenses, which provides guidance and ideas for our government and relevant departments. And domestic scholars have also begun to do researches on DRGs and made some results on DRGs grouping. Based on DRGs grouping, DRGs cost accounting is the key of DRGs payment method. Therefore, the successful implementation of DRGs cost accounting plays an important role in promoting DRGs payment method in public hospitals, which then controls the unreasonable medical expenses, eases the problem of "see a doctor difficultly and expensively", makes the public hospitals decreases the medical cost, improves hospitals’ operational performance, and finally balance the social and economic benefits in public hospitals.This article firstly outlines the research status of DRGs payment method and DRGs cost accounting at home and abroad, points out the shortcomings of overseas and domestic research literatures and determines the starting point; Secondly, this paper makes a detailed description of the current situation, problems and basic conditions for DRGs cost accounting; Then it establishes the CA-CPF model of DRGs cost accounting and preliminary explores the use of DRGs cost accounting in public hospitals by combing the relative base cost and performance comparison between public hospitals; Besides, the application of ABC public hospital’s data of DRGs grouping and expenses verifies the rationality of DRGs cost accounting CA-CPF model; What’s more, on the base of DRGs cost accounting model, it constructs the method system of DRGs cost accounting; Finally, the article establishes the implemented framework of DRGs cost accounting and also proposes the specific implementation safeguards.This article concludes the following results:Firstly, the ratio of average medical expenses for the certain DRGs patients and all patients in hospitals (DRGs cost weight) reflects the consumption of medical resources for the DRGs, therefore, the introduction of DRGs cost weight into DRGs cost accounting can effectively control medical expenses; Secondly, the nature of hospital’s base cost is the average cost for patients’ number multiplied by hospital’s weight, based on the predetermined hospital’s income, hospital’s base cost is the reflection of operational performance, so the introduction of base cost into DRGs cost accounting can improve the accuracy of DRGs cost accounting, increase medical resources’ utilization, prompt hospitals to strengthen cost control and decrease medical cost; Thirdly, DRGs cost accounting is based on historical data, in order to ensure the reasonableness of DRGs cost accounting, it needs to timely adjust historical data according to the price fluctuation in the period of accounting, which means DRGs cost accounting should take the change of price level into consideration; Fourthly, DRGs cost standard according to the DRGs cost accounting CA-CPF model is lower than the actual medical expense, which can control the unreasonable medical expense, prompt public hospitals to strengthen the cost control, decrease medical cost and finally achieve the social and economic benefits of public hospitals.