Case Study And Its Implications Of Cost Accounting In American Public Hospitals

A new round of m edical reform began in 2009,along with the medical payment system's transforming to advanced medical payment system.However,the current mainstream of cost accounting mode still stays in a state of full cost and Project Cost Accounting,controlling costshasn't been achieved.Although some pilots have been trying to put the Disease Cost Accounting into practice,achievi ng expected ef fect proves to be quite difficult.Through studying the model of Disease Cost Accounting in American public hospitals,this paper aims to develop and perfect existing m odestic models,by which we can provide certain reference value for work of national Disease Cost Accounting.From analysis of international practice,the Disease Cost Accounting model of America has been referred to or regarded as a basis in many other foreign countries.We can say that the model in America is relatively typical and advanced.In fact,the Disease Cost Accounting in American public hospitals has been practiced for a rather longer time.With the reform of the medical payment system,Disease Cost Accoun ting has evolved in the U.S.,and gradually establishs the current Disease Cost Accounting based on DRGs.In addition to patients' gender,age,disease types,hospitalization da ys,the U.S.also puts the hospital location differences,regional wage level,clinicals ituation,utilization efficiency of resource,and so on,into the cost accounting model.Firstly,this article uses the literature research to define public hospitals,DRGs and Disease Cost Accounting,gives a brief introduction to the development of cost accounting in American public hospitals,as well as its current situation,characteristics and its representativeness.Secondly,we use the case analysis to illus trate the application and detailed method of Disease Cost Accounting m odel in America.We select public acute carehospitals in Maryland as the case object,it's because that Maryland owns a relatively mature cost accounting system of public hospitals.Mary land makes the cost of its hospitals well below the average national level successfully.Besides,all of Maryland public hospitals make Disease Cost Accounting according to a unified standard,and the advanced medical payment system and the hospital service cost review commission puts quite pressure on them.Then,the paper analyzes the variables and adjustment items of the model.Finally,we attempt to make a comparison between dom estic model of Disease Cost Accounting and th e U.S.'s,outline the reasons why American model can better control costs.At the same time,this paper tries to m ake some improvements on the existing domestic models.And we also put forward corresponding policy proposals on hosp itals' work on Disease Cost Accounting,such as determining the standard clinical pathway,perfecting Disease Cost Accounting model,facilitating the construction of hospital infor mation system,improving the external supervision mechanism,and so on.