A Study On Cost Accounting Of DRGs In Public Hospital

In order to effectively curb the unreasonable increase in medical expenses and change the situation of "supporting medicine with medicine",China has accelerated the pace of reform of the medical and health system.In January 2017,the Development and Reform Commission,the Health and Family Planning Commission and the Ministry of Human Resources and Social Security jointly issued the "Notice on Promoting DRG Payment Work",requiring local governments to further advance DRG payment reform work,mainly including gradually expanding the scope of DRG payment and rationally identifying specific diseases It is in line with charging standards,solidly connecting DRG payments,and conscientiously implementing various reform policies.The direction of medical reform is to promote DRG payment.From the perspective of hospitals,it is imperative to carry out Cost Accounting of DRGs.Cost Accounting of DRGs is the sum of the medical item costs,drug costs,and the cost of individual charged materials for the treatment of a single disease while discharged patients are in the hospital to calculate the diagnosis and treatment costs.Practice has shown that Cost Accounting of DRGs can reduce the cost and optimize the diagnosis and treatment process,and can also provide data support for government functional departments to formulate reasonable disease costs,and urge them to generate cost-oriented operating mechanisms.Therefore,the introduction and strengthening of the DRGs accounting method is the highlight of the hospital's deepening of cost accounting under the new medical reform situation,especially in the DRG payment method reform.This article summarizes the existing research results at home and abroad,and sorts out related research on Cost Accounting of DRGs in public hospitals in China from the perspective of DRGs cost accounting methods,application process,results and recommendations.Furthermore,it was found that there is a problem of DRGs related concepts being confused and few scholars have researched the Cost Accounting of DRGs process in public hospitals.Based on this,this article firstdefines the concepts of DRGs,DRG payment methods,DRGs payment standards,DRGs payment fees,and Cost Accounting of DRGs,and systematically explains the basic process of Cost Accounting of DRGs in public hospitals under the activity-based costing method,providing a theoretical basis for case studies.Next,the case part selected the A hospital that implemented Cost Accounting of DRGs earlier in Yunnan Province.By introducing the development history and implementation methods of Cost Accounting of DRGs in the case hospital,and selecting the appendicitis disease,the Cost Accounting of DRGs process and cost structure were studied.It is further concluded that the implementation of Cost Accounting of DRGs in Hospital A helps optimize resource allocation and standardize the diagnosis and treatment process;control cost structure and reduce medical costs;improve service efficiency and service quality.At the same time,it was pointed out that there is a gap in the database of the DRGs grouping platform that is included in the A hospital,which is not conducive to comparative analysis of the data;the precise control of DRGs costs needs to be further strengthened and other practical problems.According to the above research,it is found that Cost Accounting of DRGs in public hospitals minimizes medical input,reduces hospital cost consumption,and standardizes diagnosis and treatment behaviors based on scientific and informative project cost and DRGs disease composition data.On the other hand,the operation cost method As an application method of Cost Accounting of DRGs,it provides a practical solution to the problem of indirect costs that are difficult to allocate for domestic public hospitals,especially large comprehensive medical institutions.However,it also has certain limitations.On this basis,in order to promote the cost calculation of DRGs in various hospitals,the author puts forward feasibility suggestions from the perspective of the government and the hospital: It is recommended that the government and related functional departments take the lead and lead the unified development of cost accounting work.Separate situations to achieve data resource sharing;bidding by the Cost Data Research Center,selection of software companies with strong information development technology to customize,and standardization of data.In addition,it is recommended that hospitals combine theclinical path with the sorting of the operation chain of the disease and the division of the operation,and use the standard and standardized diagnosis and treatment process to reduce medical speculation and waste of health resources.The implementation of DRG payment methods forced medical institutions to carry out corresponding Cost Accounting of DRGs,and for medical institutions that have never been exposed to Cost Accounting of DRGs before,how and how to start becomes a practical problem,and the reform work is difficult.Therefore,this study takes A hospital,which is a mature Cost Accounting of DRGs application as a representative,through analysis and summary of its Cost Accounting of DRGs initiatives process,aiming to provide some method guidance for medical institutions to promote the implementation of Cost Accounting of DRGs and overcome related problems in this field.At the same time,it provides certain data support for the government to implement the DRGs payment method,and provides certain reference data for the follow-up scholars' research.