Practice of medical technology performance reform in a large public hospital based on resource-based relative value scale theory / 中华医院管理杂志

With the deepening of the comprehensive reform process of public hospitals and the further refinement of high-quality development requirements, the reform of compensation system of public hospitals has also begun. Taking a hospital as an example, the authors deeply analyzed the four-dimensional performance appraisal scheme of medical technology departments based on resource-based relative value scale concept, with workload assessment as the foundation, multi-dimensional cost assessment as the emphasis, work efficiency as the spur and work quality as the foundation, and introduced the process of implementing the distribution scheme guided by knowledge value to the secondary distribution of departments. The performance appraisal scheme could scientifically reflect the work value of medical staff in medical and technical departments, strengthen the department′s awareness of cost control, improve the efficiency and quality of the department′s work, significantly motivate the medical and technical staff, and deepen the modern management of hospitals.

Contribuição para análise dos custos no tratamento da água utilizando programação linear fuzzy: um modelo para o gerenciamento do abastecimento do município de Campos (RJ) / Contribution to cost analysis in water treatment using fuzzy linear programming: a model for the supply management in the city of Campos, Rio de Janeiro, Brazil

RESUMO A água é um dos recursos naturais essenciais à sobrevivência humana, porém tem sofrido com problemas como sobrecarga de utilização, em âmbito global; distribuição desigual; e escassez, o que contribui negativamente com a disponibilidade do recurso, evidenciando, assim, a crise da água. ­Nesse cenário, surge então a necessidade de se gerenciar de maneira eficaz esse recurso que é tão importante e que apresenta fortes componentes de incertezas. Um importante objeto do gerenciamento é o tratamento químico pelo qual a água bruta passa para se tornar tratada e, então, adequada para o consumo - este processo corresponde ao segundo maior custo nas estações de tratamento de água, atrás apenas de despesas envolvendo recursos humanos, materiais e serviços. Sendo assim, o presente trabalho propõe um modelo de programação linear que incorpora a lógica fuzzy, uma ferramenta eficiente em modelos com incertezas, para auxiliar no gerenciamento de abastecimento de água, considerando os custos com produtos químicos usados no tratamento desse recurso no município de Campos dos Goytacazes. Este modelo foi resolvido utilizando o ambiente Rstudio e apresentou uma redução dos custos em 9,8% em relação ao modelo de programação linear padrão preparado para o sistema. Conclui-se, então, que o trabalho desenvolvido serve de ponto de partida para uma análise mais minuciosa sobre o impacto dos custos de alocação de água tratada no município e contribui positivamente para a racionalização da água bruta.

ABSTRACT Water is one of the essential natural resources for human survival, but it has undergone problems such as: use overload at global level; unequally distribution; and scarcity that contributes negatively to the availability of the resource, thus evidencing a water crisis. Thus, there is a need to effectively manage this important resource, which presents strong components of uncertainties. An important management object is the chemical treatment through which raw water passes in order to be treated and then appropriate for consumption, because it corresponds to the second largest cost in water treatment plants, only after expenses involving human resources, materials, and services. Thus, the present work proposes a linear programming model that incorporates the fuzzy logic, which is an efficient tool in models with uncertainties to assist in any water supply management, considering costs with chemicals used in the treatment of this resource in the city of Campos dos Goytacazes, Brazil. This model was solved using the Rstudio environment and presented a 9.8% cost reduction compared with the standard linear programming model prepared for the system. In conclusion, the developed work serves as a starting point for a more detailed analysis of the impact of the costs of treated water allocation in the municipality and contributes positively to the raw water rationalization.

Cost Management Analysis of Public Hospitals Under Comprehensive Budget Management / 中国医院管理

Cost management is an indispensable part of the economic management of public hospitals,but there are still some problems in the cost control of public hospitals in China.The work of budget management and cost accounting just stays on the surface.Hospitals are running on a large scale and spending too much to make waste.Rules and regulations are incomplete.Staff awareness of cost control is indifferent.The internal audit supervision mechanism is incomplete.Establishing comprehensive budget management is helpful for hospital managers to make decisions,which can effectively improve the cost consciousness of all staff in hospitals,and reduce the management cost of hospital.The goal of cost control should be clearly defined in public hospitals.Hospitals should improve the rules and regulations of cost control.The capital structure of the hospital and the efficiency of fund utilization should be improved.The management of human cost should be taken into account and the idea of cost control should be established.Internal audit supervision should be strengthened.

The game analysis for cost management of medical consumable and stakeholder / 中国医学装备

Objective:To provide the scientific reference basis in order to establish a perfect cost controlled system for medical consumable. To analyze game factors, such as main resource, the price-off influence and price-off aspiration and so on, from different views, such as medical institutions, patients, manufacturers and other stakeholders and so on, based on game theory and situation of medical consumables management.Methods: To collect the management information of medical consumables cost from a tertiary referral center hospital in Fujian in recent 3 years, and adopt descriptive study to analyze the income situation of medical consumable, medical consumable proportion and medical consumable cost per capita.Results: The medical consumable proportions from 2013-2015 were 14.44%, 16.27% and 18.75%, respectively. Medical consumable cost per patient from 2013-2015 were 3547.95RMB, 4122.3 RMB and 5059.02RMB, respectively. All of these datum contained the drug information.Conclusion: It is obvious that the medical consumable proportions and medical consumable cost per patient were enhancement from 2013 to 2015. The necessity of medical consumable leaded to the direct influence on medical cost. On the other hand, the artificially high price and unreasonable implement of medical consumable are the urgent problems and must be resolved as soon as possible.

Problems Analysis and Suggestions of Cost Management in Public Hospitals under the Background of Introducing Social Capital / 中国卫生经济

Leading social capital into the medical and health system reform was the trend of reform and direction of development at present.Carrying out cost management in public hospitals was indispensable to cope with the market competition and the medical and health system reform,which was conducive to allocate health resources rationally,optimize the service process,realize cost control,and promote the economic and social benefits of public hospitals.Taking the Annual Report of Shandong Province Health Finance as date source,it analyzed the current situation and reasons of cost management of the hospitals in Health and Family Planning Department in Shandong,and put forward some suggestions.

Military Hospital Should Handle a Means of Cost Management and Performance Evaluation Based on DRG / 中国卫生经济

Centered with cost and quality control techniques,DRG could promote performance and control costs in health sector initiatives.It was recommended that the army hospital should introduce the cost management and performanee evaluation method based on DRG,step up the establishment of modern hospital management system,improve the health service support capability and medical support capability.

Exploration for a new management model of quota payment for specific diseases / 中华医院管理杂志

Objective The policy of quota payment for specific diseases has been carried out at the hospital for several years, yet proven a failure. This paper aims at searching for a new way of management.Methods Since 2013,attempts have been made for classification of medical costs and the quota setting for specific diseases, and for development of a real-time supervision software for classification of disease-specific costs.The attempts prove a success with a new model for management of quota management for specific diseases.Results This practice has proved to be effective in 2014,and used in other likewise diseases,which has been embraced by administrators of medical insurance sector. Conclusion This model proves useful for reducing inpatient expenses and regulating medical behaviors. but also shorten the average hospitalization days,improve the satisfaction of patient.The method of management control can be expanded and imitated.

Cost management and its practice in project development of hospital information system / 中华医院管理杂志

Development projects of hospital information system is cited as an example,to probe into the technology and methods for cost management in such a system.These methods include total and accurate cost budgeting using the bottom-up method,and cost control using reasonably the earned value management technology.Such methods help locate problems in time and correct them when necessary, thus keeping actual costs of the stages of a project within budget,and the project completion as scheduled with quality assurance.

ANALYSIS OF THE STATUS QUO OF THE COST OF HEALTH MATERIALS IN PUBLIC HOSPITALS AND RESEARCH ON ITS MANAGEMENT METHODS / 现代医院

This thesis, with a Class 3A hospital as the research object, aims at analyzing the status quo and causes of its costs of health materials so as to put forward corresponding methods and suggestions of cost management, thus providing scientific guidance on reducing operating costs and improve medical quality in public hospitals.

Application Prospect of EPR System in Total Cost Accounting of Hospitals / 中国卫生经济

The cost accounting plays central role in enhancing financial management in the hospital. With the increasing hospital competition, conventional model of cost accounting is changing, and gradually replaced with a novel model of cost accounting-total cost accounting. With the wide spread of total cost accounting in all hospitals, it is found that the general operation of hospitals is limited by the original HIS information system. EPR system feathered with the advanced data administration and potent function of financial analysis holding promise in adoption and acceptance by hospitals, serving as information collector and analyzer following HIS system.

Current hospital cost management and studies / 中华医院管理杂志

An analysis of the development and present status of overseas hospital cost management pinpoints the setbacks found in China's hospital cost management, and brings forth the proposal to learn from advanced ideas and methods in overseas hospital industrial engineering and cost management. The goals are to build a nationwide total cost control system, explore new fields in cost management and introduce strategic cost management, in an effort to realize scientific cost management in China.

Gestão de custos aplicada a hospitais universitários públicos: a experiência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da USP / Cost management applied to public university hospitals: the experience of the The Ribeirão Preto Medical School Clinics Hospital of the University of São Paulo

Este artigo apresenta a experiência de implantação da metodologia de custos baseada em atividades (ABC) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, por meio de um estudo de caso, num período de cinco anos. As características dos hospitais universitários de alta tecnologia, tais como atividades docente-assistenciais e serviços básicos de saúde, fazem com que seus custos sejam mais elevados do que os de hospitais não universitários. Na sua trajetória institucional, o HCFMRP-USP não possuía uma metodologia consistente de mensuração e avaliação dos custos de sua atividade assistencial. No entanto, dificuldades de financiamento de suas atividades, associadas a uma completa reestruturação em seu modelo de atendimento vinculado ao Sistema Único de Saúde, impulsionaram a adoção do mapeamento de custos por atividades, para demonstrar, de forma adequada, como pode ser mensurado o impacto do ensino nos custos assistenciais, visto que a agenda democrática nacional tem reivindicado transparência, accountability e, fundamentalmente, eficiência na gestão dos recursos públicos.

This paper presents the experience of implementing the methodology of cost-based activities (ABC) at The Ribeirão Preto Medical School Clinics Hospital of the University of São Paulo (HCFMRP-USP), through a case study over a period of five years. Characteristics of high technology university hospitals, such as teaching and assistance, make their costs higher than those of non-university hospitals. In its institutional history, HCFMRP-USP lacked a consistent methodology for measuring and assessing the costs of its assistance activities. However, difficulties in financing these activities, associated with a complete restructuring in the hospital's healthcare model linked to the National Health System, have furthered the adoption of cost mapping, in order to assess adequately the impact of teaching activities in healthcare costs, considering that the country's democratic agenda has demanded transparency, accountability and, above all, efficiency in public funds management.

Avaliações econômicas em saúde: apuração de custos no atendimento de gestações complicadas pelo diabete / Economic evaluations in health care: counting the costs in the care of pregnancies complicated by diabetes

A avaliação de custos é importante instrumento de trabalho na otimização do gerenciamento hospitalar, indicando ao administrador os resultados que estão dentro dos parâmetros esperados e aqueles que exigem correção. Tal avaliação auxilia também na determinação do preço de venda, nas decisões de investimentos, na expansão de instalações hospitalares e na definição de volumes de estoques de materiais e medicamentos. Os custos podem ser classificados em diretos, indiretos, variáveis e fixos, e podem ser calculados por diferentes sistemas de custeio;entre eles, cálculo por absorção, procedimento ou atividade ABC. A partir desses dados, diversas avaliações econômicas são realizadas: custo e comparação do custo da doença, custo-minimização, custo-utilidade, custo-efetividade e custo-benefício. Tendo em vista a importância do controle de custos nas instituições de Saúde e do ensino do cálculo de custo nessa área, foram apresentados neste estudo os conceitos básicos, os tipos de custos, os sistemas de custeio e os tipos de avaliações econômicas. Finalmente, foram propostas planilhas de custo para uso em atendimento ambulatorial/hospitalar de gestações complicadas por diabete.

Cost evaluation is an important work tool in hospital management optimization as it shows managers the results that are in accordance with expected parameters and those that require correction. It also helps the determination of sale prices, investment decisions, the expansion ofhospital facilities and the definition of stock volumes of material and medicines. Costs can be classified as direct, indirect, variable and fixed, and they can be estimated by different costing systems, such as absorption costing and activity-based costing (ABC). From this information, various economic evaluations are performed: disease cost and comparison of disease cost, costminimization, cost-usefulness, cost-effectiveness and cost-benefit. Considering the importance of cost control in health care institutions and the teaching of cost estimation in health care, basic concepts, cost types, costing systems and economic evaluation types were presented in this study. Finally, cost worksheets were proposed for the use in outpatient units and hospitals for the treatment of pregnancies complicated by diabetes.

Reflections on establishing a medical quality and cost reporting system in the hospital / 中华医院管理杂志

Through an analysis of the establishment of a medical quality and cost reporting system,the paper argues that quality management in the hospital is an eternal theme and that full awareness and high regard of quality management-related costs together with an effective control of them is an important guarantee for gaining advantages amidst quality competition.

Application of activity-based costing to hospital cost management / 中华医院管理杂志

Objective To explore an advanced and effective method of hospital cost management so as to improve the effectiveness of hospital economic management. Methods A variety of methods were used, including field research, expert consultation, activity-based costing management, business process reengineering, and satisfaction survey combined with statistics and computer network technology. Results A system for implementing activity-based costing was established and remarkable results were achieved in lowering the cost of patient care, optimizing business process, raising the staff's awareness of cost, and assisting in development decision-making. Conclusion Activity-based costing, an advanced method of cost management, is of great significance to Chinese hospitals in reducing operational cost, optimizing work process, and improving the effectiveness of management.