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In the era of the new healthcare reform, high-quality cost accounting can effectively enhance the business performance of public hospitals. Compared with single-campus hospitals, the cost accounting of multi-campus hospitals is faced with greater complexity and challenges. The authors analyzed cost accounting problems found in the latter, namely the lack of top-level design in the construction of a fine multi-campus cost accounting system, difficulty of reasonable collection and allocation of various costs, lack of strong information support, outdated research methods used in item cost accounting among others, as well as their causes. On such basis, the authors put forward countermeasures for high-quality cost accounting in multi-campus hospitals, for the purpose of fully leveraging the leadership of cost control in the high-quality development of public hospitals.
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As suggested by regulatory feedbacks from relevant national regulatory agencies on the use of medical insurance funds, noticeable problems were found in the compliance and rationality of medical service charges among Chinese hospitals. Based on the practice of hospital management, the authors summarized common problems of various medical service charge management as reported by the management authorities at all levels. These problems referred to name-replaceable charges and affiliated charges, splitting charges, repeated charges, and multiple(false) charges. On this basis, the paper analyzed such hospital management risks incurred as regulatory penalties, fee disputes and medical disputes, as well as their internal and external causes. In the end, the paper put forward countermeasures and suggestions for reference by hospitals in their management of medical service charges.
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Objective:Cost accounting for its diagnosis items based on virtual standardized clinical chemistry laboratory.Methods:Relevant data of clinical chemistry laboratories from January to June 2019 were extracted from the laboratory information systems of 10 hospitals in Shanghai, and three health economic experts and the directors of their laboratory departments were interviewed in this regard.On such basis, a virtual standardized clinical chemistry laboratory was constructed. The project cost of the virtual laboratory was calculated from the aspects of supplies exhaust, labor and others. The routine clinical chemistry diagnosis items were clustered according to the principle of laboratory methods, and the cost differences of items in the same cluster were compared using paired t test. Results:The cost of rate method and dry chemical method in testing alanine aminotransferase was 5.12 and 11.63 respectively, and that of immune turbidimetry and immune scattering turbidimetry method in testing immunoglobulin G was 20.00 and 22.26 respectively. Cluster analysis was conducted on 214 routine clinical biochemical diagnostic items, of which 202 items were classified into 42 clusters. The average of clinical chemistry items accounted for 91.7%(4 493/4 900)of the total per day. Based on enzymology, the calculation costs of alanine aminotransferase(rate method), aspartate aminotransferase(rate method), cholesterol(enzyme method)and uric acid(enzyme method)was 5.12, 5.10, 5.24 and 5.14 respectively, presenting no statistical difference( P>0.05). Conclusions:Research on the cost accounting method of clinical chemistry laboratory diagnosis items constructed includes labor cost, reflects the technical labor value of medical staff. Cost accounting based on project clustering can provide references for medical service pricing and financial management of hospitals.
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Deepening healthcare reform highlights the importance of medical services pricing adjustment, and the imperativeness to strengthen the informationized management of such pricing.With this concept in mind, the authors analyzed the problems and causes of the current management on medical service pricing informatization at public hospitals, and discussed the construction strategy of an intelligent error correction system in this regard. That is, to develop a technical process from the four aspects of software flow, interface flow, project rules, and reporting system. This system is designed with such functions as inpatient cost inquiry, inpatient information, price adjustment analysis, price feedback record statistics and inquiries over the hospitalization expense ceiling, as well as inpatient cost omission inquiry.This paper also discussed the construction of a platform to transform the knowledge of pricing policy into the knowledge base of medical service pricing, in order to improve the level of medical pricing management, promote the efficiency of hospital operation and management, and reduce the burden of patients.
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Hospital A is cited as an example to analyze existing problems of pricing management in public hospitals in an attempt to use big data thinking, especially in pricing management improvement using whole sample and correlation analysis. The study covers specifics like logic relations based on pricing items and related indicators, establishment of big data analysis framework and production of analysis statements;and system automatic pre-warning using big data analysis results for higher management efficiency.
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PURPOSE: To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. MATERIALS AND METHODS: This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. RESULTS: Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%). The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years), and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months). CONCLUSIONS: Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital.
Subject(s)
Humans , Male , Compliance , Dissent and Disputes , Financial Management, Hospital , Health Personnel , Malpractice , Medical Errors , Medical Records , Negotiating , Retrospective Studies , Risk FactorsABSTRACT
Background: The blood supply chain is a complex system that considers different interconnected elements that have to be synchronized correctly to satisfy in quality and quantity the final patient requirements. Aim: To determine the blood center maximum production capacity, as well as the determination of the necessary changes for a future production capacity expansion. Material and Methods: This work was developed in the Blood Center of Concepción, Chile, operations management tools were applied to model it and to propose improvement alternatives for the production process. The use of simulation is highlighted, which permitted the replication of the center behavior and the evaluation of expansion alternatives. Results: It is possible to absorb a 100 percent increment in blood demand, without making major changes or investments in the production process. Also it was possible to determine the subsequent steps in terms of investments in equipment and human resources for a future expansion of the center coverage. Conclusions: The techniques used to model the production process of the blood center of Concepción, Chile, allowed us to analyze how it operates, to detect "bottle necks", and to support the decision making process for a future expansion of its capacity.
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Humans , Blood Banks/organization & administration , Models, Theoretical , Operations Research , Chile , Software DesignABSTRACT
Background: Since January 2005, a new model for hospital coordinated assistance was implanted in Chile, denominated Self Managed Hospitals in net, to improve resource use effectiveness and effciency. This new design changed health care and teaching models. Aim: To analyze, understand and to refect on how teachers and students of the Urology Unit of the Eastern Campus of the Faculty of Medicine in the University of Chile, perceive learning in this new hospital scenario. Material and Methods: A qualitative methodology was used, including semi-structured interviews to chief teachers and focal groups of teachers and students. Also, a written structured questionnaire was answered by a group of 5th year students and interns. Results: University teachers perceive that undergraduate learning is affected in the new hospital scenario. Students think that they have less opportunities to directly interact with patients, and therefore have fewer possibilities to take medical histories, perform physical examinations, and fewer occasions to discuss cases with their tutors. Conclusions: The new health system that runs hospitals under a network could jeopardize undergraduate teaching. This is the case for the Urology Service at Hospital and the corresponding Department of Specialties, where the dominant perception of teachers and a number of students is that their clinical learning is endangered by these innovations. To obtain the learning objectives of the undergraduate program in this subject, reorientation of their ambulatory practice and derivation skills must be rationally elaborated to improve students accomplishment.