HOSPITAL COSTING MODEL MANUAL（医院成本核算模型手册）.pdf

HOSPITAL COSTING MODEL MANUAL William Newbrander Elizabeth Lewis Health Reform and Financing Program APHIA Financing and Sustainability Project Management Sciences for Health CONTRACT NO. 623-0264-C-00-7005-00 March 1999 TABLE OF CONTENTS INTRODUCTION 1 Why are hospital costs important? 1 What are the uses of cost data? 2 Who can use cost data? 2 Who is this manual for? 2 How does one do a hospital costing exercise? 3 Step 1: Defining the major and relevant activity areas of the hospital3 Step 2: Gathering information on the services provided or the output of the hospital4 Step 3: Determining the labor and other recurrent costs4 Step 4: Ascertaining the capital costs of the hospital6 Step 5: Allocating the indirect costs8 Step 6: Reviewing and using the hospital cost summary9 CONVENTIONS USED IN THE HOSPITAL COSTING MODEL 11 ASSUMPTIONS 12 REFERENCES 13 i INTRODUCTION A concern of most countries is health sector resources: the sources of finance for health services, the ability to maintain past funding levels, resource allocation patterns, and the efficiency of health services delivery. The hospitals of these countries are an important element of the concern about health resources because they are the largest and most costly operational unit of these health systems and account for a large portion of the health sectors financial, human, and capital resources. In aggregate terms, hospitals utilize nearly half of the total national expenditure for the health sector; hospitals commonly account for 50 to 80 percent of government recurrent health sector expenditure; hospital