【摘要】：2012年新的醫(yī)院財(cái)務(wù)會計(jì)制度在全國范圍內(nèi)執(zhí)行，新的醫(yī)院財(cái)務(wù)會計(jì)制度對醫(yī)院的財(cái)務(wù)核算及收支管理都提出了更高的要求，，具體要求成本報(bào)表的內(nèi)容不僅要包括醫(yī)院的總成本、科室成本還應(yīng)該包括項(xiàng)目成本、病種成本、床日成本。新政策要求成本的管理目標(biāo)不僅涉及醫(yī)院內(nèi)部的利益分配，還應(yīng)該滿足患者和國家相關(guān)部門成本信息的使用。傳統(tǒng)的成本管理的目標(biāo)僅僅是單一的用于內(nèi)部利益的分配，導(dǎo)致其成本核算過程粗放、成本管理機(jī)構(gòu)設(shè)置權(quán)責(zé)不明。傳統(tǒng)醫(yī)療項(xiàng)目的成本主要是按照收入系數(shù)平均分?jǐn)側(cè)〉�，掩蓋了醫(yī)療檢查項(xiàng)目的技術(shù)性和成本的真實(shí)性，不能為患者和相關(guān)政府部門提供詳細(xì)準(zhǔn)確的項(xiàng)目成本。作業(yè)成本管理是一種精細(xì)化的管理方式，不僅能提供科室成本還能更準(zhǔn)確地提供醫(yī)療項(xiàng)目成本以及病種成本，有效地彌補(bǔ)傳統(tǒng)成本方法的不足。精細(xì)化的成本管理方式能讓醫(yī)院的成本核算結(jié)果既用于醫(yī)院內(nèi)部的利益考核，又能為國家與廣大患者提供服務(wù)。 本文采用理論分析與案例相結(jié)合的方法，圍繞攸州中醫(yī)院的成本核算與管理展開分析與研究。首先在作業(yè)成本管理相關(guān)理論研究的基礎(chǔ)上，以二級甲等公立醫(yī)院攸州中醫(yī)院的成本核算與管理為案例，揭示傳統(tǒng)成本核算與管理存在的問題并且分析原因；然后通過比較攸州中醫(yī)院CT室成本項(xiàng)目的傳統(tǒng)成本核算與作業(yè)成本核算的差異，得出作業(yè)成本管理是能更好地滿足醫(yī)院、患者及國家相關(guān)部門對成本需求的精細(xì)化的成本管理方法；最后提出應(yīng)用作業(yè)成本管理的重心以及應(yīng)用作業(yè)成本管理應(yīng)該具備的保障措施。本文主要目的是通過作業(yè)成本管理在攸州中醫(yī)院的具體應(yīng)用全面地展示作業(yè)成本管理思想的應(yīng)用過程，揭示作業(yè)成本管理是如何彌補(bǔ)傳統(tǒng)成本的不足以及如何滿足多方位的成本信息需求。本文的主要?jiǎng)?chuàng)新在于設(shè)計(jì)應(yīng)用攸州中醫(yī)院作業(yè)成本核算與管理，以精細(xì)化的成本信息為醫(yī)院提供成本管理決策服務(wù)，同時(shí)試圖為國家和患者提供決策支撐。
[Abstract]:In 2012, the new hospital financial accounting system was implemented throughout the country. The new hospital financial accounting system put forward higher requirements for hospital financial accounting and revenue and expenditure management. The specific requirements for the cost statement include not only the total cost of the hospital, but also the total cost of the hospital. Section cost should also include project cost, disease cost, bed day cost. The new policy requires that the cost management objectives not only involve the distribution of benefits within the hospital, but also meet the needs of the use of cost information for patients and relevant state departments. The goal of traditional cost management is only a single allocation of internal benefits, which leads to the extensive cost accounting process and the uncertainty of the establishment of the cost management organization. The cost of the traditional medical project is mainly obtained according to the average income coefficient, which conceals the technical and cost authenticity of the medical examination project, and can not provide detailed and accurate project cost for patients and related government departments. Activity-based cost management (ABCM) is a fine management method, which can not only provide department cost, but also provide medical project cost and disease cost more accurately, which can effectively make up for the deficiency of traditional cost method. The meticulous cost management method can make the cost accounting results of hospitals be used not only for the benefit assessment within the hospital, but also for the country and the vast number of patients. This paper uses the method of theoretical analysis and case study to analyze and study the cost accounting and management of Youzhou traditional Chinese Medicine Hospital. Firstly, on the basis of the theory research of activity-based cost management, taking the cost accounting and management of the second Class A public hospital in Youzhou as a case, this paper reveals the problems existing in the traditional cost accounting and management and analyzes the reasons. Then by comparing the difference between traditional cost accounting and activity-based cost accounting of CT room cost items in Youzhou traditional Chinese Medicine Hospital, it is concluded that ABCM can better meet the needs of hospitals. The detailed cost management method for patients and relevant departments of the country is put forward. Finally, the focus of the application of activity-based cost management and the guarantee measures for the application of activity-based cost management are put forward. The main purpose of this paper is to show the application process of activity-based cost management (ABCM) in Youzhou traditional Chinese Medicine Hospital through the practical application of ABCM. It reveals how activity-based cost management (ABCM) can make up for the deficiency of traditional cost and how to meet the demand of multi-direction cost information. The main innovation of this paper is to design and apply Activity-Based cost Accounting and Management in Youzhou traditional Chinese Medicine Hospital, to provide cost management decision service for hospital with fine cost information, and to provide decision support for the country and patients at the same time.
【學(xué)位授予單位】：湖南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R197.32

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