醫(yī)院年成本分析報(bào)告

1、XX縣人民醫(yī)院2018年度成本分析報(bào)告為了加強(qiáng)我院成本控制，降低運(yùn)行成本，實(shí)現(xiàn)成本最優(yōu)化，現(xiàn)按照醫(yī)院財(cái)務(wù)制度、XX縣人民醫(yī)院成本管理制度相關(guān)要求，對(duì)我院2018年度成本狀況進(jìn)行分析。本分析報(bào)告以醫(yī)院財(cái)務(wù)制度對(duì)醫(yī)療成本劃分為人員經(jīng)費(fèi)、衛(wèi)生材料費(fèi)、藥品費(fèi)、固定資產(chǎn)折舊費(fèi)、無形資產(chǎn)攤銷、提取醫(yī)療風(fēng)險(xiǎn)基金、其他費(fèi)用共七類，把各種成本按照管理費(fèi)用、醫(yī)療輔助類成本、醫(yī)療技術(shù)類成本、臨床服務(wù)類成本逐級(jí)分?jǐn)偟礁髋R床科室，最后形成臨床科室全成本為依據(jù)， 并在2018年度臨床科室全成本構(gòu)成分析表的基礎(chǔ)上進(jìn)一步深入分析，得由可供院領(lǐng)導(dǎo)參考的對(duì)于經(jīng)營(yíng)管理決策有價(jià)值的結(jié)論。一、各項(xiàng)成本的構(gòu)成結(jié)構(gòu)分析2018年度我院共發(fā)

2、生醫(yī)療成本51085988.15元，其中：管理費(fèi)用6036340.95元，醫(yī)療輔助成本1009482.39元，醫(yī)療技術(shù)成本7756806.5元，臨床服務(wù)成本36175928.31元。各項(xiàng)成本占醫(yī)療成本比例為：管理費(fèi)用11.82%,醫(yī)療輔助成本2%醫(yī)療技術(shù)成本15.18%,臨床服務(wù)成本70.8%,臨床服務(wù)類成本占重要比例。各項(xiàng)成本按三級(jí)分?jǐn)偡ò迅黜?xiàng)成本分?jǐn)偟髋R床科室后，各科室各項(xiàng)成本構(gòu)成情況如下表：2018年度臨床科室全成本構(gòu)成表項(xiàng)目/科室內(nèi)一科外一科外二科外三科婦產(chǎn)科五官科急診科針灸科合計(jì)人員經(jīng)費(fèi)1670968.741128675.84991928.91658556.141717591.28

3、391301.81239774.1949017.38703990.95衛(wèi)生材料費(fèi)235427.29134748.071782895.5961385.28365425.5504695.69170221.8224254233096.62藥品6300643.3112316.3089080.3065721.1988094.1177184.3704442.6977.21815172費(fèi)55862546217758.66固定資產(chǎn)折舊121950.4753116.9551112.13433871.5451235.878203.4361729.430875567.54無形資產(chǎn)攤銷000000000提取醫(yī)療風(fēng)險(xiǎn)基

4、金000000000其他費(fèi)用146060.752214.91162072.0811354793710.4335183.752732.17678.4548100.54合8475050.4481072.5977233.6332936.4216057.2186569.5228900.5909836985875計(jì)7563488223236.5.84各臨床科室各項(xiàng)成本構(gòu)成比例如下表所示:2018年度臨床科室全成本構(gòu)成比例表項(xiàng)目/科室內(nèi)一科外一科外二科外三科婦產(chǎn)科五官科診科針灸科合計(jì)人員經(jīng)費(fèi)4.52%3.05%2.68%4.48%4.64%1.06%3.35%0.13%23.53%衛(wèi)生材料費(fèi)0.64%0.

5、36%4.82%2.60%0.99%1.36%0.46%0.01%11.45%藥品費(fèi)17.04%8.41%8.35%8.29%5.38%3.18%10.02%0.02%58.98%固定資產(chǎn)折舊0.33%0.14%0.14%1.17%0.14%0.21%0.17%0.00%2.37%無形資產(chǎn)攤銷0.00%0.00%0.00%0.00%0.00%0.00%0.00%0.00%0.00%提取醫(yī)療風(fēng)險(xiǎn)基金0.00%0.00%0.00%0.00%0.00%0.00%0.00%0.00%0.00%其他費(fèi)用0.39%0.14%0.44%0.31%0.25%0.10%0.14%0.00%1.48%合計(jì)22.9

6、1%12.12%16.16%17.12%11.40%5.91%14.14%0.16%100.00%從“2018年度臨床科室全成本構(gòu)成比例表”中可看由我院各項(xiàng)醫(yī)療成本構(gòu)成比例為：人員經(jīng)費(fèi)占23.53%,衛(wèi)生材料費(fèi)占11.45%,藥品費(fèi)占58.98%,固定資產(chǎn)折舊費(fèi)占2.37%,其他費(fèi)用占1.48%,可看由藥品費(fèi)、人員經(jīng)費(fèi)、衛(wèi)生材料費(fèi)占重要比重，其中內(nèi)一科、急診科藥品費(fèi)占比重較大。2018年度醫(yī)療全成本按科室劃分，構(gòu)成比例分別為：內(nèi)一科占22.91%,外一科占12.12%,外二科占16.16%,外三科占17.12%,婦產(chǎn)科占11.40%,五官科占5.91%,急診科占14.14%,針灸科占0.16%

7、,可看由， 各科室醫(yī)療全成本內(nèi)一科占最大比重，其次為外三科、外二科、急診科、外一科、婦產(chǎn)科，五官科和針灸科占的比重較小。二、各臨床科室單位成本比較分析2018年度各臨床科室診次成本、床日成本構(gòu)成情況如下表所示：2018年度各臨床科室診次成本、床日成本構(gòu)成表科室內(nèi)一科外一科外二科外三科婦產(chǎn)科五官科急診科針灸科合計(jì)科 室 全 成本合計(jì)8475050.754481072.635977233.406332936.884216057.222186569.325228900.3659098.5036985875.84科室收入14321733.087368794.298328259.707091851.65

8、8523131.643099974.817890317.77115378.3256745754.03收入-成本5846682.332887721.662351026.30758914.774307074.42913405.492661417.4156279.8218009304.51門診收入3696976.801149152.081360160.31982023.854084813.87871223.126332176.63115378.3218576994.76住院收入10623417.286219642.216968099.396298371.464438317.772228751.691

9、558141.140.0038355963.93床日數(shù)29695.0016592.0016831.0015948.0013933.005192.004599.000.00102790.00床日成本211.70227.96297.13352.67157.57302.78224.52243.21診次數(shù)37996.0011103.0015179.0010900.0028582.0014791.0065276.001762.00185589.00診次成本57.5862.9464.3180.4570.6941.5564.29:33.5465.24（一）各臨床科室診次成本比較分析從“2018年度各臨床科室

10、診次成本、床日成本構(gòu)成表”中可看由，2018年度臨床科室診次成本從高到低依次為外三科80.45元/診次、婦產(chǎn)科70.69元/診次、急診科科64.31元/診次、急診科64.29元/診次、外二科64.31元/診次、內(nèi)一科57.58元/診次、五官科41.55元/診次、針灸科33.54元/診次，可看由外三科診次成本最高，其次是婦產(chǎn)科、外二科、急診科、外一科。（二）各臨床科室床日成本比較分析從“2018年度各臨床科室診次成本、床日成本構(gòu)成表”中可看由，2018年度臨床科室床日成本從高到低依次為外三科352.67元/床日、 五官科302.78元/床日、外二科297.13元/床日、外一科227.96元/床日

11、、急診科224.52元/床日、內(nèi)一科211.7元/床日、婦產(chǎn)科157.57元/床日，可看由外三科床日成本最高，其次依次為五官科、外二科、外一科、急診科、內(nèi)一科，婦產(chǎn)科床日成本最低。三、各項(xiàng)成本收益率分析2018年度各臨床科室全成本收益率構(gòu)成表如下：2018年度臨床科室成本收益率表科室內(nèi)一科外一科外二科外三科婦產(chǎn)科五官科急診科針灸科合計(jì)全成本8475050.754481072.635977233.406332936.884216057.222186569.325228900.3659098.5036985875.84科 室 收入14321733.087368794.298328259.70709

12、1851.658523131.643099974.817890317.77115378.3256745754.03收益5846682.332887721.662351026.30758914.774307074.42913405.492661417.4156279.8219759878.19成本收益率68.99%64.44%39.33%11.98%102.16%41.77%50.90%95.23%53.43%從上表數(shù)據(jù)可看由：2018年度婦產(chǎn)科成本收益率最高,其次針灸科、內(nèi)一科、外一科成本收益率較高。醫(yī)院應(yīng)加大這幾個(gè)科室的成本投入，且婦產(chǎn)科床日成本最低，針灸科診次成本最低，可重點(diǎn)加大婦產(chǎn)科住院

13、成本及針灸科門診成本的投入，使成本效益實(shí)現(xiàn)最大化。四、量本利分析2018年第一季度各臨床科室量本利分析表如下所示:2018年度各臨床科室量本利分析表科室內(nèi)一科外一科外二科外三科婦產(chǎn)科五官科急診科針灸科合計(jì)人員經(jīng)費(fèi)1670968.741128675.84991928.91658556.141717591.28391301.81239774.1949017.38703990.95固定資產(chǎn)折舊235427.29134748.071782895.5961385.28365425.5504695.69170221.8224254233096.62衛(wèi)生材料費(fèi)6300643.553112316.863089

14、080.253065721.461988094.211177184.73704442.756977.821815172.66藥品費(fèi)121950.4753116.9551112.13433871.5451235.878203.4361729.430875567.54其他費(fèi)用146060.752214.91162072.0811354793710.4335183.752732.17678.4548100.54科室全成本合計(jì)8475050.754481072.636077088.866233081.424216057.222186569.325228900.3659098.5036175928.31

15、固定成本1906396.031263423.912774824.402619941.422083016.78895997.491409996.0151442.3012937087.57變動(dòng)成本6568654.723217648.723302264.463613140.002133040.441290571.833818904.35 7656.2023238840.74科室收入14321733.087368794.298328259.77091851.658523131.643099974.817890317.77115378.3256745754.03門診收入3696976.81149152.

16、081360160.31982023.854084813.87871223.126332176.63115378.3218576994.76住院收入10623417.286219642.216968099.396298371.464438317.772228751.69155814193門診總成本2187728.67698816.35992502.08863108.102020596.39614517.814196322.8459098.5011843001.16門診固定成本492112.36197029.01453180.63362788.89998310.9725

17、1812.931131556.9351442.304235245.65門診變動(dòng)成本1695616.30501787.34539321.44500319.221022285.42362704.893064765.907656.207607755.51住院總成本6286529.723782256.285084586.785535685.752195460.831572051.511032577.520.0024452271.81住院固定成本1414105.431066394.902321643.772326806.181084705.81644184.56278439.080.008744521.

18、47住院變動(dòng)成本4872424.282715861.382762943.023208879.571110755.02927866.94754138.450.0015707750.34床日數(shù)29695.0016592.0016831.0015948.0013933.005192.004599.000.00102790.00床日成本211.70227.96297.13352.67157.57302.78224.52243.21床日固定成本47.6264.27137.94145.9077.85124.0760.5485.07床日變動(dòng)成本164.08163.68164.16201.2179.72178

19、.71163.98152.81床日收入357.75374.86414.00394.93318.55429.27338.80373.15床日單位邊際貝獻(xiàn)193.67211.17249.85193.72238.83250.56174.820.00220.33床日單位邊際貝獻(xiàn)率54.14%56.33%60.35%49.05%74.97%58.37%51.60%59.05%保本點(diǎn)床日數(shù)7301.675049.879292.3012011.014541.822571.021592.7139687.43保本點(diǎn)住院收入2612180.551892982.203847049.454743527.4714467

20、85.361103654.60539609.3614809315.91診次數(shù)37996.0011103.0015179.0010900.0028582.0014791.0065276.001762.00185589.00診次成本57.5862.9464.3180.4570.6941.5564.2933.5465.24診次固定成本12.9517.7529.8633.2834.9317.0217.3329.2022.82診次變動(dòng)成本44.6345.1935.5345.9035.7724.5246.954.3540.99診次收入97.30103.5089.6190.09142.9258.9097.0165.48 100.10診次單位邊際貝獻(xiàn)52.6758.3154.0844.19107.1534.3850.0661.1459.11診次單位邊際貝獻(xiàn)率54.14%56.33%60.35%49.05%74.97%58.37%51.60%93.36%59.05%保本診次量9342.803379.268380.248209.189