基于7所三甲医院数据的血液透析成本测算与分析

目的 通过对7所三级甲等医院血液透析医疗成本的测算和成本构成分析，找出成本构成的主要因素。方法 回顾性调查，分别采用传统成本法和作业成本法对血液透析的直接医疗成本和间接医疗成本进行测算。结果 成本构成中直接医疗成本占总医疗成本的比重最大，为36.68%,其中6所医院的血液透析收费标准低于成本，是血液透析成本的89.35%（均值）。结论 透析液和一次性材料应成为成本控制的重点，调整血液透析收费标准和调整支付方式已经成为可能。

Costing Measurement and Analysis of Hemodialysis on the Basis of Data Collected from Seven Tertiary General Hospitals

Objective To find out the main cost factors of hemodialysis by measuring and analyzing the medical cost data collected from seven tertiary general hospitals. Methods Conducting retrospective study by using traditional costing and activity-based costing approaches to estimate the direct and indirect medical costs of hemodialysis respectively. Results The largest proportion of hemodialysis cost is direct medical cost, which accounts for 36.68% of total medical cost. The charging prices of hemodialysis in six hospitals are lower than respective costs, which is around 89.35% of the cost figure on average. Conclusion Dialysate and disposable materials can be set as the target of cost control, and amendment of charging price and payment methods can make it possible.