从经营管理的角度分析肿瘤专科医院实施精细化管理的路径
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摘要
[目的]针对肿瘤专科医院存在的药品收入占比高,设备维保成本大,高值耗材使用量多等特点,寻求医院在实施经营管理方面的新措施,为肿瘤专科医院提高精细化管理水平提供参考。[方法]以浙江省肿瘤医院实施精细化管理的实践为例,介绍医院精细化管理工具和方法,并对2014～2017年的经济运行指标进行对比分析。[结果] 2017年医院的各项经济运行指标进一步改善,门急诊均次费用下降到728.56元;住院均次费用下降到17 528元;平均住院日减少到8.76d;药品、耗材、检查、化验收入总占比下降到73.13%;药占比下降到44.86%;门急诊人次同比2014年增长19.74%;出院人次同比2014年增长39.92%;住院手术人次同比2014年增长29.04%;收入结构逐步得到调整,医疗服务收入同比2014年增长41.55%;2017年医院总收入预算执行率达到106.39%,总支出预算执行率达到100.89%。[结论]肿瘤专科医院可以借助信息化的技术和手段,创新精细化管理路径的多种方式,使医院的发展进入良性循环轨道。
[Purpose] To analyze the measures for implementation of delicacy management in cancer specialized hospital from perspective of operation and administration. [Methods] Taking the practice of fine management in Zhejiang Caner Hospital as an example,the refined management tools and methods used in the hospital were introduced,and the economic operation indicators from 2014 to 2017 were analyzed. [Results] In 2017,the economic operation indicators of the hospital were further improved,the average outpatient and emergency expenses per patient visit dropped to 728.56 Yuan;the average hospitalization expenses dropped to 17 528 Yuan per discharged patient;the average length of hospital stay decreased to 8.76d;the total proportion of expenses for drug,consumables,examination and laboratory tests decreased to 73.13%;the proportion of drug expenses dropped to 44.86%. Compared to 2014,the number of outpatient and emergency patient visits increased by 19.74%;the number of discharges increased by 39.92%;the number of operation for inpatients increased by 29.04%;and the revenue of medical services increased by 41.55%. The budget execution rate of total revenue and expenditure reached 106.39%and 100.89%,respectively in 2017. [Conclusion] With the information technology and means,cancer specialized hospitals can innovate a variety of ways for refined management,so as to make the development of hospitals into a virtuous circle track.
[Purpose] To analyze the measures for implementation of delicacy management in cancer specialized hospital from perspective of operation and administration. [Methods] Taking the practice of fine management in Zhejiang Caner Hospital as an example,the refined management tools and methods used in the hospital were introduced,and the economic operation indicators from 2014 to 2017 were analyzed. [Results] In 2017,the economic operation indicators of the hospital were further improved,the average outpatient and emergency expenses per patient visit dropped to 728.56 Yuan;the average hospitalization expenses dropped to 17 528 Yuan per discharged patient;the average length of hospital stay decreased to 8.76d;the total proportion of expenses for drug,consumables,examination and laboratory tests decreased to 73.13%;the proportion of drug expenses dropped to 44.86%. Compared to 2014,the number of outpatient and emergency patient visits increased by 19.74%;the number of discharges increased by 39.92%;the number of operation for inpatients increased by 29.04%;and the revenue of medical services increased by 41.55%. The budget execution rate of total revenue and expenditure reached 106.39%and 100.89%,respectively in 2017. [Conclusion] With the information technology and means,cancer specialized hospitals can innovate a variety of ways for refined management,so as to make the development of hospitals into a virtuous circle track.
引文
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[3]Yang CX,Guo L,Cui GJ,et al.Study on the application of strategically oriented comprehensive budget management in public hospitals[J].China Health Industry,2018,29:106-107.[杨春霞,郭磊,崔国静,等.战略导向的公立医院全面预算管理应用研究[J].中国卫生产业,2018,29:106-107.]
[4]Zhong JX,Zhai HW,Peng WQ.Establishment and implementation of performance evaluation system based on job classification and levels in Sun Yat-sen University Cancer Center[J].China Cancer,2018,27(8):589-595.[钟俊学,翟慧文,彭望清.建立公立医院员工分级分类绩效评价体系的探讨---以中山大学肿瘤防治中心为例[J].中国肿瘤,2018,27(8):589-595.]
[5]Xu ZW,Qin CY,Jia LY,et al.The application prospect of RBRVS performance management model in public hospitals[J].Journal of Chinese Research Hospitals,2018,3:10-13.[徐志伟,秦成勇,贾莉英,等.RBRVS绩效管理模式在公立医院应用前景分析[J].中国研究型医院,2018,3:10-13.]
[6]Jin LX,Liu Y,Liu B.Changes of performance management thought in the public hospitals under the background of new medical reform[J].China Health Industry,2018,6:70-72.[金丽霞,刘毅,刘斌.新医改背景下公立医院绩效管理思路的转变[J].中国卫生产业,2018,6:70-72.]
[7]Zhao Y,Gao YH,Liu L.Application of total cost fine management in hospital economic management[J].Chinese Hospital Management,2016,11:98-99.[赵云,高育红,刘朗.全成本精细化管理在医院经济管理中的运用探讨[J].中国医院管理,2016,11:98-99.]
[8]Pan XZ.Research on the current situation and path of drug consumables cost control in public hospitals under the new medical reform[J].Accoutant,2015,5:20-22.[潘小珍.新医改下公立医院药品耗材费用控制现状与路径研究[J].会计师,2015,5:20-22.]
[9]Cao LL.Probing into the financial management problems and solutions of tumor specialized hospital under the new medical reform[J].China Management Informationization,2017,20(21):62-63.[曹丽丽.探究新医改情况下肿瘤专科医院财务管理问题和解决对策[J].中国管理信息化,2017,21:62-63.]
[10]Wu F.Talking about the role of informatization construction in promoting fine management of hospital finance[J].China Management Informationization,2018,21(14):28-29.[吴峰.浅谈信息化建设对推动医院财务精细化管理的作用[J].中国管理信息化,2018,14:28-29.]
[11]Yang SN.Consideration and prospect of hospital medical insurance talents team construction from the perspective of fine management[J].Human Resource Management,2018,5:351-352.[杨双能.精细化管理视角下医院医保人才队伍建设思考及展望[J].人力资源管理,2018,5:351-352.]
[12]Lu CM,Cheng C,Bao H,et al.Application of fine management in hospital economic management[J].China Market,2018,32:115,120.[陆辰铭,成城,包华,等.精细化管理在医院经济管理中的应用[J].中国市场,2018,32:115,120.]