An Activity-based Costing application in a medical radiology department-activity quality and profit management

• Main Author: 汪文煌
• Other Authors: 李佳玲
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/29163885870962473750

碩士 === 國立中正大學 === 會計與資訊科技研究所 === 91 === 　　As medical demands have increased, health care expenditures have escalated continuously. To save the finances of the National Health Insurance from bankruptcy, a series of policies have been put into effect by The National Health Insurance Bureau. The reimbursement rules to hospitals have continuously been changing, from “Case Payment”, to self-management of hospitals, and finally to “Global Budgets”, setting a target budget for the hospitals. This change forces the hospitals to improve their self-management and to take on the responsibility of cost control. The more intense the constraints on the growth of hospitals’revenues are, the more hospitals thus have to strengthen their cost control and management to obtain adequate profits. This means that medical organizations have to control their medical service costs and correctly evaluate their individual medical item costs, understand the causes of costs and operate efficiently with limited resources so as to make the best profit. 　　Having a cost accounting system is a recent trend, but the medical service procedures vary widely. The traditional cost accounting system, widely used by domestic hospitals, for the allocation of indirect costs, lacks a causal relationship. It does not reasonably reflect the actual cost, and it causes cross subsidization among departments. This situation may thus end up leading to wrong decisions by the management, who can only calculate the cost at the department level, not at the item service cost level. 　　As Activity-based Costing becomes popular, it proposes the concept that activities consume resources, and choosing proper cost drivers for cost allocation provides more precise assignment of activity costs to individual products, because, from the point of view of activities, it is easier to focus on improvement. Activity-based Costing has been becoming popular in our country, but it still has a way to go before being widely used, and it is even less used in hospitals. It may only be used for calculating item service costs, but it is seldom widely used from this acquired cost information. 　　This thesis proceeds with a case study, applying an Activity-based Costing system to calculate the medical service costs of a radiology department. Using the data of operation properties, income, cost and the method and basic principles of Activity-based Costing, we calculate the medical service costs, and make comparisons between the payments from the National Health Insurance system to calculate profit information. Furthermore, the cost information linked with Activity-based management, is practical and useful for management. This study improves the understanding and familiarity with an Activity-based Costing system in the case hospital, and the results assist to manage costs and profit information for medical service items of the radiology department. By recording the proceeding problems and difficulties, the author’s opinions help with the development and use of an Activity-based Costing system. Applying acquired cost information can help enhance the quality of activities, replace or substitute superior medical service products, and raise the importance of management by cost information, so as to use the hospital’s resources efficiently. Furthermore, this study tries to offer a helpful reference for anyone who wants to implement an Activity-based Costing system.