Martynchik S.A., Sokolova O.V., Potemkin E.L.
I.M. Sechenov First Moscow State Medical University, Moscow

Abstract. The aim of the study is to present a method to calculate actual resulting cost per completed hospital case based on the “neurology” disease group used for care cost regulation in the departmental hospital in provision of commercial services under voluntary medical insurance contracts.

We performed evaluation of clinical and economic indicators of result-oriented hospital activity – a treated patient under voluntary medical insurance. This evaluation ensures cost accounting and recourse determination, operating cost control and introduction of elements of financial management.

The study reviewed main principles of activity-based costing and analysis in developing tariffs for completed treatment case according to the “neurology” disease group, including: conditions of cost allocation: patient, disease group, type of care; method to determine cost and price: estimation of cost including complete expenses (net cost), classification of expenses by fixed and related, related profit; estimation of profitability, breakeven point, effect of operating leverage.

We studied the system of comprehensive evaluation of hospital performance based on the system approach to evaluation of results by its components: “expenses” – “volumes” – “profit”.

The study shows that evaluation of ‘result’ of commercial activity is based on indicators of medical and economic efficiency: clinical efficacy and care appropriateness; profitability; return of aggregated expenses; financial stability; managerial control of expenses.

The authors substantiated the standard cost system and net costing which is characterized by inclusion of complete expenses allowing to reimburse all expenses related to provision of medical services.

The following key indicators of hospital performance were calculated: breakeven point, financial strength, operating leverage.

The study recommends development of the system of standards of disease related groups on the basis of the method of cost analysis of a disease related group with due regard to case specifics and composition as a basis for implementing financial norms of provision of inpatient neurological care and setting up incremental contract prices. This is of great importance during transition to normative planning of hospital activity in the context of single channel financing.

Keywords: inpatient care; completed treatment case; disease related group; cerebrovascular diseases; expenses; prime cost; profitability; financial stability; managerial control of expenses; voluntary medical insurance.

References

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