About this Journal Publication ethics Editorial Board Editorial Council Editorial Office For the Authors Contacts

News feeds

Journal in Databases


Google Scholar

Google Scholar

Main arrow Archive of previous Issues arrow ¹5 2014 (39) arrow Cost analysis of completed inpatient neurological case-in the context of voluntary health insurance
Cost analysis of completed inpatient neurological case-in the context of voluntary health insurance Print
Wednesday, 26 November 2014

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.


  1. Avksent'eva M.V., Sura M.V. Clinical and economical analysis of health care facility activity. Glavnyy vrach: Khozyaystvo i pravo. 2011; (2): 32-36. (in Russian).
  2. Alekseeva V.M., Shamshurina N.G. Economics of healthcare. Economical analysis of health care activity. Zdravookhranenie. 2010; (2): 161-165. (in Russian).
  3. Andreeva N.S., Rebrova O.Yu., Zorin N.A., Avksent'eva M.V., Omel'yanovskiy V.V. The system for assessment of reliability of scientific evidences and recommendations: comparative characteristics and prospects for unification. Meditsinskie tekhnologii. Otsenka i vybor. 2012; (10):10-24. (in Russian).
  4. Vorob'ev P.A., Avksent'eva M.A., Borisenko O.V., Vorob'ev A.I., Vyalkov A.I., Luk'yantseva D.V., at al. Clinical and economical analysis. 3d ed. rev. Moscow: N''YuDIAMED; 2008. 778 p. (in Russian).
  5. Ivakhnenko O.I., Avksent'eva M.V., Maksimova L.V. Methods for accounting indirect costs in assessment of health care technologies. Meditsinskie tekhnologii. Otsenka i vybor. 2013; (1): 29-35 (in Russian).
  6. Kucherenko V.Z., Martynchik S.A., Osokina O.V. Information tools for controlling of production and business activity of health care facilities. Yekaterinburg, 2008. Series. Training manual for post graduate students. 32 p. (in Russian).
  7. Kucherenko V.Z., Martynchik S.A., Osokin R.S., Martynchik E.A. Organization of management account and analysis of production and business activity of health care facility. Yekaterinburg, 2008. Series. Training manual for post graduate students. 41 p. (in Russian).
  8. Kucherenko V.Z., Martynchik S.A., Osokin R.S., Osokina O.V. Management account and tools for controlling production and business activity of hospitals as a base for increasing the efficiency of medical care. Ekonomika zdravookhraneniya. 2009; (5-6): 5-12. (in Russian).
  9. Kucherenko V.Z., Sokolova O.V., Martynchik S.A. Principles of organization and budgeting of inpatient care with vascular cerebral diseases (a brief literature review). Ekonomika zdravookhraneniya. 2012; (3): 3-10 (in Russian).
  10. Martynchik S.A., Sokolova O.V. Organization and information technologies for managing cost for medical service by the fact of patient treatment in a hospital. Kremlevskaya meditsina. Klinicheskiy vestnik. 2008; (4): 91-93 (in Russian).
  11. Martynchik S.A., Glukhova E.A. Development of technological and consumable standards of inpatient care. Zdravookhranenie Rossyskoy Federatsii. 2010; (1): 11-14 (in Russian).
  12. Martynchik S.A., Sokolova O.V. Improvement of methods for payment for result-oriented inpatient medical care in voluntary health insurance. Kremlevskaya meditsina. Klinicheskiy vestnik.. 2011; (2): 103-105 (in Russian).
  13. Martynchik S.A., Sokolova O.V. Health and economic assessment and grounds for improving organization forms of providing inpatient care for cerebral stroke patents. Sotsial'nye aspekty zdorov'ya naseleniya [series online]. 2013 [cited 2014 Sep 04]; 30 (2). Available from: http://vestnik.mednet.ru/content/view/473/30/lang,ru/ (in Russian).
  14. Omel'yanovskiy V.V., Avksent'eva M.V., Derkach E.V., Sveshnikova N.D. Methodical problems in an analysis of the cost of disease treatment. Meditsinskie tekhnologii. Otsenka i vybor. 2011; (1): 42-45 (in Russian).
  15. Reshetnikov A.V., Alekseeva V.M., Galkin E.B., Efimenko S.A., Zhilina T.N., Il'yasova L.V., et al. Economics of health care. Training guide for students of higher education medical institutions. 2nd ed. Reshetnikov A.V., editor. Moscow, 2010. 272 p. (in Russian).
  16. Shamshurina N.G. The methodic for calculation of the price for medical service. Zdravookhranenie 2006; (2): 161-166 (in Russian).
  17. Shamshurina N.G. The structure of the cost for medical service. Ekonomist lechebnogo uchrezhdeniya. 2008; (8): 28-32(in Russian).
  18. Shamshurina N.G. Economical analysis in health care facilities: the theory and practice. Zdravookhranenie 2013; (9): 20-29 (in Russian).

Views: 14400

Be first to comment this article

Write Comment
  • Please keep the topic of messages relevant to the subject of the article.
  • Personal verbal attacks will be deleted.
  • Please don't use comments to plug your web site. Such material will be removed.
  • Just ensure to *Refresh* your browser for a new security code to be displayed prior to clicking on the 'Send' button.
  • Keep in mind that the above process only applies if you simply entered the wrong security code.

Code:* Code

Last Updated ( Monday, 01 December 2014 )
< Prev   Next >
home contact search contact search