Research On Accounting Of DRG Cost Based On Cost-to-Charge Ratio

BackgroundIt is necessary to continue to promote the development of DRG payment work,and emphasize the fundamental role of medical insurance payment method reform in medical reform.In February 2021,the Department of Finance issued the "Notice on the Cost Accounting Standards for Public Hospitals" for the first time that the Diagnosis Ralated Groups(DRG)were listed as cost accounting objects.Encourage hospitals to carry out DRG-based cost accounting work in accordance with specifications.In order to play the role of cost accounting in medical service pricing,hospital cost control and performance evaluation.The hospital is facing various problems caused by reform of medical compensation mechanism,reform of medical insurance payment method,and improvement of cost accounting method.Promoting the hospital’s DRG-based cost accounting of disease components not only complies with policy requirements,but also provides reliable data support for the promotion of DRG practice in medical institutions.Lay a foundation for the hospital to carry out cost control,improve the efficiency of fund use,and improve the internal management level and operational efficiency of the unit.ObjectiveThe cost-to-charge conversion method is adopted to carry out cost accounting,and then the DRG component cost accounting results are analyzed.Discuss the main factors affecting patient costs from the aspect of cost composition,and propose improvement measures for the sample hospitals to implement cost control,save medical resources,and improve hospital operation efficiency.MethodsThis article uses the literature research method to consult the relevant literature of hospital cost accounting,DRG,and cost-to-cost Ratio.On this basis,form the DRG-based cost accounting steps for the disease;then through on-site survey method and interview method to understand the current situation of S hospital cost accounting,consult the feasibility of the method in S hospital;then collect the required cost data,data It mainly comes from the medical record information management system,HIS,OES,and DRG information management system of S Hospital.This article takes the S Hospital from January to June 2020 in the "OB21-cesarean section,accompanied by important comorbidities and concomitant diseases" DRG group as an example,using the cost-to-charge conversion method to calculate the cost of DRG disease.The accounting steps mainly include the direct cost accounting of the department;the cost allocation of the department;the determination of the accounting unit and the cost-to-charge ratio;the calculation of the patient cost;The costing results discuss the composition of DRG costs through descriptive analysis.The main statistical indicators selected are frequency,percentage,mean and standard deviation.Single factor analysis is used to determine the relationship between the basic special diagnosis and inpatient diagnosis and treatment of patients in different categories in the DRG group and the DRG disease component cost.According to different types of data,non-parametric test methods such as Kruskal-Wallis H Test,Wilcoxon Signed Rank Test and the test level is α=0.05.ResultsFirst,through cost-to-charge conversion method for cost accounting,the "OB21"DRG component cost is 9666.41￥.After verification by the Finance Department and the Price Department of the hospital,the result is in line with the actual situation and is more accurate.Second,Ward units,medicines and consumables units accounted for the main part,especially the cost of ward units accounted for the largest proportion,reaching 49.89%.The results of scatter plot and Pearson correlation analysis also show that the cost of ward unit is positively correlated with the cost of DRG.The higher the unit cost of the ward,the higher the cost of the disease type.Third,through a single factor analysis of the results of cost accounting,it is found that different types of medical insurance,clinical path access conditions are the main factors affecting the cost of DRG.Age is not factors that influence the cost of the DRG.Conclusion and suggestionCompared with the results of traditional cost accounting methods,this study found that under the conditions of insufficient hospital cost accounting work,using the cost-to-charge conversion method can obtain relatively accurate DRG component cost data.And it can meet the DRG grouping requirements,the operation is simple,and the refined cost management requirements of public hospitals guided by the current cost accounting policy.Therefore,it is recommended that the cost accounting-related departments of the S hospital should be familiar with and master the cost accounting method as soon as possible,further improve the internal cost accounting system of the hospital,and improve the cost accounting level of the hospital;in the accounting process,it is found that the internal information island problem in the hospital is serious,and the department The degree of cooperation between them is not enough.It is recommended that the hospital integrate internal information systems and strengthen data integration and management.In addition,hospitals should pay more attention to labor costs in ward units,establish a reasonable scheduling system,and dynamically adjust the number of people on duty to save labor costs.By increasing the entry rate of the clinical path,the doctors’diagnosis and treatment behaviors can be standardized,the unreasonable use of drugs and consumables can be reduced,and the cost of the drug unit and the consumable unit can be reduced.