Study On The Cost-accounting Of Home Health Care In Shanghai

Objective To build a cost-accounting model applying to home health nursing in Shanghai urban area, then use the model to account the cost of home nursing projects currently carried out in Shanghai, in order to help the government formulate reasonable prices on home care services, improve community health services-related policies, and provide the basis for compensation.Methods Use the modular theory as guidance, through literature study, combination of three community health service center in Shanghai to carry out field surveys, preliminary building a home health nursing project cost-accounting model; applying the Delphi expert consultation to demonstrate the scientific, feasibility and rationality of the cost-accounting model, then through a small sample test to modify the cost-accounting model for further optimization. On this basis, use self-recording method and third-party observation method to collect 1161 pieces data of patient's home care cost, using the model to account the cost of home nursing projects currently carried out in Shanghai urban area,Resultsâ‘ The cost-accounting model of home health care project consists of labor costs (A), material costs (B), equipment costs (C), management costs (D), education cost (E) and transport costs (T) six sub-modules. The cost accounting formula is:an item cost of nursing project (F)= A+B+C+D+E; The single home health care project services cost =T+F.â‘¡The top nine frequently home health nursing projects carried out in Shanghai communities are intramuscular injection, intravenous injection, intravenous infusion, subcutaneous injection, medication, bedsore care, catheterization, oxygen, home health care and health guidance, home health nursing project service costs ranged from 2.73 Yuan (health education and skill instruction) to 40.23 Yuan (catheterization).â‘¢Among the six sub-modules of a nursing project cost, labor costs account for 40% to 90%.Conclusionâ‘ In this study, the home health care project cost-accounting model has been built for Shanghai urban Community Service Center, and the accounting results can reflect the costs of the service process in a variety of nursing resources consumption.â‘¡According to the study, the actual costs of home health care project are far more than charged, suggesting that the government should raise home health nursing items fees, or tilt the compensation policy-making for rationalizing compensation mechanism.â‘¢Labor cost is the main cost of home care services, suggesting that community health service centers should follow the principle of nursing personnel classification, and properly use the human resources.