Research On Single Item Nursing Accounting Of A Tertiary Hospital Based On TDABC

Objective: The purpose of the study is to explore the application path of time-driven activity-based costing(TDABC)in single-item nursing cost accounting,and provide methodological guidance for indirect cost accounting of nursing units and cost sharing of assessed projects,thus providing comprehensive and accurate nursing cost accounting and decision-making institutions.Provide a reference for price development and optimal allocation of nursing human resources.Method: The total cost of the 63 care accounting items is the sum of the labor costs,material costs,indirect costs,and labor costs and material costs from the apportionment project.This study continues to calculate the other four costs based on the completion of the single project nursing labor cost in the early stage of the research group.The calculation methods for each cost are as follows: Material cost: Through the literature review method,mainly refer to the content of the preparations for the nursing operation items in the fifth edition of Basic Nursing,and jointly determine the material composition of 82 nursing projects in combination with the on-site observation method;Using the unit price of the extracted nursing project materials,the material cost of the nursing project is measured by the cumulative method.Allocation of labor cost and material cost allocation: The classification of nursing items is defined by the expert consultation method,and 82 nursing items are divided into nursing accounting items and nursing sharing items based on the principle of the plural number,and the cost of the nursing sharing items should be determined.The cost of the nursing accounting project is apportioned,and the cost of the apportioned project is allocated to the corresponding accounting project cost through the TDABC method.Indirect cost: using the HRP system to extract the indirect cost of the whole hospital through the secondary data,the indirect cost of the whole hospital is distributed to the nursing unit of the whole hospital by the staff cost allocation method,and the indirect cost of the nursing unit of the whole hospital is allocated to the cost of the accounting project by the TDABC method.Results: The 82 basic nursing items commonly used in clinical practice were divided into 63 accounting projects and 19 assessed projects.By adding the five cost elements,the total cost of the 63 nursing accounting items is TPR 2.627 yuan,blood pressure 3.351 yuan,height and weight 1.199 yuan,oxygen saturation 1.755 yuan,central vein pressure measurement 7.941 yuan,Venous blood collection 13.878 yuan,arterial blood collection 16.617 yuan,intravenous infusion 16.128 yuan,intravenous infusion(retained needle)38.918 yuan,replacement liquid 3.634 yuan,intravenous injection 4.727 yuan,intravenous pump infusion 18.528 yuan,intravenous blood transfusion 21.449 yuan,intradermal injection 15.831 yuan Intramuscular injection of 9.410 yuan,subcutaneous injection of 8.290 yuan,ultrasound guided PICC catheterization 172.906 yuan,venous catheter care 7.350 yuan,PICC catheterization 117.140 yuan,oral drug delivery 2.537 yuan,gastrointestinal tube catheterization 18.853 yuan,Gastrointestinal tube feeding,injection of 10.742 yuan,enteral nutrition solution input of 6.000 yuan,Catheterization 55.210 yuan,sucking 11.51 yuan,skin preparation 16.227 yuan,drainage tube care 7.258 yuan,negative pressure drainage care 27.818 yuan,oral care 13.162 yuan,bladder irrigation 6.302 yuan,sputum specimen collection 3.379 yuan,enema 15.703 yuan,pharynx The swab collects 4.355 yuan,visible light irradiation 6.170 yuan,retains the urine and urine specimen 2.928 yuan,Steel pipe exhaust 12.395 yuan,cold and hot wet compress 4.16 yuan,tracheal intubation care 17.395 yuan,tracheotomy care 18.406 yuan,eye drops Into 2.616 yuan,blood glucose measurement 16.250 yuan,ECG monitoring 9.412 yuan,replacement dressing 15.990 yuan,turn over buckle back 6.832 yuan,corpse cooking 112.604 yuan,terminal treatment 8.970 yuan,chest and abdomen bandage 3.931 yuan,stress injury care 36.403 Yuan,body constraints 7.190 yuan,oxygen inhalation 36.732 yuan,ultrasonic atomization inhalation 34.233 yuan,special physical cooling 20.013 yuan,general physical cooling 1.613 yuan,postoperative patient 17.356 yuan,preoperative preparation 7.274 yuan,stoma care 56.728 Yuan,perineal scrub 13.436 yuan,mechanical assisted drainage 11.203 yuan,insulin subcutaneous injection 4.669 yuan,intravenous high nutrition treatment 9.753 yuan,oral intake 8.354 yuan,"anti-tumor chemotherapy drugs The concentration of the substance/parenteral nutrient solution is 8.896 yuan,and the toilet care is 12.533 yuan.Conclusions: Comprehensive cost accounting is an important premise to reflect the true value of nursing services;dividing nursing projects into accounting projects and apportioning projects from the perspective of cost accounting can lay the foundation for single project nursing cost accounting;TDABC method is used for single project nursing cost accounting In order to make the cost of indirect costs and apportioned items more scientific and accurate,it is allocated to the nursing accounting project.The TDABC method effectively compensates for the defects that the traditional indirect costs cannot be specifically allocated to the project.The use of the TDABC method in nursing cost accounting has contributed to the overall medical cost management and provides methodological guidance for future medical project costing.