醫院成本制度之分析－以傳統制度與目標制度爲例

本研究旨在探討醫院成本制度之運用，以南部某區域醫院爲研究對象，分析傳統成本制度與目標成本制度。傳統成本制度以個案醫院內、外、婦、兒四大科95年8月1日至96年1月l日收入支出明細做分析，目標成本制度以個案醫院單項醫療之頭頸部立體血管造影檢查64切CT、無痛內視鏡（麻醉）、一般造影劑肝癌篩檢磁振造影掃描(MRI)做分析。研究結果顯示：以傳統成本制度而言，個案醫院於收案期間，內科爲績效較佳的部門，平均獲利爲9,135,867.5元，爲值得個案醫院投資的科別。外科與兒科爲虧損之部門。另外，婦、兒二科之人事成本分別占收入51.39%與57.16%，顯示宜再加強個案醫院人事成本的控制。內科之衛藥材成本占33%，顯示該項之成本比例偏高，建議個案醫院可尋求成本較低但品質優良的衛藥材。若以盈虧趨勢分析，此四大科在10月之後均由虧轉盈之趨勢。以目標成本制度而言，個案醫院單項醫療之64切CT可獲得利潤爲14%，無痛內視鏡（麻醉）可獲得利潤爲8.03%、一般造影劑肝癌篩檢磁振造影掃描(MRI)收費可獲得利潤爲3.09%。可知如能合理的控制分析成本，基本上個案醫院仍有一定的利潤可得。

關鍵字

傳統成本制度；目標成本制度；盈虧分析；單項醫療

並列摘要

The purpose of this research was to analyzes the traditional cost system and the target costing based on the Regional Hospital of Southern Taiwan. The traditional cost system was analyzed according to the revenue expenses by the case hospital's internal medical, surgery, obstetrics and gynecology departments through Aug. 01, 2006 to Jan. 31, 2007. For the target costing, we analyzed the three-dimensional head and neck 64 slide CT scan, painless endoscopy, and MRI with contrast (Gd-DTPA) for screening of Hcc.The result showed that in point of the traditional cost system, the department of internal medical has been rated the better performance during the investigation. The average profit is NT $9,135,868. Thus, it is the department which is worth to invest for the hospital. On the contrary, the departments of surgery and pediatrics were in the loss. In addition, the personnel cost of the gynecology and pediatrics departments account for 51.39% and 57.16% of income; it showed that control the personnel cost should be strengthened by the hospital. For the material cost accounts for 33% in department of internal medical, seeking lower cost but high quality of material and medicine are the essential way for the hospital. According to this analysis of its profit and loss, all four departments will be operated from loss into profit after October.In target costing, the three-dimensional head and neck 64 slide CT scan get 14% of the profits, painless endoscopy get 8.03% of the profits, and MRI with contrast (Gd-DTPA) for screening of Hcc get 3.09% of the profits. As the result, if we can conduct a reasonable cost-control analysis, the hospital can still reach its certain profit.