Development of an alternative method of cost accounting for objectively estimating the indirect cost of each department and practice in hospitals.

【目的】作业成本法（作业成本法）被广泛应用于医院各部门医疗服务间接成本的精确分配。在ABC法中，一个部门的间接成本按“成本驱动因素”的数量，如人工小时数和手术小时数，按比例在医疗服务中分摊。但是，如果有许多成本驱动因素，则收集成本驱动因素的数据的工作量可能非常耗时，并且是相当大的负担。作者的目的是开发一种方法，客观地减少成本驱动因素在ABC法中使用。【方法】在分配活动间接总成本时，采用成本动因法确定医疗服务（成本对象）投入的成本金额。为每项活动分配成本动因。我们假设作业和成本动因在ABC法中是最好的组合。我们的方法，即成本驱动减少（CDR），可以客观地从候选成本驱动因素中为ABC中的每个活动选择成本驱动因素的替代品。具体地说，一个活动的总间接成本被临时分配给使用每个候选成本动因的成本对象。计算每个候选人计算的成本与ABC中使用的适当成本驱动因素之间的差异，通过评估函数来评估相似性。为了说明CDR的程序，我们对实验室测试的间接成本分配进行了实际成本核算。【结果】采用本方法对实验室检测成本进行了估算，发现成本驱动因素可以从ABC中的7个减少到4个。同样，用我们的方法得到的成本估算结果与使用ABC计算的结果一样准确。结论：与ABC法相比，我们的方法具有两个优势：(1)它提供的结果与ABC法一样准确；(2)它更容易进行复杂的医院费用估算。一旦我们通过将我们的方法应用于ABC方法的数据来减少成本驱动因素的数量，我们就可以在第二次成本核算后使用更少的成本驱动因素轻松地进行数据收集和成本核算。少

【Objectives】Activity Based Costing (ABC) is widely used to precisely allocate indirect costs to medical services in each department of a hospital. In the ABC method, the indirect cost in a department is divided among the medical services in proportion to the volume of "cost drivers", for example, labor hours and the number of hours of surgery. However, the workload of data collection of cost drivers can be time-consuming and a considerable burden if there are many cost drivers. The authors aim to develop a method for objectively reducing the cost drivers used in the ABC method.【Methods】In the allocation of the total indirect cost belonging to activities, cost drivers are used to determine the amount of cost invested with medical services (cost objects). A cost driver is assigned for each activity. We assume that activities and cost drivers used in ABC method is the best combination. Our method, that is, cost driver reduction (CDR), can objectively select surrogates of the cost drivers … More for each activity in ABC, from candidate cost drivers. Concretely, the total indirect cost of an activity is temporarily allocated to the cost objects using each candidate of cost drivers. The difference between the costs calculated by each candidate and the proper cost driver used in ABC is calculated to evaluate the similarity by the evaluation function. To illustrate the procedure of the CDR, we performed actual cost accounting of indirect cost allocation for laboratory tests.【Results】We estimated the cost of laboratory tests using our method, and revealed that the number of cost drivers could be reduced from seven in the ABC to four. Similarly, the results of cost estimation obtained by our method were as accurate as those calculated using the ABC.Conclusions : Our method provides two advantages compared to the ABC method : (1)it provides results that are as accurate as those of the ABC method, and (2)it is simpler to perform complicated estimation of hospital costs. Once we reduce the number of cost drivers by applying our method to the data for the ABC method, we can easily perform data collection and cost accounting using fewer cost drivers after the second time of costing. Less