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（ActivityBasedCosting，ABC）被广泛应用于医院各科室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是按照“成本驱动因素”的数量（例如，人工小时和手术小时数）按比例分配给医疗服务的。然而，如果有许多成本动因，收集成本动因数据的工作量可能很耗时，而且是一个相当大的负担。作者的目的是开发一种方法，客观地减少成本动因中使用的ABC法。[方法]在分配全部间接成本时，利用成本动因确定医疗服务的成本投入量（成本对象）。为每项活动分配一个成本动因。我们假设作业成本法中使用的作业和成本动因是最佳组合。我们的方法，即成本动因削减（CDR），可以客观地选择成本动因的替代者 ...更多信息 对于ABC中的每项作业，从候选成本动因中。具体地说，一项活动的总间接成本是使用每个候选成本动因临时分配给成本对象的。计算每个候选人计算的成本与ABC中使用的适当成本动因之间的差异，以通过评价函数来评价相似性。为了说明CDR的程序，我们进行了实验室检测间接成本分配的实际成本核算。[结果]应用该方法对实验室检测成本进行了估算，发现成本动因可以从ABC中的7个减少到4个。同样，通过我们的方法获得的成本估计的结果是准确的，那些使用ABC.Conclusions计算：我们的方法提供了两个优势相比，ABC法：（1）它提供的结果是准确的ABC法，（2）它是更简单地执行复杂的估计医院成本。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动因的数量，我们就可以在第二次成本计算后使用更少的成本动因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