Objective To explore a scientific disease cost accounting. Method Disease cost accounting = disease cost accounting of clinic pathway + disease basis cost accounting. Conclusions It is the tendency with the medical reform for the social security department to pay by disease for the hospitals, as a result, both social security department and hospitals have to resort to the scientific way in terms of cost accounting of disease. And it is practical and effective by means of cost accounting for clinic pathway.
As an advanced mode of diagnosis and treatment, day surgery is widely carried out in foreign countries. Although it started late in China, it has been gradually valued and vigorously promoted in medical and health field in recent years. The effective implementation of day surgery in hospital cannot be separated from the strong support of performance management system. Through introducing the performance management experiences in promoting day surgery mode in West China Hospital of Sichuan University, this article discusses how to construct an effective whole-course performance management system for day surgery combined with operation management through three mechanisms: the management committee mechanism, the operation management mechanism and the performance assessment mechanism, which are based on the structure-process-outcome dimensions of quality management system, at the three levels of hospital, department and position, so as to provide a reference for developing day surgery in China.
ObjectiveBased on the localization of resource-based relative value scale (RBRVS) in H Hospital, to implement a surgical performance management model reform with the main surgery as the core, and to construct a more scientific and fair surgical performance distribution system. MethodsA surgical performance management model with the main surgery as the core was constructed. Relevant data such as RBRVS, diagnosis related groups (DRG), case mixed index (CMI), and surgical time of 65 915 inpatient elective surgeries in H Hospital in 2023 were collected and organized. Large sample historical data analysis was conducted using SPSS software, and the rationality of the optimized surgical performance management model was verified through key indicators. ResultsThe total coefficient of multiple orders for surgery in the 22 departments included in the study was highly correlated with the main surgery coefficient (γ>0.85), and the matching coefficients for each specialty were significantly different (P<0.001). The surgical performance management model with the main surgery as the core showed a significant improvement in the key indicators (doctor’s time resource investment and surgical risk and difficulty). ConclusionBy implementing a surgical performance management model with the main surgery as the core, we aim to strengthen the performance orientation that reflects the risks and difficulty of diagnosis and treatment, as well as the value of doctor services. This will guide clinical practice to return to the essence of medicine, support the development of discipline construction, and further stimulate the vitality and motivation of clinical work.