A Pilot Study of Nursing Care Cost System Integrated Diagnosis and Resources Utilization
Date Issued
2004
Date
2004
Author(s)
Lee, Ming-Chun
DOI
zh-TW
Abstract
With the continuously changing of medical industrial environment, hospitals in Taiwan face more and more fierce competition. Cost control and quality enhancement become the key factors in organization’s survival, especially when the global budget mechanism has been implemented. However, one of the major functions of hospitals is to provide inpatient services, which consume most of hospital resources. Understanding the resources utilization of hospitalization department will facilitate hospital to extend viability. In the process of providing patient care, nursing care plays a vital role as well as medical care, examination, and operation do. Nursing cost analysis therefore becomes an essential part of cost management. Thus, the purpose of this research is to develop a prototypical model of nursing care cost analysis which integrates diagnosis, patient day in order of stay, and resource utilization. Moreover, we wish to provide the useful information for nurse managers and support them to perform cost management efficiently.
The study adopts the concept of multiple dimensional classification model presented by Fischer (1998). In our model, we classify patient days into several groups by different dimensions and establish a patient day classification matrix. The establishing process was divided into three stages: 1. Develop resource consumption patterns for individual nursing care activities. 2. Establish patient day classification system and nursing care costing model. 3. Validate the nursing care costing model by the second set of data.
The data of cost and nursing care activities collected form five sample wards each patient day in a certain medical center from February to April in 2003 are analyzed in this study. We use 18 diagnoses and 132 patient day types from 2,884 patient days to build the final model.
The results of this research are as follows. When we classified the patient days into groups by these two dimensions of diagnosis and patient stay process, different resources utilization patterns are found. Each patient day can be classified into 16 clusters based on their resources utilization patterns. The overall estimation error is -0.34%. Comparing with earlier researches, predictability of our model is superior.
Through this study, it can be concluded that the nursing care costing model integrated diagnosis, patient day in order of stay, and resource utilization is applicable. Moreover, it can provide valuable information for nurse managers from the combining of case-mix not only for short- term cost control and nurse staffing but also for long-term human resource planning to meet the various management needs.
Subjects
護理照護
資源耗用
成本分析
護理成本
診斷群組
costing system
nursing care
nursing cost
resources utilization
Type
thesis
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