종합병원의 활동기준원가계산제도에 관한 연구

Abstract

In todays competitive environment, a hospital cost accounting system should accomplish cost efficiency without a negative impact on the quality of service delivery, provide information for management to maximize resources, and assist in continuous quality improvement. Todays hospital system encompasses a wide diversity of service. In order to manage them, it is important to determine the amount of resources that are consumed by each service. Activity-Based Costing (hereunder ABC) accomplished all three of these aims. The objective of this study is to find out the differences of the accounting of practical cost between the ABC system and the traditional cost system applied in the general hospital in Korea. The prepared questionnaires comprised of the actual status of the accounting systems mailed to the 292 fully inspected general hospital in Korea. One hundred six (36%) general hospital responded to these questionnaires. Only 46.2% of these responders has been adapted the cost accounting system. Eight six percents of those who applied the cost account system has been used this system since 1991. It suggested that the cost accounting system have not been used efficiently in general hospital in Korea. There are several reasons that have not been used efficiently. The first, the history of cost accounting system in hospital is too short. Second, It has been far backward adapting the technique of the cost accounting system. Finally, may be because of lack of the information system. In addition, when the cost of ward including allocated nursing activity distributed to the in patient part of the respective clinical department, it showed maximum difference of 22.1% between the ABC system and traditional cost system. After distributing the allocated activities of hospital administrators to the respective clinical department whether the cost is inpatient or outpatient care, the maximum differences in the accounting of practical cost showed 106.5% in outpatient part and 69.6% in inpatient part. Management decision makers can utilize ABC information to accomplish cost efficiency without negatively impacting the quality of service delivery while also assisting in continuous quality improvement because ABC provide six major benefits: (1) more accurate costs of services delivered, (2) better discrimination between profitable and unprofitable services and service lines, (3) improved pricing and contracting strategies, (4) improved management decision making capability, (5) greater ease of determining relevant costs, and (6) reduced nonvalue added costs.