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[目的]建立肿瘤专科医院临床科室综合效益评价指标体系,为提升临床科室医疗资源利用效率和管理水平提供参考。[方法]应用文献研究和专家咨询的形式评估各类成本在科室所占比例。用线性回归分析人力成本、医疗成本、药品成本、管理保障成本和固定资产折旧这5类成本对总收入的影响。数据包络分析方法进行临床科室的规模效益分析。[结果]5类成本中,药品成本在各临床科室所占比重最大,各科室成本回收率均>1,说明各科室收入均大于成本。其中F科室成本回收率高于其他临床科室。线性回归分析表明5类成本对总收入的影响决定系数为0.972(F=203.258,P<0.001),影响力从大到小的3类成本依次为人力成本、医疗成本和药品成本,三者对总收入的影响均有统计学意义。科室A和C相对效率最优,科室G相对效率最低。科室D、F和G规模较大,但效益偏差。[结论]医院临床科室成本效益评价体系中药品成本所占比重最大,应作为成本要素管理的重点。部分临床科室存在投入过剩或产出不足现象,且规模较大、效益差,需缩小其规模、减少投入。
[Objective] To establish the index system of comprehensive benefit evaluation in clinical departments of cancer hospitals and provide references for improving the utilization efficiency and management level of medical resources in clinical departments. [Methods] The application of literature research and expert advice in the assessment of the various types of costs in the proportion of departments. The linear regression was used to analyze the impact of the five categories of costs, including labor costs, medical costs, pharmaceutical costs, management support costs and depreciation of fixed assets, on total revenue. Data Envelopment Analysis of the clinical departments of scale and benefit analysis. [Results] Of the 5 categories of costs, the cost of medicines accounted for the largest proportion of all clinical departments and the cost recovery rates of all departments were> 1, indicating that the income of all departments exceeded the cost. F department which cost recovery rate is higher than other clinical departments. The linear regression analysis showed that the coefficient of determination of category 5 costs on total income was 0.972 (F = 203.258, P <0.001). The three types of costs with descending influence were labor costs, medical costs and pharmaceutical costs in turn. The impact of total revenue was statistically significant. The relative efficiency of department A and C is the best, and the relative efficiency of department G is the lowest. Department D, F and G larger, but the benefits of bias. [Conclusion] The cost accounting system in the clinical departments of hospitals occupies the largest proportion of the cost of medicines and should be the key point of cost factor management. Some clinical departments exist over-investment or under-output phenomenon, and large-scale, poor efficiency, the need to reduce its size and reduce input.