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台灣公共衛生雜誌 ScopusTSSCI

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篇名 作業基礎成本法與相對值單位法之成本結構相關性比較--以牙科60項處置為例
卷期 23:5、23:5
並列篇名 Contrasting Cost Conponents of ABC and RVU for 60 Dental Procedures
作者 陳琇玲張睿詒戴復興
頁次 388-397
關鍵字 作業基礎成本法相對值單位法牙科成本Activity-based costingABCThe relative value unit methodRVUDentalCostScopusTSSCI
出刊日期 200410

中文摘要

     目標:比較作業基礎成本法(the activity-based costing method, ABC)及相對值單位法(the relative value unit method, RVU)分析牙科處置所獲得結果之相關性,以提供醫院及衛生主管機關選擇成本分析方法之參考。方法:以前人利用ABC及RVU二種方法,分析牙科成本或投入資源相對值所獲得結果(ABC研究與RVU研究),探討二個研究60個可對應處置,區分牙體復形科、根管治療科、牙周病學科、口腔外科四科,其醫師成本、耗材成本、其它執業成本、總成本之Spearman掇 rho相關。並且將二個研究結果分別與92年健保支付標準進行Spearman掇 rho檢測。結果: ABC研究與RVU研究結果,不論在醫師成本、耗材成本、其它執業成本、或總成本四個構面,相關性均達顯著(p<0.01)。口腔外科四個構面相關性更高,根管治療科四個構面卻均未達顯著相關。二個研究結果之各構面中,「醫師成本」與「總成本」相關性均高,其次為「其它執業成本」,「耗材成本」相關性最低。二個研究結果均分別與92年健保支付標準呈顯著且高度相關(p<0.01)。結論:(1)ABC研究與RVU研究結果在四個構面(醫師、耗材、其它執業成本、總成本)之成本與相對值排序關係一致,尤其是醫師成本及總成本。(2)不論ABC研究或RVU研究,健保支付標準足以反應牙科處置投入資源相對性的排序關係。(3)雖然無法判定ABC與RVU的優劣,但是二個研究結果的高度相關,顯示醫療機構及衛生主管機構可以依據可投入資源多寡,以及目的不同,來選擇成本分析方法。

英文摘要

     Objectives: The purpose of this study was to compare the correlation of cost datas for 60 dental procedures between the activity-based costing method (ABC) and the relative value unit method (RVU). This may serve as a reference for choosing the optimum cost method for hospitals or government health departments. Methods: From previous research (ABC study and RVU study), 60 procedures from four dental specialities (Operative Dentistry, Endodontics, Periodontics, and Oral Surgery) could be found correspondingly. The correlation between two studies in terms of physicians?cost, medical material cost, other practice cost, and the total cost were compared by Spearmen掇 rho. The correlation between the total cost of each of the two studies and the reimbursement given by the National Health Insurance (NHI) were also compared. Results: The cost datas of ABC and RVU studies correlated significantly with each other (p<0.01) in respect to physicians?cost, medical material cost, other practice cost, and total cost. The costs of Oral Surgery had the best correlation of the four specialties with the lowest one being Endodontics. On the four dimensions, physicians?cost and total cost had the best correlation. Other practice cost was second, and medical material cost was the lowest. The total cost of ABC study or RVU study was significantly correlated with the reimbursement given by NHI. Conclusions: The sequencial relationship of costs between ABC and RVU were similar, especially in terms of physicians?cost and total cost. (2) The reimbursement given by NHI can respond to the costs of ABC study or RVU study. (3) In respect to the high correlation between two studies, though one cannot judge which one is better, we suggest hospitals or governments adopt the cost method according to the resouces which can be utilized.

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