활동기준원가계산[ABC]을 적용한 가정 간호 원가 분석

Cost Analysis of Home Care with Activity-Based Costing(ABC)

  • 이수정 (연세대학교 간호대학 가정간호·호스피스 연구소)
  • 발행 : 2004.10.01

초록

Purpose: This study was carried out to substantiate the application process of activity-based costing on the current cost of hospital home care (HHC) service. The study materials were documents, 120 client charts, health insurance demand bills, salary of 215 HHC nurses, operating expense, 6 HHC agencies, and 31 HHC nurses. Method: The research was carried out by analyzing the HHC activities and then collecting labor and operating expenses. For resource drivers, HHC activity performance time and workload were studied. For activity drivers, the number of HHC activity performances and the activity number of visits were studied. Result: The HHC activities were classified into 70 activities. In resource, the labor cost was 245₩per minute, operating cost was 9,570₩ per visit and traffic expense was an average of 12,750₩. In resource drivers, education and training had the longest time of 67 minutes. Average length of performance for activities was 13.7 minutes. The workload was applied as a relative value. The average cost of HHC was 62,741₩ and the cost ranged from 55,560₩ to 74,016₩. Conclusion: The fixed base rate for a visit in the current HHC medical fee should be increased. Exclusion from the current fee structure or flexible operation of traveling expenses should be reviewed.

키워드

참고문헌

  1. Baker, J. J. (1998). Activity- Based Costing and Activity-Based Management for Health care. mayland; Aspen Pub. Inc
  2. Brimson J., Antos, J. (1995). Activity-Based Management for service Industries, Government Entities, and Non Profit Organizations, John Wiley & Sons
  3. Canby, J. B. (1995). Applying activity- based costing to healthcare setting. Healthcare financial management, 49(2), 50-2, 54-6
  4. HCC (1995). The Council of Home Agency. Home Care Competency
  5. Hong, J. E., Yun, S. N. (2000). Estimation of Home care Nursing Cost to the patient with cerebrovascular Disease based on a Bundle of Home Care Nursing Service. The Journal of Korea Academy Society of Home care Nursing, 7(1), 26-38
  6. Kim, B. K. (1998) The study on the cost analysis based on ABC system in clinical laboratory, unpublished master dissertation university of Yonsei
  7. Kim, E. S., Kim, S. S., Ko, I. S., Cho, W. J., Chang, H. S., Lu, S. J., Kim, H. Y., Lee, S. J. (2002). The evaluation hospital-based home care and research of system with community-based home care agency. Korea ministry of health and welfare, Seoul : Korea
  8. Kim, J. H., Lee, H. J., Lee, K. S., Whang, J. H. (1998). Model Development for Hospital Process Reengineering by Activity-Based Costing. Journal Korean Society of Medical Informatics, 6(1), 39-51
  9. Kim, J. S. (1998). Current managerial accounting, Hyungseul publising : Seoul
  10. Kim, M. S., Lee, H. J., Kim, H. Y., Kim, J. S. (2002). The resource-based relative value scale and nursing cost calculation of operating room nursing activity, Journal of Korean Academy of Nursing Administration. 8(2) 283-293
  11. Kim, S. J. (2000). Activity Based Cost Management. Mbabook : Seoul
  12. Korea Health Industry Development Institute (2003). 2002 Current census of Home Nursing Care Services
  13. Korea Home Care Nurses Association (2001-a). The home care practice principle. Seoul : Korea
  14. Korea Home Care Nurses Association (2001-b). The symposium of hospital-based home care in present condition and development direction. Seoul: Korea
  15. Lee, K. C. (2001). The introduction in hospital of activity based costing. The korea hospital management research institute, Seoul : Korea
  16. Lee, T. H., Park, J. S., Kim, I. S. (2000). Workload Measurement of Home Health Care Nurses Services using Relative Value Units. Journal of Korean Academy of Nursing. 30(6) 1543-1555
  17. Ministry of health and welfare (2001). The manual of hospita based home care. Seoul : Korea
  18. National health insurance corporation (2003). An annual report of national health insurance major index
  19. Oh, K. S., Kim, K. T. (2002). Costing . managerial accounting. Hongbooks : Seoul
  20. Oh, K. S., Kim, K. T. (2002). Costing . managerial accounting. Hongbooks : Seoul
  21. Park, D. Y., Grandt, M. T., Levine, S. P., Paik, N. W. (1996). Activity-BVased Costing and Management Applied to Occupational and Environmental Health. Korean Industry Hygiene Association, 6(1), 144-155
  22. Park, J. S. (1997). The evaluation research of appropriateness in home care cost. Unpublished doctoral dissertation, University of Yonsei, Seoul, Korea
  23. Ryu, H. S. (1999). A Study on Development of a Model and Payment System for Home Health Care Nursing in Korea. Unpublished doctoral dissertation, University of Yonsei, Seoul, Korea
  24. Sim, W. H., Park, J. H. (1999). Search of hemodialysis nursing behaviors and Estimation of hemodialysis nursing costs at a tertiary hospital. Journal Korean Academy of Nursing Administration. 5(2), 297-316
  25. Stiles R. A., Mick S. S. (1997). What Is the Cost of Controlling Quality? activity-based cost accounting offers an answer, Hospital & Health Services dministration, 42(2) 193-204
  26. Udpa S. (1996) Activity-Based Costing for Hospital. Health Care Management Review, 21(3) p83-96
  27. Whang, N. M., Cho, J. G., Jang, I. S., Kim, E. S., Kim, J. J., Yang, B. M., Yun, S. N. (1999). Model Development and Systemization of Hospital-based Home Health Care. Ministry of Health & Welfare, Korea Institute for Health and Social Affairs