Abstract
After the preparation of cost accounting data classified by patients in the first study, this study researches cost accounting classified by medical department. Eight different medical departments were analyzed and additionally patients including seven different types of critical paths, cost accounting classified by critical path, a Diagnosis Procedure Combination (DPC) analysis and the benchmark at several institutions were examined.
The ranking changed noticeable according to examined items such as number of hospital days, income, profit (income-cost), profit ratio (profits/income) and profit per one bed per day. In regard to expensive direct material costs profit rates were low at two medical departments.
Analyzing the cost accounting classified by the critical paths, no problem was identified for the paths of un-ruptured cerebral aneurysm clipping and carotid endarterectomy. An amendment of the length of hospital stay corresponding to the DPC payment system was required for the paths of pacemaker implantation, abdominal total hysterectomy, distal gastrectomy and mastectomy (drain insertion). On the other hand, for femoral neck fracture (Bipolar hip prosthesis) and pacemaker implantation, the profit ratio was as low as 21.6% and 24.1% respectively, because of the expensive direct material cost. Additionally standardization of the heart and blood vessel reference as well as orthopedic surgery material and measurements for purchasing quality products for lower prices were introduced.
