应用时间驱动作业成本法优化急诊医疗服务流程*

目的 通过建立测算模型，对急诊3种常见疾病进行成本核算，以提升急诊服务质量。方法 运用时间驱动作业成本法（TDABC）、专家访谈法、现场调研法进行相关研究。结果 急诊3种疾病患者成本由高到低依次为意识障碍患者（436.27元）、呼吸衰竭患者（287.60元）、胸痛患者（253.16元）。TDABC法考虑了急诊医务人员的人力资源成本和时间成本，测算结果更符合实际。结论 TDABC法较现行的成本核算系统更精确，并且可以帮助急诊科优化诊疗流程，进行成本管控，提高医疗效率，降低患者医疗成本，以不断提升急诊服务水平。

Application of Time-Driven Activity-Based Costing in Emergency Medical Services Process Optimization

Objective To improve the quality of emergency services by establishing a model to perform cost accounting of three common diseases.Methods The time-driven activity-based costing(TDABC),expert interview and field research were used.Results The cost of the patients with three diseases in the Emergency Department from high to low was consciousness disorder(436.27 yuan),respiratory failure(287.60 yuan),and chest pain(253.16 yuan).The TDABC method considered the human resource cost and time cost of emergency medical personnel,and the calculation result was more realistic.Conclusion The TDABC method was more accurate than the current cost accounting system,and could help the Emergency Department to optimize the diagnosis and treatment process,control the cost,improve the medical efficiency,reduce the medical cost of patients,and constantly improve the level of emergency services.