印度医院部门的医疗成本核算。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Yashika Chugh, Shuchita Sharma, Abha Mehndiratta, Deepshikha Sharma, Basant Garg, Shankar Prinja, Lorna Guinness
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引用次数: 0

摘要

确定国家保险计划的报销比例需要可靠的成本数据。收集提供者生成的成本核算信息是改进成本证据的潜在机制。为了为获取成本数据以制定报销比例的策略提供信息,本分析旨在描述成本核算在印度公共和私营医疗部门中的作用,并说明改进成本核算系统的重要性、可感知的障碍和促进因素。对 11 位关键信息提供者进行了深入访谈(IDI)。访谈工具指南参考了已出版和灰色文献以及政府网站。对访谈进行了录音和录像,并进行了誊写。为分析制定了主题编码框架。通过多次讨论,对主题进行了增删、分类或合并。确定的主题包括:印度医院部门成本会计的现状、成本报告的法律法规要求、实施成本会计的挑战以及改进医疗机构成本报告的建议。研究结果表明,由于对成本核算的好处缺乏了解、能力有限以及成本报告法规执行不力,印度医院行业在成本核算方面还不够成熟。医疗机构认识到成本分析对投资决策的价值,但对收集和报告成本信息的意愿意见不一,理由是资源限制和对支付方缺乏信任。此外,由于医疗服务提供者之间存在差异,因此在制定成本核算报告框架和法规时需要采取量身定制的方法。印度的医疗成本核算系统除少数例外情况外都很简陋,这就提出了如何可持续地获取这些数据的问题。要加强成本核算系统,就必须制定标准化格式,为决策提供足够的信息,为私营医疗服务提供者所接受,并能与现有的数据管理系统相结合。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Health care cost accounting in the Indian hospital sector.

Setting reimbursement rates in national insurance schemes requires robust cost data. Collecting provider-generated cost accounting information is a potential mechanism for improving the cost evidence. To inform strategies for obtaining cost data to set reimbursement rates, this analysis aims to describe the role of cost accounting in public and private health sectors in India and describe the importance, perceived barriers and facilitators to improving cost accounting systems. In-depth interviews were conducted with 11 key informants. The interview tool guide was informed by a review of published and grey literature and government websites. The interviews were recorded as both audio and video and transcribed. A thematic coding framework was developed for the analysis. Multiple discussions were held to add, delete, classify or merge the themes. The themes identified were as follows: the status of cost accounting in the Indian hospital sector, legal and regulatory requirements for cost reporting, challenges to implementing cost accounting and recommendations for improving cost reporting by health care providers. The findings indicate that the sector lacks maturity in cost accounting due to a lack of understanding of its benefits, limited capacity and weak enforcement of cost reporting regulations. Providers recognize the value of cost analysis for investment decisions but have mixed opinions on the willingness to gather and report cost information, citing resource constraints and a lack of trust in payers. Additionally, heterogeneity among providers will require tailored approaches in developing cost accounting reporting frameworks and regulations. Health care cost accounting systems in India are rudimentary with a few exceptions, raising questions about how to source these data sustainably. Strengthening cost accounting systems in India will require standardized data formats, integrated into existing data management systems, that both meet the needs of policy makers and are acceptable to hospital providers.

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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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