• Korea Journal of Hospital Management
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• v.19 no.1
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• pp.32-42
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• 2014

It is necessary to calculate prime cost of medical services accurately in order to evaluate the adequacy of medical fee. This paper aims to identify cost analysts' perception on prime cost of medical services and needs in establishing a cost accounting system in hospitals, proposing future directions and guidelines for the calculation of medical fee. A self-administered questionnaire and telephone survey on operation of a hospital cost-accounting system was conducted in November, 2012, among cost analysts currently working in the hospitals and hospital administrators planning to implement the hospital cost-accounting system. Our study shows that most of the cost analysts were aware of the importance of calculating prime cost and responded that collection of the prime cost data from government is necessary although they are less likely to provide the data in the future concerning the risk of data misuse and data security. They also responded that lack of budget allocation and excessive workload were the main reasons for not estimating the prime cost and operating cost management information system. Results show that hospital cost analysts considered the data accuracy is the most critical factor in calculating prime costs of medical services. However, there was no investment budget allocated in some hospitals or limited to less than 100 million, indicating that hospitals are reluctant to invest on implementing the cost accounting system. Respondents stated the organization that collects the prime cost of medical services among hospitals should display strong analytical capabilities, ensure data security, and maintain independence, which is most demanded. There are 57 hospitals that calculated the prime cost of medical services for 2012 by each medical department and 20 hospitals that calculated the prime cost by fee-for-services, aiming to establish a cost accounting system. Our results indicate that hospitals should voluntarily provide the accurate prime cost for medical services in order to properly evaluate the adequacy of medical fee. Consequently, it is critical to establish an independent organization to collect and appraise the data. It is also recommended that government should implement various policies to encourage hospitals to participate in the data collection to achieve the data accuracy and representativeness.

• Health Policy and Management
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• v.8 no.2
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• pp.88-109
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• 1998

The main purpose of this study is to compare the traditional cost system and ABC(Activity Based Cost) system of clinical laboratory department in a hospital. The study subject was 296 services in clinical laboratory from March, 1997 to August, 1997. In a new costing system, cost for a lab test consist of direct cost element, activity based cost element, and allocated common cost element. In a traditional cost system, cost elements included direct cost element and indirect cost allocated based on test volumes The major findings of this research were as follows. 1. In the application of ABC system, total cost was analyzed as follows. Direct cost was 39.3% of total cost. Activity cost and allocation were 20.9% and 39.8%, respectively. The results of analysis to use traditional cost system were as follows. Direct cost was 39.3% and it was as same as the result of direct cost of ABC system. Indirect cost was 60.7%. 2. Activities of clinical laboratory of subject hospital were registration, pre-test operation, test, test result handling, delivery, culture, post-test operation, technical support, management support, and educational support. 3. The differences of the case of higher number of test case being carried out, the cost of ABC system was lower than the cost of traditional cost system. Otherwise in the case of lower number of test case being carried out, the rests have not been appropriately evaluated, and effective management were needed in clinical laboratory.