The Exploration on the TD-ABC Application under DRG Payment Mode in Department Cost Management of Public Hospitals

Li Weihua; Zheng Caineng; Li Sihai

Abstract：Objective:To explore the application value of Time-Driven Activity-Based-Costing (TD-ABC) under Diagnosis Related Groups (DRG) payment mode in department cost management of public hospitals. Methods:The medical project cost of obstetrics department in Baise Maternal and Child Health Hospital in Guangxi was selected as the research object between January and December 2023. The medical service quality and department cost management were studied to explore the applicability,effectiveness and potential problems of TD-ABC under DRG payment mode so as to provide practical experiences and theoretical support for cost management and improvement of medical service quality in public hospitals. The cost management in obstetrics department of Baise Maternal and Child Health Hospital in Guangxi after implementation of TD-ABC under DRG payment mode was evaluated,and reform results of medical insurance payment mode were presented to provide data support for improving medical service quality and reducing department cost. Results:In Obstetrics Department of Baise Maternal and Child Health Hospital in Guangxi between March 2023 and March 2024,the total cost was 12.6826 million yuan,and labor cost was the highest. In all the 16 main medical service items,there were 10 profitable items and 6 defective items. The item with the worst yield rate was puncture,followed by obstetric examination,medical registration,consultation of difficult cases,discharge nursing and preoperative preparation. Conclusion:As a new cost management method,TD-ABC has broad application prospect and practical value in public hospitals. Application of TD-ABC under DRG payment mode in cost management can control cost more effectively,optimize allocation of resources and improve quality of medical service.