成本資訊系統之實證研究

A Case Study of Applying Activity－Based Costing to Build Hospital Cost Information System

全民健康保險的開辦是醫療界近年來的大事之一，由於健保局打算變更醫療支付制度，使得醫院不得不開始重視成本管理，以因應即將面臨的變革。作業基礎成本制乃是管理會計的一項新搬術，強調以作業做為成本衡量的要點，起初應用於製造業之成本改善，近年來逐漸受到醫療界的重視與青睞，認為它是解決醫療作業成本不易衡量的不二法門。對於醫療界而言，作業基礎成本制尚停留在探討、了解作業基礎成本制實際應用於醫院之種種情形。由於實施作業基礎成本制需要收集大量的成本數據，而且期間的計算過程十分繁複，因此得倚靠資訊科技的輔助，才能發揮其最大的效益。本研究旨在協助醫院建立一套符合作業基礎成本制精神之成本資訊系統，並且提供一個簡易的導入模式，幫助醫院快速地將其成本制度由傳統制更新為作業基礎成本制。研究中以國內某地區教學醫院為研究對象，試著導入模式，並且建置一套成本資訊系統雛形，作為驗證之用。研究中發現，導入模式確實可協助個案醫院快速地、有系統地轉換其成本制度，而本研究所提出之成本資訊系統雛形，確實比原系統更能契合作業基礎成本制之精神。

The implementing of National Health Insurance（NHI）is a big event of Taiwan in recent years. The NHI Bureau plans to change the medical insurance payment system to encourage hospitals administrators to concentrate on cost management. Activity-Based Costing (ABC) system is a technique in managerial accounting. Many parctitioners think it is the best method to measure medical activity cost. Because implementing the ABC system requires complex design of calculating financial data, the assistance from information technology is crucial. The purpose of this paper is not only to help hospitals build a cost information system that consists with the spirit of ABC system but also to provide a brief guidance model to help hospitals change cost system quickly. Via the experiment at a regional teaching hospital, the theory introduced in this paper has been verified. This paper has found that the guidance model can surely help hospital change cost system rapidly. And the prototype of cost information system meets the spirit of ABC system much more than the old cost information system.