某医院成本核算系统

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某医院成本核算系统的设计与实施

摘要

如何以合理的医疗价格和良好的医疗服务质量为社会大众提供健康保障，是政府

和医院需要共同面对的问题。从政府层面看，解决该问题，需要科学的定价依据，达到

合理补偿功效；从医院层面看，需要从提高自身的运营管理能力、降低成本的角度着手

使服务功效最大化。所以无论从哪个层面分析，都需要以医院成本核算为基础提供数据

保障；因此成本核算工作是医院财务精细化管理中的最基本，最重要的第一步。

本次实践是在分析医院财务管理的基础上，对医院的会计核算、预算管理、成本核

算以及物流管理进行了充分的调研和沟通，最终形成了成本核算管理系统。

本系统通过对医院财务综合管理相关的各项业务的调研、设计和实施，将医院的

“医疗业务流”和 “物流、资金流”进行全方位的资源整合，着重对于医院成本核算、

成本归集、成本分摊以及成本分析等各个环节进行论述和分析。实现了医院人、财、物各

项综合资源的计划、使用、协调、控制、评价和激励等应用，最终为医院构建起一整套以

会计为核心、成本为基础的医院成本核算管理系统。实现医院的成本管理，帮助医院院

长、科室主任、医院经济科、医院上级管理部门进行成本分析和成本控制，把医院成本分

析员从繁重的劳动中解脱出来。

该系统能够接收医院现运行的“HIS管理系统”、“财务管理系统”中与成本核算有

关的数据，并且提供其他与成本有关数据的归集和管理。以月为单位，通过四级分摊的

方法进行成本核算。按科室、项目分类汇总直接成本，进行成本分析，分析结果以报表

图形等多种形式显示和打印，以方便数据分析，供各级各类使用人使用。

本系统整体设计采用 B/S 结构，运行环境 Windows server 操作平台＋SQLserver2000

数据库＋Tomcat 中间件技术，最后对系统的运行情况和结果进行了总结、评价与展望。

关键词：医院信息化，财务管理，成本核算，系统设计，系统实施

Abstract

How to provide health security for the public in reasonable medical price and with

medical service of high quality is an issue that our government and hospitals face together.

From the perspective of government, scientific pricing base is needed to achieve the rational

compensation effect, so that the problem can be solved; from the hospitals’ view, they need to

improve their operation management ability and cut off their cost to maximize the service

efficacy. The data support based on the hospitals’ cost accounting is necessary from either

point of view, so cost accounting is the very first step which is most fundamental and essential

in the refinement of hospitals’ management.

Based on the analysis of the hospitals’ financial management, this study has carried out

a full investigation and communication in the hospitals’ accounting, budget management, cost

accounting and logistics management, and finally obtained the cost accounting management

system and put it into practice.

This scheme has all of the hospitals’ "medical business flow" and "material flow, cash

flow" integrated through research, design and implementation of specific business related to

the hospitals’ financial comprehensive management, mainly discuss and analyze the hospitals’

cost accounting, cost accumulation, cost allocation and cost analysis. The scheme realized the

planning, using, coordinating, controlling, evaluating and stimulating of the comprehensive

resource of hospitals like human resource, financial resource and material resource and build

a whole set of management system centered on accounting and based on the hospitals’ cost

accounting.Realizing the hospitals’ cost management is mainly to help the presidents of

hospitals, directors of the economic department of hospitals and superior management

departments conduct cost analysis and cost control, bringing the hospitals’ cost analysts from

the heavy work.

This system can receive the cost accounting related data from the hospitals’ current "HIS

management system", "financial management system" and provide the function of collection

and management of other cost related data. It proceeds the cost accounting by month through

4-level allocation. The system collects direct cost by departments and programs, and conducts

cost analysis. The results of analysis are displayed and printed in statements, graphs or other

forms to make it convenient for all kinds of staff at different levels.

This system’s overall design employs B/S structure, and its running environment is

Windows server operating platform, plus SQLserver2000 database and Tomcat middleware

technology. The results of its operation have been summarized and appraised and forecasted

in the end.

Key words: Hospital computerization, Financial management, Cost accounting, System

design, System implementation

目  录
第一章  绪论..............................................................1
1 课题背景及意义....................................................1
1.1 课题背景...............................................................1
1.2 课题意义...............................................................1
2 新医改下的医院管理模式............................................2
3 国内外研究现状及对比分析..........................................2
3.1 国外研究现状...........................................................2
3.2 国内研究现状...........................................................3
3.3 对比分析...............................................................3
4研究目标及研究内容................................................4
4.1 研究目标...............................................................4
4.2 研究内容...............................................................6
5论文组织结构......................................................7
6本章小结..........................................................7
第二章  需求分析..........................................................8
1 医院管理面临的突出问题............................................8
2 医院管理模式的发展趋势...........................................10
3 再造和优化业务流程...............................................12
3.1 医院业务框架示意图...................................................12
3.2 医院优化业务流程对比..................................................12
4系统需求分析.....................................................15
4.1 系统的业务需求........................................................15
4.2 系统的功能性需求......................................................16
4.3 系统的非功能性需求....................................................21
5本章小结.........................................................22
第三章  总体方案设计.....................................................23
1 设计原则.........................................................23
2 系统逻辑架构设计.................................................23
3 系统功能架构设计.................................................25
3.1 系统模块的主要功能...................................................26
3.2 系统的成本分摊模型...................................................30
3.3 系统核心处理过程......................................................32
4 系统网络拓扑设计.................................................34
5 数据库设计.......................................................35
5.1 数据库设计的标准和原则...............................................35
5.2 数据库概念设计.......................................................36
5.3 数据库详细设计.......................................................37
5.4 数据库逻辑结构设计...................................................39
5.5 数据质量控制.........................................................40
6 系统采用的关键技术...............................................41
6.1 采用开放的分层架构技术...............................................41
6.2 采用大粒度应用组件技术...............................................42
7系统选型.........................................................43
iii

8本章小结.........................................................44
第四章  系统测试.........................................................45
1 系统测试概述.....................................................45
2 测试目的.........................................................45
3 测试环境.........................................................45
4 测试流程.........................................................46
4.1 详细测试计划制定......................................................46
4.2 研发人员自测..........................................................47
4.3 集成测试阶段..........................................................47
4.4 验证测试..............................................................47
4.5 系统测试阶段..........................................................48
4.6 系统功能测试..........................................................49
4.7 兼容性测试............................................................50
4.8 发布测试阶段..........................................................51
4.9 测试总结..............................................................51
5 测试用例及测试结果...............................................52
5.1 典型的测试用例........................................................52
5.2 测试记录和测试结果反馈................................................63
6本章小结.........................................................64
第五章  系统实施.........................................................65
1 实施概述.........................................................65
2 数据准备.........................................................65
2.1 本阶段的主要工作目标和任务............................................65
2.2 静态数据转换..........................................................65
2.3 动态数据转换..........................................................67
2.4 分配项目实施的角色与责任..............................................68
2.5 实施过程中常出的问题..................................................69
3 系统配置.........................................................70
3.1 系统运行环境配置......................................................70
3.2 系统参数配置..........................................................70
3.3 用户权限配置..........................................................73
4系统切换.........................................................76
4.1 切换前期准备..........................................................77
4.2 上线切换..............................................................78
5上线支持.........................................................79
6系统验收及运行情况介绍...........................................79
6.1 系统验收情况..........................................................79
6.2 系统运行情况..........................................................80
7本章小结.........................................................86
总结与展望...............................................................88
主要参考文献.............................................................89
致 谢....................................................................91
iv 

图 清 单
图 1  传统管理向综合管理转变示意图..................................................................................10
图 2　医院业务示意图............................................................................................................12
图 3　系统优化业务示意图....................................................................................................14
图 4  医院成本核算业务示意图..............................................................................................15
图 5  系统体系架构图..............................................................................................................24
图 6  医院成本核算系统业务框架示意图..............................................................................25
图 7  系统模块结构图..............................................................................................................26
图 8  医院全成本核算分摊模型..............................................................................................31
图 9  数据归集时序图..............................................................................................................33
图 10  成本分摊时序图............................................................................................................34
图 11  系统网络拓扑结构图....................................................................................................35
图 12  成本核算系统核心业务实体 E-R 图...........................................................................37
图 13  数据库逻辑结构设计....................................................................................................39
图 14  J2EE 的N层体系构......................................................................................................41
图 15  系统全面核算效果图....................................................................................................81
图 16  财务综合分析效果图....................................................................................................82
图 17 科室成本差异汇总.........................................................................................................83
图 18 本量利分析.....................................................................................................................84
图 19  成本分析效果图............................................................................................................86
v

表 清 单
表 1  全院收入成本收益总表..................................................................................................17
表 2  医技科室保本点分析一览表..........................................................................................19
表 3  科室盈亏情况表（元）..................................................................................................20
表 4  成本机构分析表..............................................................................................................21
表 5  科室盈亏分析表..............................................................................................................22
表 6  科室核算系统功能描述..................................................................................................26
表 7  科室核算系统功能描述（续表）..................................................................................27
表 8  医院运营综合分析平台功能描述..................................................................................28
表 9  医院运营综合分析平台功能描述（续表）..................................................................29
表 10  科主任经营分析平台....................................................................................................29
表 11  科主任经营分析平台（续表）....................................................................................30
表 12  材料消耗成本数据表....................................................................................................37
表 13  成本归集数据表............................................................................................................38
表 14  人力成本数据表............................................................................................................38
表 15  资产折旧成本数据表....................................................................................................39
表 16  软、硬件配置表............................................................................................................43
表 17  系统管理员记录表........................................................................................................45
表 18  服务器硬件配置............................................................................................................46
表 19  服务器软件环境............................................................................................................46
表 20  客户端机器配置............................................................................................................46
表 21  期初余额示意................................................................................................................49
表 22  BUG 严重程度划分表..................................................................................................50
表 23  产品功能点测试内容....................................................................................................53
表 24  产品功能点测试内容（续表）....................................................................................54
vi 

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摘要：

某医院成本核算系统的设计与实施摘要如何以合理的医疗价格和良好的医疗服务质量为社会大众提供健康保障，是政府和医院需要共同面对的问题。从政府层面看，解决该问题，需要科学的定价依据，达到合理补偿功效；从医院层面看，需要从提高自身的运营管理能力、降低成本的角度着手使服务功效最大化。所以无论从哪个层面分析，都需要以医院成本核算为基础提供数据保障；因此成本核算工作是医院财务精细化管理中的最基本，最重要的第一步。本次实践是在分析医院财务管理的基格，对医院的会计核算、预算管理、成本核算以及物流管理进行了充分的调研和沟通，最终形成了成本核算管理系统。本系统通过对医院财务综合管理相关的各项业务的调研、设计和实施，...

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