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Medical Laboratory Budgeting

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Lab budgeting and cost accounting under DRGs
Medical Laboratory Observer, Feb, 1985 by W. Glenn Cannon

Cost accounting is not a solution to management problems. It is a management tool designed to provide information that facilitates sound decisions. The two primary objectives of cost accounting are 1) to match cost with revenue and 2) to match resource consumption with the units of service provided.
Under the DRG system, matching revenue with cost and evaluating appropriate utilization levels must be done on a patient-by-patient or case-by-case basis. These are hospital management functions. Overutilization of services for a patient will drive costs above the level of the fixed payment rate for a particular diagnosis.
Since the …show more content…

Each laboratory section will probably have its own set of PMUs. For example, microbiology is heavily manual while chemistry is highly automated, and their outputs cannot be measured in the same manner. In selecting a reasonable PMU, consider the following criteria:
1. It is the single factor that most clearly causes resource consumption to vary. Note that this must relate to consumption--the use of labor and materials, and instrument costs--not to what the laboratory has been charging for a test.
2. It must be measurable and easily understood by laboratory personnel. If the staff cannot understand the PMUs, the system won't be effective.
3. It must be affected only by volume changes.
Laboratories have an advantage over other areas of health care through a long history of using CAP units as a statistical measure for volume. CAP units, however, may fall short when used to measure resource consumption. Some observers argue that workload recording relates quite well to labor consumed but may cause distortion in highly automated labs.
PMU measurements must be accurate, indicating the relative weight of each procedure in comparison with other procedures. The tabulation method should also be capable of summarizing PMUs by patient.
* Natural expense classifictions are used in grouping costs,

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