Study of the financial structure of the basic management fee for admissions in national hospital organizations, comparing 7 to 1 and 10 to 1 calculation methods.

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  • 国立病院機構における７対１及び10対１入院基本管理料算定病院別の財務構造に関する検討

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Abstract

English This study aimed to compare and examine differences in the financial structure between 7 to 1 and 10 to 1 patient-to-nurse staffing ratio hospitals, in calculation methods of the basic management fee for admission in national hospital organizations (7 to 1 hospitals and 10 to 1 hospitals). Of 143 hospitals in national hospital organizations in Japan, 41 hospitals which were notified as 7 to 1 hospitals with an average bed occupancy rate of 80% or more, and 13 hospitals which were notified as 10 to 1 hospitals, were included as subjects in this study (based on notifications in FY 2016).Results showed that, in the balance structure of both the 7 to 1 and the 10 to 1 hospitals, the current profit ratio tended to decrease from FY2015 onwards. Additionally, in terms of their ratios of hospitalization to outpatient treatment, it became clear that the proportion of outpatients increased year on year, and in the cost structure, the materials cost burden, consisting mainly of medical products, was large. In addition, stability indicators showed that quick assets were weak in the current assets. When looking in detail at each item, the salary expenses in the cost structure of the 10 to 1 hospitals were higher than those of the 7 to 1 hospitals. Looking at the reasons for the salary expenses being higher for 10 to 1 hospitals despite 7 to 1 hospitals having higher proportions of nurses, it was found that 10 to 1 hospitals with 300 or fewer beds and a negative current profit ratio had remarkably low quick assets and tended to have an increased personnel cost ratio. In addition, it was assumed that the problems in manpower management and inventory management influenced the operational deficit, based on the relationship between the current profit ratio showing these trends, and the salary expenses plus material expenses.

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