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基于德尔菲法构建医疗机构制剂成本项目库
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| 篇名： | 基于德尔菲法构建医疗机构制剂成本项目库 |
| TITLE： | Construction of hospital preparation cost item library based on the Delphi method |
| 摘要： | 目的 构建医疗机构制剂成本项目库，为医疗机构制剂成本的精细化核算管理提供参考。方法在文献分析与工作实践基础上，初步拟定成本项目条目。采用德尔菲法，通过分析问卷回收率、专家权威系数、条目重要性评分、变异系数及肯德尔协调系数，对条目进行筛选与优化。结果两轮专家咨询的问卷回收率分别为95.7%和100%，专家权威系数分别为0.937和0.939，肯德尔协调系数均有统计学意义（P＜0.001）。最终构建的医疗机构制剂成本项目库包含6个一级条目（如原材料和包装材料成本、人力资源成本和生产运营成本等）和29个二级条目（如主药原材料成本、生产人员薪酬和成品全项检验成本等），全面涵盖了原材料和包装材料、固定资产折旧与设备维护、人力资源、生产运营、能源与环境、研发与其他成本等维度。结论本研究成功构建了科学可靠的医疗机构制剂成本项目库。该项目库可指导医疗机构逐项归集制剂实际支出，为行使自主定价权提供结构化证据，同时为创新制剂的医保准入与支付政策制定提供数据支撑。 |
| ABSTRACT： | OBJECTIVE To establish a hospital preparation cost item library， providing a reference for the refined accounting management of preparation costs in medical institutions. METHODS Based on literature analysis and practical work experience， a preliminary list of cost items was drafted. The Delphi method was employed to screen and optimize the items by analyzing the questionnaire recovery rate， expert authority coefficient， item importance score， coefficient of variation， and Kendall’s W of concordance. RESULTS The questionnaire recovery rates for the two rounds of expert consultation were 95.7% and 100%， respectively； the expert authority coefficients were 0.937 and 0.939， respectively； Kendall’s W of concordance were statistically significant （ P ＜0.001）. The finally established hospital preparation cost item library included 6 first-level items （such as raw material and packaging material costs， human resource costs， and production operation costs） and 29 second-level items （including main drug raw material costs， production personnel compensation， and finished product full-item testing costs）， comprehensively covering dimensions such as raw materials and packaging materials， fixed asset depreciation and equipment maintenance， human resources， production operations， energy and environment， and R & D and other costs. CONCLUSIONS This study successfully establishes a scientific and reliable cost item library for medical institution preparations， which can guide institutions to itemize actual expenditures， provide structured evidence for autonomous pricing， and support data needs for the formulation of insurance access and payment policies for innovative preparations. |
| 期刊： | 2026年第37卷第09期 |
| 作者： | 藕顺龙；林洪；蒋倩；金朝辉 |
| AUTHORS： | OU Shunlong，LIN Hong，JIANG Qian，JIN Zhaohui |
| 关键字： | 医疗机构制剂；成本；德尔菲法；成本核算；定价 |
| KEYWORDS： | hospital preparations； cost； Delphi method； cost accounting； pricing |
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