1 目前变动成本控制状况及不利因素 所谓变动成本,即随着医疗服务收入的增长而同比例增长的费用成本,主要是指卫生材料的消耗。笔者最近对本市几家大中小医院进行了调查,新物价体系颁布后,大多数医院对卫生材料管理模式没有进行改变或调整。如:有些医院还按物价调整前确定的消收比发放卫生材料,有些医院则按各科护士长提出的卫生材料请领单进行发放。这样一来因物价调整而带来的含利水平的提高,却没有如实地反映出来。长此下去,因物价调整而应收取的医院技术上的收入会在变动成本控制不良的状态下而流失掉。卫生材料难于控制的原因有两条:(1)随着医药费负担主体的 1 The current changing cost control situation and unfavorable factors The so-called variable cost, that is, the cost cost that increases with the proportion of medical service income, mainly refers to the consumption of health materials. The author recently conducted investigations on several large, medium, and small hospitals in the city. After the new price system was promulgated, most hospitals did not change or adjust the management mode of sanitary materials. For example, some hospitals also distribute sanitary materials according to the consumption-recovery ratio determined before the price adjustment, and some hospitals issue the health materials requested by the nurses of each department. As a result, the increase in the level of profitability brought about by price adjustments has not been faithfully reflected. If this situation continues, the technical revenues of hospitals that will be charged due to price adjustments will be lost in the event of poor control of variable costs. There are two reasons why sanitary materials are difficult to control: (1) With the main burden of medical expenses