资源同步共享下的成本系统误差建模与仿真研究

Current research on costing system error typically assumes that tasks are well-defined and identified and that the required resources are consumed in a sequential manner. However, since the healthcare delivery system in China compared to developed countries has significant differences in the functions of outpatient appointment scheduling and the scale of the medical service groups, it is characterized by the fact that tasks arrive unevenly and urgently with synchronous sharing of resources. Accordingly, this study establishes a resource sharing model for the costing system. The proposed model aims to detect the costing system errors as well as analyze their interactions. Furthermore, a simulation-based approach is employed as identify the conditions of resource sharing under which it can ensure robustness of the costing system to possible errors. Taking the aforementioned new characteristics into account, this study reviews and covers previous research efforts and can answer the cost questions of the manufacturing industry in which task processing is explicit and resources are consumed sequentially or even extend the model to solve the same questions in the general service industry if the time dimension is taken out. Hence, the error investigation of the costing system with synchronous resource sharing has broader significance and impact. The results can provide new insights on how to make effective investment decisions and reasonably allocate resources to obtain reliable cost information.

成本系统误差研究通常假定任务明确且已全部到达、资源被顺序消耗。而我国医疗服务机构与发达国家在预约机制、服务群体规模上存在巨大差异，使其呈现出任务到达不均衡且紧急、资源同步共享等特征。理论和实践表明，该特征下成本系统鲁棒性差，极易导致成本偏差，致使成本管理和控制失效。基于此，本项目建立成本系统的资源同步共享特征模型，研究共享特征下成本系统误差及其交互影响，识别可有效提高成本系统精确性的边界条件，为成本系统设计、控制成本误差和提高成本系统鲁棒性提供理论依据。同时，将任务的随机紧急和资源的同步消耗特征从时间维度加以简化，可以退化为加工任务明确、资源顺序消耗的制造业或一般服务业中的成本问题，从而使得具有资源同步共享新特征的成本系统误差研究具有更广泛的意义。

控制和降低成本是企业获取经济效益、赢得竞争优势的重要途径，而成本分析的准确及合理程度直接影响企业对成本的改善和对生产或服务过程的修正。本课题通过分析建模首先界定成本系统三种计量误差与两种归集误差，并在资源消耗差异性的基础上，推导了成本池费用大小、资源使用比例和资源共享三种资源消耗差异性因素对成本系统相对计量与归集误差鲁棒性的影响。研究结果发现：①资源成本池费用的差异性越大，成本系统的鲁棒性不一定越差，其取决于差异性大的资源成本池向每个成本对象分配百分比的平方和大小。若差异性大的资源成本池向成本对象分配百分比的平方和小于每个成本对象消耗所有资源成本池百分比均值的平方和，成本系统的鲁棒性越强；相反，若差异性大的资源成本池向成本对象分配百分比的平方和大于等于每个成本对象消耗所有资源成本池百分比均值的平方和，成本系统的鲁棒性越差；②资源使用比例的差异性越大，资源消耗差异性越大，成本系统的鲁棒性越差；③资源共享的差异性越大，成本系统的鲁棒性不一定越差，当成本动因量较小或成本动因的分配不均衡即差异性越大，资源动因、作业动因中存在计量误差或资源成本池费用被高估、低估时，整个成本系统的鲁棒性越强。研究结果可弥补现有仿真研究结论的不足，为成本系统设计、控制成本误差和提高成本系统鲁棒性，进而精确成本信息奠定理论基础。.依据上述理论研究，本课题结合医疗背景中急诊、门诊与住院病人的多种混合需求，考虑医生、床位和医疗设备的资源消耗差异，设计成本对象即需求病人的排程、床位资源配置、作业分配等合理规则，基于实际数据建模与仿真，比较不同分配规则对病人等待成本、医院收益与医疗资源消耗等因素的影响，找到了作业与资源配置的优化组合方案，可在医生、床位和设备等关键医疗资源消耗时间即成本不增加的基础上增加产出。