병원 전자구매조달시스템의 경제성 분석

Abstract

[한글]

이 연구는 디지털 병원환경에서 구매조달의 직․간접비용을 절감시키고 구매혁신을 위한 경영전략대안으로 제시되고 있는 병원의 전자구매조달시스템이 조사병원과 병원계전체에 미치는 순편익효과를 알아보고자 하였다. 연구대상은 서울특별시소재 종합병원 2곳(A, B병원)과 지방소재 종합병원 2곳(C, D병원)으로 하였으며, 전자구매조달 시행전,후의 변화를 측정하여 향후 5년동안 4개 병원과 전체병원의 순편익 규모를 추계하였다. 이 연구의 결과를 요약하면 다음과 같다. 첫째, 전자구매조달시스템 구축이유는 공동구매로 인한 구매직접비용과 구매환경개선으로 인한 구매간접비용절감에 두고 있었으며, 4개 병원의 전자구매조달 확대폭은 2001년도 재료비예산의 평균 32.6%였다. 둘째, 공동구매로 인한 직접원가절감은 서울소재 병원(A, B병원)의 경우공동구매액 대비 평균 3.4%, 지방소재 병원(C, D병원)에서는 2.9%의 구매조달원가절감이 있었다. 셋째, 4개 조사병원의 전자구매조달 확대폭이 현재와 같이 32.6%일 경우 향후 5년동안 순편익 현재가치는 28억 933만원이었으며, A병원 8억 7,494만원, B병원 10억 4,766만원, C병원 4억 4,819만원, D병원 4억 3,853만원이었다. 그리고 4개 병원의 100병상당 순편익은 연간 2,351만원이었다. 넷째, 전체병원의 향후 5년간 순편익 현재가치 규모는 전자구매조달 확대폭이 32.6%일 경우 1,416억 4,112만원으로 추계되었다. 다섯째, 현재수익률 5.74% ± 0.5%를 기준으로 할 때 향후 5년간 순편익 현재가치 변동액은 A병원의 경우 8억 6,313만원과 8억 8,710만원으로, 4개 병원의 경우 27억 7,081만원과 28억 4,780만원, 전체병원으로는 1,397억 3,7 88만원과 1,436억 169만원이었다. 현재 수익률 5.74% ± 1%에서는 향후 5년간 순편익 현재가치 변동이 A병원은 8억 5,146만원과 8억 9,949만원, 4개 병원의 경우 27억 3,334만원과 28억 8,760만원, 전체병원으로는 1,378억 5,726만원과 1,455억 9,928만원이었다. 여섯째, 상황의존도 분석결과 전자구매조달의 확대폭증가에 따라 순편익이 증대되었다. 향후 5년간 4개 병원의 평균확대폭이 현재 32.6%에서 50%로 확대될 경우 43억 880만원, 75%로 확대되는 경우에는 64억 6,320만원이었고, 100%확대시에는 86억 1,760만원의 순편익이 있는 것으로 추계되었으며, 전체병원으로는 50% 확대시 2,172억 4,098만원, 75%확대시 3,258억 6,147만원, 100%확대시 4,344억 8,196만원으로 추계되었다. 이상의 결과를 종합하여 볼 때, 병원은 전자구매조달 시행후 순편익을 얻고 있는 것으로 분석되었고, 순편익 규모는 확대폭 32.6%기준으로 향후 5년간 4개 조사병원이 28억 933만원, 전체병원으로는 1,416억 4,112만원이었다. 전자구매조달의 확대폭이 현재보다 늘어날 경우 순편익의 규모가 증대될 것으로 예측된다. 이 연구에서는 구매조달 업무흐름구간 이외의 부서에서 파생되는 비용-편익항목과 질적가치를 계량화하지 못하였으며 순편익추계시 금리변동과 구매확대폭 이외의 장래변동요인을 고려하지 못하였다. 향후 병원과 공급자, 시스템운영사를 포함한 전체적인 측면에서 가치재구성과 가치혁신부분의 편익을 고려하여 경제성분석이 이루어지길 기대한다.

[영문]

This study was tried to survey how much total hospitals are getting net benefit through Electronic Purchase and Supply System that is to reduce direct and indirect cost for purchase and supply under digital hospital environment and to be suggested as one of management strategy measures for purchase innovation This study estimated the amount of net benefit of 4 hospitals and total hospitals for 5 years through selecting two general hospitals located in Seoul (A and B) and two general hospitals located in other than Seoul as targets and measuring the change between before and behind performance The results are as follows First, surveyed hospitals constructed Electronic Purchase and Supply System because of reduction of purchase direct cost caused by joint purchase and purchase indirect cost caused by improvement of purchase environment and the degrees of enlargement of Electronic Purchase and Supply in 4 hospitals were measured as 32.6 % of 2001 budget of material expense on the average. Second, in case of reduction of direct prime cost due to joint purchase, it is analyzed as that hospitals located in Seoul (A and B) showed reduction of purchase and supply prime cost of 3.4% on the average when it is compared to the amount of joint purchase and hospitals located in local (C and D) showed one of 2.9% on the average Third, when the degree of enlargement of Electronic Purchase and Supply of 4 hospitals is 32.6%, present value of net benefits of 4 hospitals for next 5 years were estimated as 2,809 million Won and present value of net benefit of each hospital for next 5 years was estimated as 875 million Won in case of hospital A, 1,048 million Won in case of hospital B, 448million Won in case of hospital C and 439 million Won in case of hospital D. Net benefit per 100 beds of 4 hospitals were estimated as 24 million Won per year Fourth, the amount of present value of net benefits of total hospitals for 5 years were estimated as 141,641 million Won when the degree of enlargement of Electronic Purchase and Supply is 32.6%,. Fifth, in case of the degree of sensitivity, the change of present value of net benefit from the present rate of benefit (5.74% ± 0.5%) for next 5 years was from 863 million Won to 887 million Won in case of hospital A, from 2,771 million Won to 2,848 million Won in case of 4 hospitals and from 139,737 million Won to 143,616 million Won in case of total hospitals. The change of present value of net benefit from the present rate of benefit (5.74% ± 1%) for next 5 years was from 851 million Won 899 million Won in case of hospital A, from 2,733 million Won to 2,888 million Won in case of 4 hospitals and from 137,857 million Won to 145,599 million Won in case of total hospitals. Sixth, in case of Analysis on the degree to depend on condition, net benefit was increased according to the degree of enlargement of Electronic Purchase and Supply System. It was estimated that when degrees of enlargement of 4 hospitals increases from 32.6% to 50% for next 5 years, net benefit will be 4,309 million Won, when it increases to 75%, it will be 6,463 million Won and when it increases to 100%, it will be 8,618 million Won. In case of total hospitals, it was estimated that when it increases to 50%, it will be 217,240 million Won, when it increases to 75%, it will be 325,861 million Won and when it increases to 100%, it will be 434,481million Won.From the above result, it was analyzed that hospital acquired net benefit after performance of Electronic Purchase and Supply System. The amount of net benefit was 2,809 million Won in four hospitals and 141,641 million Won in total hospitals for next 5 years when selecting 32.6% of degree of enlargement as standard. It was expected that the amount of net benefit would be increased if the degree of enlargement of Electronic Purchase and Supply was increased in future.This study couldn