The time-driven activity-based costing method can solve problems of the difficulty in operating and does not consider the issue of capacity utilization of operation-based costing,which is more suitable for cost accounting of medical service projects. In order to reflect the different core functions of personnel and equipment,this paper was of great reference value by adopting the two-factor driving method of personnel cost motivation rate and equipment cost motivation rate to realize the cost accounting of medical projects,revealing the efficiency of capacity utilization.