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目的在测算深圳市社康中心开展的各项基本公共卫生服务成本的基础上预测下一年度所需经费。方法通过特尔斐专家咨询法界定社区基本公共卫生服务的流程及标准;然后从深圳市全部社康中心中随机抽取60家社康中心,对其中负责开展基本公共卫生服务的医护人员进行问卷调查,测定各项基本公共卫生服务的成本,以此为基础建立方程模型来预测2015年所需经费。结果调查社康中心提供不同服务项目差异较大,部分服务开展情况已达到国家标准(如预防接种率达98%以上),部分服务达标率较低(如高血压患者规范管理率为15.0%,老年人健康管理的规范管理率为32.9%)。不同服务对象单位成本亦存在较大不同,按照不同管理目标(高、中、低)及调查社康中心在编人员平均收入75.3元/h为人力成本价格,预测2015年深圳全市基本公共卫生服务经费总额及人均成本为:高16.4亿元,人均109.4元/人年;中14.2亿元,人均94.6元/人年;低9.7亿元,人均64.8元/人年。结论目前深圳市开展社区基本公共卫生服务存在经费补偿不足的问题,所需经费远超现行45元/人年标准;要达到中等目标要求,2015年经费至少为95.0元/人年。
Objective To estimate the requirements for the next year on the basis of calculating the cost of various basic public health services carried out by Shenzhen Social Health Center. Methods To define the process and standards of community basic public health services through the Delphi expert consultation method. Then 60 community health centers were randomly selected from all the social health centers in Shenzhen to conduct a questionnaire survey among the medical staff responsible for conducting basic public health services , To determine the cost of each essential public health service and to build an equation model based on that to forecast the requirements for 2015. Results There were significant differences in the service provided by the community health centers. Some of the services were up to the national standards (such as vaccination rates of more than 98%), and some of the service compliance rates were low (such as the standardized rate of hypertensive patients was 15.0% The standardized management rate of health management for the elderly was 32.9%). According to different management objectives (high, medium and low) and investigation of the average income of staff in community health centers of 75.3 yuan / h as the cost of labor costs, the unit cost of different clients is also expected to be quite different. It is estimated that in 2015, the city’s basic public health services The total funding and per capita costs are: 1.64 billion yuan, 109.4 yuan per person per year; 1.42 billion yuan, 94.6 yuan per capita per person; 9.7 million yuan lower, and 64.8 yuan per capita per capita. Conclusion Currently, there is a problem of inadequate compensation for basic public health services in Shenzhen. The required funds far exceed the current standard of 45 yuan / person. To achieve the medium-term target, the funds in 2015 will be at least 95.0 yuan / person.