北京市月坛社区卫生服务中心服务项目的成本测算

目的测算北京市月坛社区卫生服务中心(中心)项目成本,为政府完善社区卫生服务补偿机制提供参考依据。方法调查中心2006年度社区卫生服务项目数据。对全科医生、社区护士、防保人员的工作内容及其所用时间进行一周的追踪调查。应用项目成本测算方法计算出各社区卫生服务项目成本。结果2006年度中心开展各类社区卫生服务项目60个(政府制定了收费标准的项目13个)。个体卫生服务项目11个,公共卫生、准公共卫生服务项目49个。单位服务实际成本较高的项目有慢性疾病普查、各类健康教育和健康指导、肠道门诊、传染病访视、应急接种与强化免疫、城市病媒监测与报告和计划免疫资料统计评价与管理。结论社区卫生服务机构提供的服务以公共卫生、准公共卫生服务项目为主,需要政府大力支持。缺乏符合社区卫生服务特色的收费价格体系。

Items Cost Accounting of Yuetan Community Health Services in Peking

Objective To calculate the costs of Yuetan community health service (CHS) items in Peking and provide reference for the community health service reimbursement system.Methods The CHS items in 2006 were investigated.The working contents of doctors and nurses and time of services were investigated retrospectively for one week.The costs of CHS were calculated by the method of item cost accounting.Results The total number of CHS items was 60(There was 13 items for which the charge criteria is set by the government)in 2006,including 11 items of self-employed health services and 49 items of public health service and semi-public health service.The items that had higher real cost of services included screening of chronic diseases,various kinds of health education and instruction,work in gastrointestinal department,follow-up for infectious diseases,emergency inoculation and potentiated immnonization,surveillance and report of disease medium in urban areas,and evaluation and management of data for planning immunonization.Conclusion The most of work in CHS centers was public health service and semi-public health service and it needs compensation by the government.The standard of charge coincident with the feature of CHS is absent at present.