浙江省预防接种门诊经济运行模式分析

Analysis on the Economical Operation Mode of Vaccination Clinics in Zhejiang

目的:分析扩大国家免疫规划后预防接种门诊设置和运行的合理性,为浙江省预防接种门诊建设提供参考建议。方法:选择浙江省有代表性的17家预防接种门诊,采用统一设计的调查表进行服务成本及相关信息收集,通过理论测算、焦点小组访谈法对预防接种门诊经济运行模式进行分析。结果:浙江省内的城区、城郊、山区、海岛预防接种门诊服务人口数量、工作量、人员配置、平均每针次服务成本差异较大。从调查的17个预防接种门诊投入预防接种服务的总成本来看,人力成本占投入总成本的主要部分(平均占91.78%)。山区、海岛门诊开设频次较少,工作成本较高;按日接种的门诊平均每针次工作成本(不含人力成本)为1.92元,按周为2.93元,按旬为10.16元。海岛、城区预防接种门诊人员配置水平最高,平均分别达到1.25人/万服务人口和1.23人/万服务人口,城郊地区预防接种门诊人员配置水平最低,仅为0.25人/万服务人口。结论:浙江省预防接种门诊设置和人员配置合理性有待进一步提高,运行模式和开放周期应根据当地服务人口数量和接种工作量进行改善,保障科学性和经济合理性,并满足群众实际需求。

Objective:To analyze the rationality of vaccine clinic setup and operation in Zhejiang after expanding national vaccineplan, so as to provide reference commendations for vaccination outpatient service construction in Zhejiang.Methods:Investigation andthe focus group interview study were conducted to collect the service cost and other related information from 17 sampling vaccine out-patient cRlinics in: Zhejiang. The economical operation mode of vaccine clinic was analyzed by theoretical estimation and focus group in-terview.esultsThere is a large difference among the factors of vaccine clinic service population, workload,staffing,average ser-vice cost in vaccine clinics of urban areas, rural areas, mountainous areas and islands in Zhejiang. For the total cost of the vaccinationservices of 17 investigated outpatient clinics, human cost occupied the main part of total cost(generally accounted for 91.78%). Theopening frequency of mountainous and island outpatient clinics was relatively less, the work cost was relatively higher; the ave,ra gework cost of outpatient clinics processing vaccination by day(excluding human cost) was 1.92 yuan, by week was 2.93 yuanbymonth was 10.16 yuan. The allocation level of vaccination outpatient staffs in island areas and urban areas was the highest,respective-ly reached 12.25 person/thousand service person and 12.3 person/thousand service person. The allocation level of vaccination outpa-tient staffs in urban areas was only 2.5 person/thousand service person.Conclusion:Vaccine clinics setup and the rationality of staff-ing were expected to be improved;the operation mode and opening frequency should be adjusted according to the local service personnumber and vaccination work load, guarantee the scientificity and economic rationality, and satisfy the actual requirement of the crowd.