深圳市社区卫生服务机构运行成本与效益分析

Analysis of running cost and benefit of community health service center in Shenzhen City

目的了解深圳市基层社区卫生服务中心运营成本构成与效益。方法采用描述回顾性调查方法,选择深圳市运行成熟的A社区卫生服务中心,对其2004～2006年间的人员配置、设施设备、服务项目开展及运行的成本投入与效益等情况进行比较分析。结果2004～2006年,A社区卫生服务中心皆能全面开展"六位一体"的基本医疗卫生保健服务,门诊人均医疗费用69.57元,明显低于全市二级各医院门诊人均124.9元的费用,人年均医疗服务2365人及人年均绩效16.46万元,显示医疗资源和医疗服务利用率高,但由于政府财政扶持投入不足,社康中心门诊继续处于亏损运行,医疗服务仍为主要的服务内容,影响公共卫生服务项目开发和供给。结论A社区能提供有效的基本医疗卫生服务,保证居民基本医疗服务和基本卫生保健需求,但政府应对不同规模的社区实行具体不同的财政投入政策,以促进基层卫生服务的良性发展。

Objective To understand operational cost and benefit in community health service centers of Shenzhen City, Methods A retrospective survey of A community health service center was conducted , the running status including the basic conditions, stafflng, facilities and equipment, services, income and expenses etc uring the period of from 2004 to 2006 was surveyed. Results From 200 mental health and medical health care service, The medical cost of an outpatient was RMB69.57 yuan, significantly lower than the cost of other outpatients in other hospitals of Shenzhen （RMB124.9 yuan）, The coverage of A doctor or nurse was 2 365 residnets per year, and the annual per capita achievement was RMBI64,600 yuan as the medical resources and health services were fully utilized . There was a ecominic loss due to insufficient financial support of the government , affecting the smooth development and the supply in public health services, Conclusion A community can provide an effective basic health services and satisfy basic medical needs of the residents. The governments at various levels should formulate concrete policy on the investment of community health service centers so as to ensure the smooth running and development of community health services sustainable development.