样本地区农村公共卫生项目成本构成分析

Components Analysis of Public Health Services’ Cost as Different Cost in Sample Rural Areas

目的分析上海市、江苏省和青海省3个样本县农村公共卫生不同职能和项目房屋折旧、设备折旧、公务业务费、低值易耗品、材料费和人员经费等各种成本的构成。方法通过对3个县93家县、乡、村三级卫生机构的成本消耗调查,借鉴经济学上成本核算的思路和方法。结果样本地区的农村公共卫生项目成本消耗以人员经费和材料经费为主,占总成本的比例均在70.00%以上;3个样本县项目成本消耗以县级为主,占总成本比例均在60.00%以上;不同样本地区乡、村两级成本构成差异较为明显,上海和江苏的样本县乡级机构的成本比例比村级高出12.00%以上,而青海样本县则比例相当,分别为19.67%和19.64%。讨论为保障农村公共卫生项目的职能得到切实落实,对人员经费和材料经费的重视不容忽视;同时,由于各样本地区人口、经济等因素存在差异,农村县、乡、村三级公共卫生网工作重点和任务分工有所不同,进行农村公共卫生服务项目投入标准测算时应引起足够的重视。

OBJECTIVE To analyze the different functions of rural health care in 3 sample counties of Shanghai Municipality, Jiangsu Province and Qinghai Province and the components of all kinds of cost including housing depreciation, equipment depreciation, official operating expenses, low-valued materials and material costs and personnel costs. METHOD To measure and analyze the costs of public health projects in sample rural areas by carrying out the survey of costs in 93 counties, townships, and village health institutions and grounding on the ideas and methods of cost measurement in economics. RESULT Materials costs and personnel costs are accounting for 70.00% of the total cost of rural health care in sample areas; the cost in county level is accounting for 60.00% of the total cost, meanwhile, the difference between the township and village levels in the same sample area is obvious. While the cost ratio of the county and township levels is 1.12 times of that of the village level in Shanghai and Jiangsu, the cost ratio of the county and township levels and the village level is ahnost the same, reaching 19.64% and 19.67% respectively. DISCUSSION In order to effectively carry out the functions of rural public health projects, material costs and personnel costs should be paid great attention to; meanwhile, due to the differences in the population, economic development and other factors in the sample areas, the focus and division of tasks in the threelevel network of public health should also be different, which should be attached great importance to, especially in the measurement of the financing of rural public health services.