浙江省免疫规划服务的成本测算和筹资机制研究

Study on the Cost Management and Financing Mechanism of Expanded Programme on Immunization Services in Zhejiang Province

目的:明确浙江省不同地区开展免疫规划服务成本,为探讨建立扩大免疫规划经费保障机制提供依据。方法:采用分层抽样方法,选取8个县开展免疫规划服务的成本与筹资机制现场调查和专家访谈。结果:县、乡和村每服务人次的免疫规划工作成本分别为0.70元/人次、3.48元/人次、0.63元/人次,合计为4.81元/人次,其中乡村两级占85.45%;城区、经济发达、中等和欠发达的农村地区的免疫规划服务三级成本分别为4.75元、4.47元、4.30元和5.70元。结论:建立实施扩大免疫规划经费保障机制,重点是保障乡村工作补种经费,建议由省或国家级财政对不同经济水平地区的保障经费进行分类统筹,以保证公平性。

Objective： To account the cost of Expanded Program on Immunization （EPI） in Zhejiang Province, and to provide the evidenee for establishing the corresponding financing policy. Methods： Field investigate and expert discussion were used in the 8 counties, which were selected by stratified sampling. Results： The cost of EPI services in counties, countries and villages was 0.70, 3.48 and 0.63 yuan per dose, and total cost was 4.81 yuan per dose. The subtotal of countries and villages account for 85.45% of the total cost. The total EPI services cost of three levels in the city zone county, and de- veloped, mid-developed, under developing rural county were 4.75, 4.47, 4.30, and 5.70 yuan per dose. Conclusion： The ef- fective financing strategy should be established, and the key point is to ensure the expenditure of the township and village level EPI services. In addition, national and provincial governments should provide different financial support to guarantee the fairness of different economic level areas.