基于标化工作量的基本公共卫生服务理想经费的投入预测

Forecast of Ideal Funding of Basic Public Health Services Based on Standardized Workload

目的预测基于标化工作量的基本公共卫生服务理想经费投入,为标化工作量促进服务供方资源最优配置提供佐证。方法以上海市浦东新区惠南镇为例,以本课题组拆分成的232项基本公共卫生服务项目为基础,从上海市浦东新区惠南社区卫生服务中心收集2013底惠南镇分村/居委、年龄、性别的人口统计资料,以及经本课题组文献考证确定的各项服务的调节系数、权重等指标,在工分制原理原始公式的基础上,增加质量系数和每标化工作量的政府投入标准两项内容,对惠南镇各村/居委2014年理想经费投入进行估算,并与实际经费投入进行比较分析。结果基于标化工作量核算的2014年惠南镇各村/居委的理想经费投入与实际经费投入排名一致,但各有出入,即50个村/居委中,有20个村/居委都显示出实际经费投入不足,平均缺少额度为792.03元;另有30个村/居委显示出实际经费投入冗余,平均冗余额度达到528.02元。结论基于标化工作量的基本公共卫生服务理想经费投入可以有效实现区域间的服务均等化,促进资源有效配置;同时,从需方角度估算区域标化工作总量,进而确定的理想经费投入为区域服务经费投入设定了上限,可有效避免资源浪费。

Objective To predict the ideal funding for basic public health services based on standardized workload,in order to provide references for the optimal allocation of resources by service suppliers by standardized workload. Methods Huinan Town in Pudong New Area of Shanghai was taken as an example. Based on the 232 items of public health service items formed by the research team and according to the demographic data of villages / residential committees,age and gender of Huinan Town at the end of 2013 that was collected from Huinan Community Health Service Center in Pudong New Area of Shanghai,the adjust coefficient and the weight of each service item determined by literature review and the original formula of the principle of labour voucher,we added quality factor and government funding standard of each standardized workload,estimated the ideal funding for each village / residential committee of Huinan Town in 2014 and compared it with the actual fund. Results The 50 villages / RCs turned out the same rank in ideal funding with the actual funding in Huinan in 2014,but the exact funding was different. That was to say,in 50 villages / RCs,there were 20 villages / RCs that had insufficiency in actual funding,and the average amount of shortage was 792. 03 yuan; other 30 villages / RCs showed redundancy in actual funding,and the average redundancy reached528. 02 yuan. Conclusion The funding accounting method based on standardized workload of basic public health services can effectively promote equalization and efficient allocation of resources among regions. At the same time, the regional total standardized workload is estimated from the perspective of demand,and the ideal funding is an upper limit for the funding for regional services,which can effectively avoid the waste of resources.