浙江省免疫规划实际成本与合理成本比较分析

Comparative Analysis on Actual Cost and Reasonable Cost of Expanded Program on Immunization in Zhejiang

目的:通过对浙江省免疫规划实际成本与合理成本的测算和分析,为免疫规划工作经费保障提供数据支持。方法:通过填写调查表对省、市、县、乡、村五级的免疫规划实际成本进行调查测算,并按照相关法律法规及专家估算法计算合理成本,并对实际成本和合理成本进行比较分析,对合理成本进行敏感性分析。结果:浙江省每针次疫苗接种免疫规划实际成本合计为19.55元,其中省、市、县、乡、村级每针次免疫规划实际成本分别为0.27元、0.34元、1.41元、16.89元和0.64元;浙江省每针次疫苗接种免疫规划合理成本合计为85.21元,其中省、市、县、乡、村级每针次免疫规划合理成本分别为0.78元、0.92元、10.65元、67.96元、4.91元。浙江省每针次疫苗接种的实际成本比合理成本低65.66元。对合理成本按照工作人员数量、接种针次、工作时间等指标进行单因素敏感性分析,发现接种针次变化对合理成本的影响最大。乡级每半天接种30~50针次所测算的成本较合理。结论:浙江省基层免疫规划工作成本较低,政府应按照合理成本对免疫规划工作提供经费和人员配备支持,保证基层免疫规划工作质量,使免疫规划工作持续健康发展。

Objective： Based on the calculation and analysis of the actual cost and reasonable cost of expanded program on immunization （EPI） in Zhejiang Province, it provided the data support for EPI. Methods： The actual cost of EPI in province, cities, counties, townships and villages were investigated by filling out questionnaires. According to the relevant laws, regulations and expert estimation method to calculate the reasonable cost, making a comparative analysis between the actual cost and reasonable cost, and making sensitivity analysis at reasonable cost. Results： The actual cost of per injection in Zhejiang provincewas 19.55 yuan, of which the provincial, city, county, township and village level, the actual cost of per injection was 0.27 yuan, 0.34 yuan, 1.41 yu- an, 16.89 yuan and 0.64 yuan. The reasonable cost of per injection in Zhejiang province was 85.21 yuan, of which the provincial, city, county, township and village level, the reasonable cost of per injection was 0.78 yuan, 0.92 yuan, 10.65 yuan, 67.96 yuan and 4.91 yuan. The actual cost of vaccination in Zhejiang province was 65.66 yuan lower than the reasonable cost. The single factor sensitivity analysis was carried out on the reasonable cost according to the number of employees, vaccine injection times and the working time. It found that there was a positive correlation between vaccine injection times and the reasonable cost. The 30~50 times per day inoculation needle estimates the cost was reasonable. Conclusion： The cost of grass-roots EPI in Zhejiang province was low, so the government shouht provide financial and staffing support to EPI in accordance with the reasonable cost, so as to ensure the sustainable development of EPI.