上海市基层医疗卫生机构经常性卫生费用核算

Accounting on regular health expenditure in Shanghai primary healthcare institutions

目的标化工作量是上海市社区卫生服务综合改革工作的创新与亮点之一,文章旨在对基于标化工作量的上海市基层医疗卫生机构经常性卫生费用核算方法进行探讨。方法选取上海市在2014年开展标化工作量试点的全部66家社区卫生服务中心,收集其2014年全年各项标化工作量开展数,以及1—12月所有诊疗记录信息。结果2014年上海市基层医疗卫生机构经常性卫生费用总量为180.58亿元,占全市经常性卫生费用的比例为14.14%,占全市国内生产总值比例为0.77%。其中,治疗性卫生费用为127.67亿元,预防服务费用为52.91亿元。同时,慢性病患者和老年人群费用占比高。结论建议加强对重点人群及疾病的防控,提高预防服务费用投入,完善基于基层医疗卫生机构的预防服务体系。

Objective Measuring standardized workload is one of innovations and highlights resulting in community health service comprehensive reform in Shanghai.This article aimed at exploring the accounting methods on regular health expenditure in Shanghai primary healthcare institutions based on this measurement.Methods All 66 community healthcare centers implementing the standardized workload in Shanghai were selected,and data related with their implementing status and diagnosis and treatment from January to December of 2014 were collected.Results In 2014,the regular health expenditure of primary healthcare institutions was 18.058 billion yuan,accounting for 14.14%and 0.77%of Shanghai total regular health expenditure and Shanghai gross domestic product,respectively.Among the regular health expenditure,treatment expenditure had a largest percentage,which was 12.767 billion yuan.The preventive expenditure was 5.291 billion yuan.Meanwhile,the expenses that chronic disease patients and elderly population spent were relatively high.Conclusion It is suggested to strengthen the preventive intervention for target population and diseases,improve investment on preventive services,and promote preventive service system based on primary healthcare institutions