中国2015年国家免疫规划成本构成和筹资渠道研究

Costs and financing of China’s National Immunization Program, 2015

目的了解2015年中国国家免疫规划(NIP)工作实际成本和筹资渠道。方法根据地域和经济水平,选取15个省份、40个地市、46个县区、138个乡镇/居委会和276个村进行NIP成本和筹资渠道调查,测算2015年出生儿童的疫苗成本和非疫苗成本,以及2015年财政投入和外部投入。结果2015年NIP人均成本为619.21元/儿童,总成本为102.47亿元;其中人员报酬、疫苗、工作实施和其他成本分别占53.46%、20.64%、14.23%、11.66%;国家级、省级、市级、县级、乡级、村级成本分别占21.68%、1.84%、5.02%、8.41%、41.44%、21.61%;在总投入中,创收、财政投入分别占29.36%、70.64%,中央、省级、市级及以下财政投入分别占38.94%、5.00%、26.70%。结论中国NIP成本中疫苗成本所占比例较低;财政投入在预防接种经费支持中占主导地位,但仍不能满足NIP所需疫苗和预防接种成本的需求。

Objective To describe actual costs and financing of China’s National Immunization Program(NIP)in 2015.Methods We selected 15 provinces,40 prefectures,46 counties,138 townships or communities,and 276 villages stratified by geography and economic development and conducted an evaluation of NIP costs and financing.We determined vaccine and non-vaccine costs for the 2015 birth cohort,and we obtained financing data from government and external sources for the year 2015.Results NIP cost per capita was 619.21 yuan in 2015,and the total cost was10.247 billion yuan for the 2015 birth cohort.Costs for staff salaries and benefits,vaccines,work implementation,and other costs accounted for 53.46%,20.64%,14.23%,and 11.66%of total costs,respectively.Costs at national,provincial,prefectural,county,township,and village levels accounted for 21.68%,1.84%,5.02%,8.41%,41.44%,and 21.61%of total costs.Of the total financing,29.36%came from revenues from Category 2 vaccines and their administration,and70.64%came from government at all levels-38.94%,5.00%,and 26.70%from national,provincial,and prefectural or below levels,respectively.Conclusions Vaccine costs were relatively low in China’s National Immunization Program.Government investment in vaccination provided most of the financial support of immunization but was insufficient to support the total costs of vaccine and vaccination needed by the National Immunization Program.