2018年北京市4家戒烟门诊工作流程和运营成本调查

The investigation of workflow and cost in four smoking cessation clinics of Beijing in 2018

目的了解北京市4家发展较好的戒烟门诊工作流程和人员、设备等成本信息,总结戒烟门诊工作经验,用以规范基本公共卫生项目戒烟门诊的创建,为项目投入政策提供参考。方法于2018年4月选取北京市4家戒烟门诊,通过问卷调查、观察和访谈获得戒烟门诊人员、设备和耗材等的成本数据。通过调查访谈和直接观测方法获取门诊作业内容、作业耗时、设备和耗材使用等情况,收集戒烟门诊所在科室人员直接成本数据,使用估时作业成本法计算人员成本,通过使用年限折旧方法分摊计算设备折旧。计算软件为Excel 2007。结果戒烟门诊核心作业包括首诊、随访和数据录入,被调查医院根据自身情况有选择地开展患者支持、环境建设等补充作业。根据财务成本资料最全的1家医院的财务数据进行测算,为完成项目每年干预200例吸烟者的要求,戒烟门诊每周至少需开诊1 d。为完成200例患者戒烟干预的核心作业和补充作业,每年分别应投入人力成本37 470和34 472元;设备耗材投入7 626元。人力和设备耗材成本共计79 568元,平均分摊到每个患者约为398元。结论建议政府按成本对戒烟门诊和医务人员给予补贴,提高戒烟服务提供者的积极性。加强对吸烟危害健康和戒烟门诊的宣传,增加戒烟门诊门诊量,提高门诊使用率及投入效率。

Objective To investigate the workflow and cost of stuff and equipment in 4 well-developed smoking cessation clinics,to summarize the operational experiences of those clinics,to standardize the establish of smoking cessation clinics of basic public health projects,and to provide the reference for investment policies. Methods In April 2018,4 smoking cessation clinics in Beijing were selected as the samples. The investigation was performed with questionnaire,observation and interview to obtain the cost data of staff,equipment and consumables. The operation content and time,equipment,consumables and so on were obtained by direct observation and interview. The direct cost data of staff was collected. The cost data of staff was calculated by working cost,the equipment depreciation was calculated by usage years. The used software was Excel 2007. Results The core operation content of smoking cessation clinics included the first consultation,follow-up,and data input. Sampled clinics also carried out supplementary operations such as doctor-patient communication group,environment construction. According to estimating the financial data in a hospital with the most complete financial cost data,the smoking cessation clinic should operate one day per week for completing the intervention of 200 cases per year required by project. The smoking cessation clinic should input labor cost37 470 yuan or 34 472 yuan a year for completing the core operation and supplement operation of smoking cessation intervention of200 cases;and input 7 626 yuan in equipment and consume materials. The labor cost plus the cost of equipment and consume materials were 79 586 yuan,which were divided into each case about 398 yuan. Conclusion It is suggested that the government should provide the subsidies for smoking cessation clinics and clinical staff to promote the activity of smoking cessation service.The propaganda for health hazard of smoking and smoking cessation clinics should be strengthened,the operational volume of smoking cessation clinics should be increased,the usage rate and input efficiency of smoking cessation clinics should be enhanced.