城市社区公共卫生成本测算与经费保障研究——以湖南为例社会医学与卫生事业管理专业论文.docxVIP

摘要 社区卫生服务是为保障人群健康权利向居民提供基本卫生服务的主要载体， 特别是承担了预防、保健等基本公共卫生服务，是公共卫生的网底。政府承担社 区公共卫生服务的主要筹资责任，是当今世界多数国家的通常做法。但是，我国 政府对社区公共卫生服务的投入长期缺乏“预算根据”，补偿不合理且没有保障， 以致公共卫生功能难以充分发挥。 社区卫生服务机构开展的公共卫生服务项目（国家项目和省规项目）应当有 哪些（财政补什么）？开展这些公共卫生服务项目成本是多少（补多少）？采取 什么卫生经济政策才能实现公共卫生服务持续发展（怎么补）？解决这些问题首 先必须科学测算社区公共卫生服务的成本。 本研究以湖南城市社区卫生服务开展相对较好的长沙市、湘潭市、岳阳市和 衡阳市作为样本，每个城市又抽取公共卫生服务相对开展较好的社区卫生服务中 心【共 16 个中心，其中 13 个城市区和 3 个县（市）社区卫生服务中心】作为调 研和测算点。采取以开展公共卫生服务的实际消耗（物化劳动消耗与活劳动消耗） 计算物化成本和人力成本。测算社区公共卫生服务项目全面开展所需成本（即补 偿标准）。 在此基础上，就政府财政投入标准、各级财政分担公共卫生经费合理性以及 建立科学的公共卫生服务补偿机制等提出政策建议。 关键词 公共卫生 项目成本 计算与测算 经费保障 The Study on Cost Estimation and Financial Security Mechanism in Community Public Health : A Case Study in Hunan Province Abstract The community health service has undertaken the basic public health work (especially prevention and health care) and is the bottom of public health net. Government take the major responsibility for funding of community public health service, which is the worlds common practice in most countries. But in China, according to a lack of a state budget，the government to the community public health service investment is unreasonable which causes the public health function not to be able to display fully. What is the community public health service items (national items and provincial items)? How much the community public health service costs? How to carry on the payment to the community public health service? To solve these problems ,we must rely on the scientific community health service cost estimation. In this study, Changsha, Xiangtan, Yueyang and Hengyang City which urban community health service was carried out relatively good in Hunan Province were taken as samples, and Community Health Service Centers[total of 16 centers, 13 urban districts and 3 counties (cities) Community Health Service Center]which public health service was carried out relatively good were cramped out from each city, as research and measurement points. Taken to carry out the actual consumption (materialized labor c