The Human Resourses Allocation Standard Study Based On The Community Public Health Service Package,Take Shenzhen City For Example

The study on the human resource allocation standard of the urban community health services is important and urgent. In 2007, Shenzhen spearheaded design research and commissioning work on the community public health service package. In 2008, Shenzhen Technology Bureau key funded the project named Shenzhen community public health service package operation cost analysis. 2009, Shenzhen Technology Bureau funded"the research on the community health human allocation standard based on community package, support for community public health service package human cost estimates, this work just remain consistent with the new national medical scheme purpose spirit.Objective"Health Care and Health Quality Enhances Unceasingly for All"is one of the important targets of the Socialist modernization.Health human resources development is one of the important security conditions."2001-2015 program for the development of human health of China–MOH"puts forward the goals of the development of the health human resource, and the regulation of human resource allocation standard overall the national, namely"above 30% of the national health teams engaged in community health work and no less than one-third of the community doctor are general practitioner. The Scientific configuration of the community health human resource is the basis and premise if the sustained and healthy development of CHS, the study on the community human resource allocation standard is significant.The study based on the analysis of the domestic and overseas research on the cost of the health sector, refer to traditional methods and Activity-Based Costing, according to the task of the community health package, compute the necessary monetary human costs and the number of personnel of the services per million population, so as to achieve the purpose of the scientific community health human resources configuration.Methods According to the 2007 Shenzhen community health service package, combined with the characteristics of the process of the community public health service, make questionnaire for the CHC director, public health doctor, general practitioner, general nurse etc. The questionnaire mainly includes the time of each task completion and service frequency. The pre-survey test rationality of the questionnaire, understand the difficulty of the investigation, and clear quality control links. After per-survey, according to the size sample 99 community health service centers in 6 districts to launch a formal investigation.The study introduces "person ? day" as an intermediate unit costs to lower the impact of market prices and the average salary changes, improve the universal of the cost data; introduce "effective work time factor", remove the service gaps time, use the factor of effective work time; estimated annual effective community health service staff working hours; form a service package of human time cost formula:a human time cost service package (person ? day) = the sum of the human time cost of the sub-services of the service package, the sum of the human time cost of the sub-services = [the time required of the unit (minutes)×the the number of participants take×the the required amount of service]÷420÷coefficient of effective working time, through the conversion of the base to get the results of the human cost of the service package.ResultsAccording to the process of the community health service package, the study estimates the time of the public health service completion in sample center. The study results that, the human resource cost of the all and the basic items of the community diagnosis service package respectively is 64.57 person ? day and 64.16 person ? day; the human resource cost of the all and the basic items of the community health education and health promotion services package respectively is 118.80 person ? day and 116.73 person ? day; the human resource cost of the all and the basic items of the community inoculation and infectious diseases control services package respectively is 750.38 person ? day and 679.72 person ? day; the human resource cost of the all and the basic items of the community women health service package respectively is 1554.73 person ? day and 583.30 person ? day; the human resource cost of the all and the basic items of the community children health service package respectively is 452.43 person ? day and 352.93 person ? day; the human resource cost of the all and the basic items of the community chronic comprehensive prevention and control service package respectively is 764.39 person ? day and 756.18 person ? day; the human resource cost of the all and the basic items of the community elderly health service package respectively is 295.27 person ? day and 287.41 person ? day; the human resource cost of the all and the basic items of the community rehabilitation services package respectively is 357.07 person ? day and 240.64 person ? day; the human resource cost of the all and the basic items of the community mental health services package respectively is 72.85 person ? day and 67.24 person ? day. So considering the staff's actual work time of every year, the human resource number of each service package should be 0.28, 0.52, 3.00, 2.58, 1.56, 3.34, 1.27, 1.06, 0.30, the human resource number of community public health service package should be about 13.90, according to doctors and nurses ratio 1:1, the doctor and nurse's number respectively is 6.95 and 6.95.ConclusionThe main findings1. The overall cost is not high. In 2008, the human resource cost of the basic item of Shenzhen community public health service package is $454,000 per 10,000 service population, accounted 70.20% for total cost; the human resource cost of the all item of Shenzhen community public health service package is $638,900 per 10,000 service population, accounted 76.83% for total cost. In the total cost of the community public health service package operation, the cost of the basic item is $919,435,800, accounted only 1.03% for the same period fiscal general expenditure $88,986,000,000, the cost of the all item is $1,182,314,500, accounted only 1.33%.2. Fiscal gap is bigger. Judging from this research, relative to the necessary cost of the service package operation, there is still $446,700 fiscal gap in the cost of the basic item.3. Human allocation space is exist. The study show the number of the health human resource of the community health basic item service package is 4.3 per 10,000 service population. To perfect the community public health functions and ensure community public health service package complete benign operation, it must be done to allocate enough health human resource. Policy recommendations1.It needs to improve community health personnel team construction to solve personnel shortage at present.2.It is essential to create CHS talent strategy project.3.It is necessary to increase the funds investment to support the normal operation of CHS center.Innovation1. The study takes advantage of traditional method of cost accounting and ABC and avoids their shortage when calculating the cost of human resources of medical services.2. In the calculation of community public health service package, the term"person ? day"is applied.ShortageBecause the limitation of research circle, time and academic level, the study of community public health service package of human resources need further discussion and improvement in the future.