Study On Cost Estimation And Compensation Mechanism Of Community Public Health Services In Guangzhou

ObjectiveThis research took the 11 community public health services programs in Guangzhou as costestimation targets, through cost estimation on the four major types, such as personnel cost,special equipment cost, housing construction cost, operating cost, etc. to identify serviceitems and cost composition, so as to provide a basis to government for compensationstandards and compensation styles of community public health services in Guangzhou. Atthe same time, combined with the factors such as economic development level, pricefluctuation level and resident income growth, we want to establish financial compensationforecasting model of the 11 community public health services in Guangzhou, to enable amore objective and reasonable financial compensation standard, in order to provide ascientific and effective basis to the government for fulfilling functions of public healthservices, improving basic compensation mechanism and protecting stability anddevelopment of community public health services.MethodsThrough literature research and expert panel discussions, according to the actual situation of community health services in Guangzhou, the indicators and methods of cost estimationwere determined. The existing 128 community health service agencies in Guangzhou weresuveyed to understand their financial situation, personnel structure, public health servicescontents, public health services times, fund raising, and resource consumption and so on. Atlast, 65 community health service centers with independent agency installations andindependent financial affairs were selected for cost estimation. Quantitative analysis wasperformed on the existing resources status and public health service costs, to establish costforecasting model, and explore the feasibility of future government compensation standard.Results1. Basic situation of community health services in Guangzhou.By 2008, there were a total of 128 community health centers in Guangzhou, with 8192 staff,the average fixed value of which was 4.933 million yuan, with an average housing floorarea of 2145 square meters. The total revenue per center was 10.907 million yuan, and thefinancial assistance revenue was 1.378 million yuan, accounting for 12.6% of the total cost.The average total expenditure was 10.655 million yuan.2. Community public health services.Among the carried out projects, the rates of health education, women's health, child health,prevention and control of communicable diseases, as well as planned immunity were allabove 90%, but the rates of prevention and control of chronic disease and health care ofolder persons were at a low level.3. Actual cost of community public health services.In 2007, the cost per capita of the 11 public health services projects was 37.2 yuan.The project of prevention and control to chronic disease had the highest cost per capita as8.2 yuan, followed by other projects ranked as immunization program, health informationmanagement, health education, etc.4. Standard cost of community public health services projects. According to income per capita of health industry in Guangzhou as 57,000 yuan, standardcost per capita of community public health services in 2007 was 42.0 yuan.5. Financial compensation predicted results of community public health services.Combined with the level of economic development, the level of price changes and incomegrowth and other factors, the cost forecasting model analysis showed that from 2008 to2010, financial compensation standards per capita of community public health services was46.8 yuan, 52.2 yuan, 58.3 yuan respectively, of which, the direct personnel cost accountedfor 75%.ConclusionsAfter 10 years of efforts, the community health service system with community healthservice centers as the mainstay has been intially established, yet there are still factors suchas insufficient business space, lack of infrastructure, low service quality, limited capacity ofservice supply, and insufficient financial compensation of public health services, to impedefurther development of community public health services. This research determined thecost estimation methods of community public health services projects in Guangzhou. Itestimated actual cost and standard cost of community public health services in Guangzhouin 2007, and established financial compensation prediction model of the 11 communitypublic health services of Guangzhou City, and forecast the future compensation standardper capita of the community public health services, which plays an important role inreasonably determining the financial compensation amount of public health services andformulating price standard of community public health services.