Costing Of CHS Public Health Program In Ji'nan City

The Community Health Services (hereinafter shortened as CHS) plays a crucial role in urban sanitation campaign and paves the way for achieving the goal that everyone enjoys elementary health care. By the end of 2005, the Community Health Services have become available in 95% of cities above prefectural-level, 86% of urban districts and a group of cities at county level, where CHS centers and stations are set up. Supported mainly by CHS centers, assisted by CHS stations and supplemented by various medical clinics and medical rooms, a framework of CHS is coming into shape in large and medium-size cities. CHS is transferring itself in development stages from framing its structure to strengthening its functions, improving its management efficiency and pursuing sustainable development.In Guidance of the State Council on Nurturance of CHS in Urban Areas issued in Feb. 2006, it is stated that the public health and basic medical services provided by CHS organizations are commonweals in nature, which should not seek profits. Local governments should provide financial subsidy to buy those services, according to different community population sizes, the public service items and quality offered by CHS organizations and the involved costs. In June 2006, twelve public health service categories from CHS organizations are recognized in Measures for CHS Organizations (Trail) (hereinafter shortened as Measures, jointly issued by the Ministry of Public Health and the State Administration of Traditional Medicine. Those rules and regulations released by the State Council and relevant ministries supply the CHS organizations with supporting policies so that they can identify their public health service items and evaluate the service cost. However, the existing public health service items are beyond counting in number; to evaluate the cost of each service item stipulated by the Measures is too difficult; and the services currently offered and the record measures in different regions are also of various types. Therefore, to strengthen the supervision and control of CHS organizations, perfect the compensation mechanism and realize CHS's sustainable development, we must further explore the costing methods based on local conditions, refine and reassemble the public health service items, and deepen our efforts to cost CHS's public health service.Ji'nan city is one of the first CHS pilot places in our country. With the fast development in most recent 10 years since 1996, a total of 114 CHS organizations have been up built by the end of 2005, which benefits more than 2 million people in this region. Meanwhile, CHS in Ji'nan is also facing such problems as low enthusiasm to offer public health services, insignificant benefits and unreasonable compensation mechanism. It is increasingly necessary to evaluate the CHS's public health service cost, to improve the compensation mechanism, to stabilize and raise CHS functioning ability, to strengthen the supervising measures on CHS organizations. Only by taking those measures can CHS develop in a healthy and sustainable way.With strong literature support, this paper takes into consideration the CHS practices in Ji'nan city and identifies the methods of CHS's public health service costing. On the other hand, according to the relevant regulations, this paper also refines and reassembles the CHS public health service items in Ji'nan. Based on those efforts, the questions of how to calculate program actual and standard cost, how to manage service cost and how to control CHS's public health service compensation fee are also explored. The supporting data on Ji'nan CHS and its public health service program cost is collected form field survey. Methods taken in this study are literature reviewing, costing and field survey. Conclusions: In general, the actual cost of CHS's public health services programs is higher than their standard cost in Ji'nan city, so we should strengthen the cost management and control; Meanwhile, the financial subsidy to CHS's public health services is not sufficient and the mechanism is not reasonable, so the government of Ji'nan should increase the compensation fee and perfect the subsidy mechanism.