The Idenntification And Cost Accounting Of The Community Public Health Service Items In Futian District Shenzhen City

The community health service contains massive pure public products (health education, community health information management and so on) and the public product, such as the prevention health care, the planned immunization program, the infectious disease management and so on, these services have the higher cost benefit to the entire society, but certainly cannot bring the corresponding income for the community health service organization, some even is free provided. The community public health service must have the government policy and the fund support in particular that can be able to develop and to maintain. The persisting governmental finance input to the community health service is the embodiment of the governmental recognition on CHS.But, in so many public health service items that is provided by the community health service organization, what is the government investing scope, which should compensate by the government sum total, which should compensate by unifying the government and the market, these questions must be solved by in the foundation of quantitative investigation and analysis, according to the different time, the different local economy level of development and the financial resource possibility, in close integration with community crowd's health need, identificating the community public health service items, to determine the scope of the community public health finance input. At the same time, through the cost accounting of the community health service items, provide the basis for formulation the community health service charge price and consummation of the CHS compensating mechanism.Since 1996 official start community health service, the CHS in Futian ditrict Shenzhen city obtained the support from government and populace, the network and function of the CHS organizations is perfected and enhanced. But compare with the governmental financial input on the medical orgnizations, the governmental financial input on the CHS is insufficient in a mass, the disconformity between the input and the public health service function and the duty blocked the sustaining development of CHS, but meanwhile the quantity basis and scientific accounting method of the governmental financial input is not provided ,and the compensating mechanism of community public health service must be further optimized and perfected.Objective: This research take to provide the basis of the governmental financial input on CHS in Futian distric as the final goal, mainly through profits from the domestic and foreign communities health service project cost survey method, surveys community health service project actual cost and standard cost which the Futian area already developed, unifies the Futian area economy level of development, the government financial resource, the inhabitant public health service demand, initially ascertain the present scope of community basic public health service that the government compensates, simultaneously take the cost surveys result as the reference of the community health service compensated service project fixed price, builds the foundation that fulfills the public health service function of the government, consummates the compensating mechanism of Futian area community basic public health service, safeguard community basic public health service development and realization.Method: Using the literature methodology determined the method of the basic public health service project actual cost and the standard cost survey; according to the data main origin and the data type request, extracts 31 community health service centers in the Futian area, consult the finance record and the commodity expenditure record, union questionnaire survey , half structure interview, the review investigation and the observation methodology, obtains various communities health service organization service, the personnel and so on, and each kind of cost, each service project actual investment manpower and the time, uses the time distribution system method to carry on the cost to survey; Using the literature methodology, the logical induction, the expert consult methodology, inputs the superior foreword chart method to determine the principle and the method of community basic public health service project limits, and according to the above ascertain the project of Futian area community basic public health service in the present stage.Result:(1) The ordinary circumstances of community health service in Futian areaIn recent years the social economy development in Futian area is good, the growth is maintaining with steady steps, the resources in the area is rich, the community health service organization, the city large-scale medical and health organization and the social medical service health service organization coexists. At present the Futian area has developed the community health service project total 10 big kinds of 76 items, the health service organization service is complete in various communities, "a six body" consummates day by day. The end of 2004 Futian area community health service personnel total 515, average 9.4 person of/centers.In 2000 ~2004 the investment of Fukuda area government to the community health service increases year by year. The drugs income is the main source of income in the Investigated 31 society health centers, the drugs income accounts for the service income proportion to surpass 80% in the individual society health center. The service income average of community health service organization in Futian area in 2004, 54.2% comes from the drugs income, 45.8% of income comes from medical service income.(2) The community health service cost surveys in Fukuda areaThis research carry on the actual cost and standard cost surveying to 10 big kinds of 76 items of communities health service project which already developed in Futian area, 59 items of community health service projects'standard cost had to be higher than the actual cost, accounted for the service project total 75%, another 19 actual cost was higher than the standard cost. The concrete result sees the main text.(3) The limit of community basic public health service project in Fukuda areaThis research proposed the characteristic and the limits principle of community basic public health service project, and proposed the community health service project classification means union public product theory, according to the above connection gathered the standard cost reference value of the cost to survey in the result and 10 big kind of prioritys-rating arrangements expert consults, has carried on the classified arrangement to the Futian area community health service project, then obtained.(4) The community basic public health service package in Futian areaTaking the Futian area community health service project arrangement and an entire area total standard cost volume table as the foundation, the reference concerned expert's correlation findings, by taking 0.1% of GDP in the Fukuda area in 2004 as the standard financial investment of community basic public health service, respectively is the resident population number and the household register population number for surveys caliber, had determined the concrete project in Futian area community basic public health service package under this standard investment.Conclusion:(1) this topic has surveyed the Futian area community health service project actual cost and the standard cost taken 2004 as the type, the result of surveys data can be applied to the Futian area community health service organization operation efficiency appraisal, the standard cost reference has the important reference value to reasonable determination compensation to the community health service finance and make community health service price standard.(2) This topic had determined the concrete projects of community basic public health service package at present in Futian area, and in this foundation has obtained the finance subsidy gap in community pure public health service package in Fukuda area, has provided the quantification promotion tool to ascertain the compensating scope of the community public health and realize government responsibility to the community public health service.