Basic Public Health Services For Urban Communities In Sichuan Province Package

Objective:Through the investigation of Sichuan economic development level,urban community public health service present situation and residents' demand,based on the result of Activity-Based Cost,urban community basic public health service package which suits our province's fact will be established,for regulating the standard of community public health service and enhancing the effective utilization ratio of government compensation fund.Method:Literature Review was adopted to definition principles of items and the cost reckoning method of the basic public health service package: 12 Community Health Service Centers of six cities in Sichuan province were selected as representative survey objects,and the data we need were collected:Focus group discussion and questionnaire interview were introduced to know demand of community public health service items'; Activity-Based Cost was used to count the cost of the community public health service items.Result:(ⅰ)The Sichuan political environment is advantageous to the community health service's development.Different levels of government have not only issued the related policies,but also increased grants year by year.But the grants of government is still insufficient,and the average proportion of the government's grants in the community health service center revenue is 9.02%,otherwise,the medical and drugs income contribute to the most proportion of the revenue.(ⅱ) At present,part of the public health service work develops comparatively solidly,such as baseline investigation,establishment of health records,home visit to chronic patient,programmed immunization, epidemic reporting,child care,pregnant woman and reproductive health care and so on;But some items like health propagandas and cathedras in health related subject days,chronic diseases screening,tuberculosis and other infectious disease's home visit,health consultation and so on are also needed to improve.(ⅲ) The community residents need the community health service,items with the highest demand rate are the establishment of health records and the continuous management,health care of elder,the health education and the prevention and control of key chronic diseases,etc.However,there are few residents who will pay for these services,and the proportion who will pay are less than 50%.The use of the community health service is not very ideal,and the reasons are the following:the community health service center has not provided satisfying services,the higher technical guidance institutions has not transferred these functions to the community health center,and the residents do not accept some items.(ⅳ) Synthesizeing the residents' demand,the central director's opinions and results of the focus group discussion,health service situation of the sample centers in 2006,and the reckoning of the cost, the Sichuan city community basic public health service package was finally formed.It contains 5 aspects with 15 work points and 52 targets.Contents and goals of the community health service are specified,and the work procedure will be standardized.(ⅴ) Without considering of unpredictable cost in the future,based on the basic package,the total cost of the community health service centers providing the public health service to every ten thousand residents is 91498.105 Yuan:the cost of the health life information management is 13897.84 Yuan,of the health education is 8328.70 Yuan,of prevention and control of diseases is 30851.62 Yuan,of the key crowd health care and recovery service is 37015.44 Yuan,and of the report of public events that break out is 1404.55 Yuan.