The Community Health Service Project Cost Calculation Model Research Of Beijing

Objective:Community health services project cost is relatively mature, but there are some difficulties for the majority of community health services cost estimates based on existing information, the cost is difficult to draw to departments or projects; the cost of new project can not get from historical data estimates.To investigate and build a handy, scientific and feasible cost estimation model that can be applied to Beijing community health service programs. This model will help to decide scientific and reasonable government investment and reimbursement mechanism, to provide reference and evidence for continuously improving, adjusting and designing health policy for community health. The model will be typically helpful and be factored into organization budgets design, cost management and control, performance evaluation, and fund flow analysis. These, working together, will help to improve efficiency and effectiveness of organization grant.Method:This paper mainly used literature review, sample surveys, specialist interview and onsite surveys to obtain relevant data and information. Literature review mainly focuses on well-established national and international costing and accounting methods for hospitals, community health centers and medical service programs. With reference to these published research and report, this paper summarized main characteristics and existing problems about costing and accounting in community health service programs. This helped lay the foundation for the cost estimation model for Beijing community health service programs. In sample survey,17community health centers were randomly drawn to be surveyed. These centers cover urban and suburban areas of Beijing, which guarantees representativeness of the sample. Specialists on relevant health service costing and accounting research areas were interviewed and consulted to gain authoritative opinions. Combined with the features of Beijing community health service organizations, a cost estimation model that can be applied to Beijing community health service programs were discussed and projected. Details about the model such as standard equivalent, service projects, service programs equivalent were also consulted, discussed and proved. These provide guidelines for onsite surveys. Onsite surveys were separated into onsite observation group and informed people interviewing group to keep record of how long each service program took. For those public health service programs that could not be observed on each site such as family visit and infectious disease report, data were obtained from informed individuals who estimated the time each program would always take.Body details:First, Beijing communicity health services projects’content:Basic medical care, public health services, nursing services, pharmaceutical services, auxiliary inspection services.Second, Beijing communicity health services projects’ content:Basic medical care, public health services, nursing services, pharmaceutical services, auxiliary inspection services. Third, this paper summarized the overall ideas, principles and methods for the cost estimation model, specific procedure to implement the model, and all the innovative points of this model. Last but not the least, the availabilityof the estimated cost of some of the community service programs with the help of the model willhelp to decide scientific and reasonable government investment and reimbursement mechanism provide reference and evidence for designing and improving health policy for community health.Results:First, the main features of Beijing community health service organization include separate management for revenue and spending, proactively guiding patients to seek medical service in community facilities, pharmaceutical drug selling with zero profit, hospitals sending aid group counterparts community centers, position and placement unifying policy for personnel, and stable government financial compensation."Basic Public Health Services Specification (2009edition)"."Beijing Community Health Services Performance appraisal Program (2010edition)" and other documents defined services projects and the object of cost estimation. Second, the main model of domestic medical institutions cost accounting is the total cost-department cost-project cost, getting the department by four allocation method, project cost by time allocation coefficient method. Third, the new community health service project cost estimation method:determine the cost estimation of object, determine project standards equivalent, determine the equivalent of the various service projects, collect the workload of the services and compute total services equivalent, collect and calculate cost by category, estimates the cost of unit equivalent, estimate the project cost. Calculate the model coefficients.Conclusion:The principle now used for costing and accounting in community health service programs is borrowed from the model for hospitals and public health programs. That is break down cost from total cost to department cost, and then to program cost. Community health service organization’relatively more lately development than hospitals and public service organization and its relatively weaker financial foundation make it difficult to break down cost using appointing method. From the perspective of estimation, this paper aims to design a cost estimation model for Beijing community health programs while at the same time avoids the problem of apportioning. The most important meaning of this model is that it will add service time of each project to the model to realize to goal of quantifying specifically how much to reimburse.