The Cost Estimation Of Immunization Service In Community Of Shenzhen City

BackgroundCommunity immunization service is mainly carried by the community health service institution which is one of the most important contents of the basic public health service. The government should make compensation with the "thing fixed fee" principle for the cost of community immunization service which is the way to reflect the public welfare and maintain the community immunization service level.According to the 《 Regulations of vaccine and prevention management 》(2005), the cost of vaccines included in the national immunization program should be provide by the government. And the state compensation standard was 5 Yuan per case at present. Judging from the current situation, the subsidy standard is too low to keep the community immunization services to remain positive which is seriously affecting the quality of immunization service, especially in economically developed city. Further exploration and research of the cost estimation of community immunization service in China is needed. ObjectiveTo measure the cost of the community immunization service based on the actual situation of Shen Zhen city,provides the base and reference for the fund input policy of the community immunization service. Subjects and methodsThe index database was set up by the literature review and panel discussion, the “standardized basic public health service” was determined by a two-round Delphi method. Then 60 community health centers sampled by stratified random sampling were investigated to measure the work time and service units in 2013. ResultsThe community immunization service included 3 service types, 14 service contents and 49 work steps. The adjusted immunization service work time of 60 investigated community health centers was 221663.2 hours in 2013. On 4 human cost standard prices, the total cost were 18.4 million Yuan, 18.6 million Yuan, 20.8 million Yuan and 23.8 million Yuan, the average cost per population were 17.4 Yuan per year, 17.6 Yuan per year, 19.7 Yuan per year and 22.6 Yuan per year, the unit cost were 27.4 Yuan per case, 27.8 Yuan per case, 31.1 Yuan per case and 35.6 Yuan per case. The fund allocation proportions of the community immunization service in 10 basic public health services was 25.9%, and on 4 human cost standard prices, the average cost per population should increase to 17.8 Yuan per year, 18.1 Yuan per year, 20.2 Yuan per year and 23.1 Yuan per year in 2015. Conclusion 1. This study uses activity based costing(ABC) to measure the cost of community immunization service which shows that ABC is suitable to measure the cost of the community immunization service. 2. The the average cost per population of the community immunization service were 17.4 ~22.6 Yuan per year. The cost of the community immunization service is far above the state compensation standard in 2005(5 Yuan per case). 3. This study can provides references for the fund input policy of the community immunization service.