The Study Of Differential Funds Allocation Of The Village-level Basic Public Health Service Projects

[Purpose] Through the implementation of differential funds allocation project to Increasing the funds efficiency of the basic public health service project at the village leve in our country,improve the service behavior of the village health personnel,so as to achieve the purpose of improving the system performance of basic public health services.[Methods] Through the literature research to understand common methods of workload measuring and workload measurement method for medical and health personnel,and to analyze the theoretical basis of differential funds allocation.Through the brainstorming method,literature research and individual in-depth interviews method to analyze the factors of differentiated funds allocation of village basic public health service,and through the expert consultation to determine indicator framework of differentiated funds allocation of village basic public health service.Screening the basic public health services of the village health workers affordable based on investigation and individual in-depth interview method.Measuring the workload of village-level basic public health services based on questionnaire survey.[Results](1)The measurement of workload about the health workers focused on the measurement of the nurses,but few about the primary public health service programs of the primary public health workers.In terms of the measurement of the primary public health services work,which was considered time as a coefficient to distribute the cost of service items,rather than measure the work in accordance with the time and labour intensity.The RBRVS comprehensively considered the ideas,the technology and labour intensity,the risk pressures and the workload time to evaluate the relative work in the clinic.(2)The theoretical basis of the differential payment was based on the Adam Smith and Samuelson's wage discrimination.The wage discrimination,in the working content,health service quality,health service environment,analyzes the differential payment of the primary public health service programs in the villages.(3)Establishing the indicators fragment by the theory analysis,personal interview,the experts' consultation,to confirm the 16 indicators about the differential payment of the primary public health in villages.All the 16 indicators include the unit workload,the service numbers,the popularity of the service rate,the compliance rate,the disease control rate,the resident satisfaction assessment,the medical education background,the professional qualification,the professional the knowledge level assessment scores,the public health work experience,the communication barriers,the physical barriers,the residents of the village doctors trust,the traffic conditions,the service radius,the population density,and the population ratio.(4)The village health workers will undertake 39 primary health service items,based on the RBRVS theory,through on-the-spot investigation and expert consultation.[Conclusions](1)At present,to implemente the differentiated funds allocation project,which regrad the work as core and comprehensive consider the quality of service,quality of service provider,the service object accept ability and service environment,not only conform to the requirements of national policies,but also the practical needs of basic public health service project funds management.(2)The differential payment of the village primary public health service project funds as a kind of management mode can be existed for a long time,but different payment elements will be changed with the development and time flying.So the differential payment needs dynamic management,moreover,the differential payment schemes should be based on workload,fair,dynamic,primary public health service project funding allocation schemes,to adapt to the regional development.