目的测算湖南省妇幼保健机构妇幼公共卫生服务项目成本投入现状,建立成本资源数据库,并分析各级妇幼保健机构项目成本投入-产出相对有效率,为政府制定合理的财政经费补偿机制提供依据。方法通过问卷调查收集湖南省9个不同级别的妇幼保健机构财务报表和工作量表等数据进行成本测算分析,计算人均成本和工时成本等指标,最后通过数据包络分析评价各机构项目成本投入-产出的相对有效率。结果妇幼保健机构妇幼公共卫生服务项目平均年总成本为396.18万元,呈现省、市、县逐步下降趋势,市级机构财政补助缺口较大。省级妇幼保健机构中各服务项目直接成本所占比例为74.9%~93.3%、市级为34.9%~82.1%、县级为71.3%~90.3%。省、市、县三级机构项目年人均成本分别为0.12元/人、3.3元/人和0.77元/人,市级机构人均成本最大。数据包络分析发现各机构中均存在部分服务项目的相对有效率<1,需针对性加强项目管理。结论政府财政在妇幼公共卫生服务方面投入不足,市级开展妇幼公共卫生成本与市级财政对妇幼保健的总投入差距较大,西部、中部地区财政补助缺口较大。根据功能定位明确不同级别服务项目划分和确定投入标准,成本测算分析需进一步细化;数据包络分析结果可为妇幼公共卫生服务项目成本调查和保健服务持续改进提供依据。 Objective To estimate the cost of MCH public health service project in MCH institutions in Hunan Province, establish the database of cost resources, and analyze the relative cost-effectiveness of project M & E of MCH institutions at all levels, so as to provide the basis for the government to formulate a reasonable financial compensation mechanism. Methods The data of 9 different levels of maternal and child health institutions in Hunan Province were collected and analyzed by questionnaires. The cost estimates were calculated and the per capita and labor costs were calculated. Finally, the project cost inputs of each agency were evaluated by data envelopment analysis - The relative efficiency of output. Results The average annual total cost of maternal and child public health services for MCH institutions was 3,961,800 yuan, showing a gradual downward trend in provinces, cities and counties, and a large gap in municipal government financial subsidies. The direct costs of various service items in the provincial MCH institutions accounted for 74.9% -93.3%, 34.9% -82.1% at the municipal level, and 71.3% -90.3% at the county level. The annual per capital costs of the projects at provincial, municipal and county levels are 0.12 yuan / person, 3.3 yuan / person and 0.77 yuan / person, respectively. The per capita cost of municipal-level institutions is the highest. Data envelopment analysis found that there was a relative efficiency of some service items in all agencies <1, and the project management should be strengthened accordingly. Conclusions The government finance has not invested enough in maternal and child public health services. There is a big gap between the municipal maternity and child public health costs and the total input of municipal finance to maternal and child health care. The gaps in financial subsidies in the western and central regions are large. According to the functional positioning of different levels of service classification and determination of input standards, the cost estimation analysis needs to be further refined; the results of data envelopment analysis can provide the basis for the investigation of the cost of maternal and child public health service items and the continuous improvement of health services.