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目的:构建深圳市家庭医生式(上门)服务项目成本核算模块,对已经开展的服务项目进行成本核算,以期为政府合理制定上门服务价格、完善补偿机制提供依据。方法:以模块化理论为指导,结合文献研究,采用问卷调查与焦点观察方法获取家庭医生式服务的基本情况劳务与物质消耗,通过计算标准人力成本与标准交通成本核算家庭医生式服务项目成本。结果:深圳提供上门服务的医师单位时间人力成本为1.683元/分钟,护士为1.497元/分钟,康复师为1.574元/分钟。结论:各项上门服务项目的成本均远高于现行收费价格,家庭医生团队上门服务的积极性受到影响。建议政府界定上门服务性质,理顺补偿机制,根据成本测算结果,按上门服务人员的职称分级、上门服务的路程长短,分门别类地确定上门服务价格,使上门服务人员的劳务价值得到充分体现。
Objective: To construct the cost accounting module of Shenzhen family doctor (on-site) service project and carry out costing on the service projects that have been carried out in order to provide the basis for the government to make reasonable on-site service prices and improve the compensation mechanism. Methods: Based on the theory of modularization, combined with the literature research, the questionnaire survey and focus observation method were used to obtain the basic situation of family doctor service, labor and material consumption, and the cost of family doctor service was calculated by calculating the standard labor cost and the standard transportation cost. Results: The on-site physician cost of labor in Shenzhen was 1.683 yuan / minute, that of nurses was 1.497 yuan / minute, and that of rehabilitation physicians was 1.574 yuan / minute. Conclusion: The cost of all on-site services is much higher than the current fee, and the enthusiasm of family doctor team on-site service is affected. It is suggested that the government define the nature of home-visit service and rationalize the compensation mechanism. According to the result of cost estimation, according to the grade of home-service staff, the length of door-to-door service and the price of door-to-door service, the service value of on-site service personnel should be fully reflected.