论文部分内容阅读
目的测算老年人、重症精神病患者和残疾人健康管理服务成本。为开展上述人群社区健康管理、制订政府经费投入政策提供参考依据。方法 2013年10—12月,通过文献研究及专题讨论建立备选指标库;经两轮德尔菲法专家咨询,确定重点人群社区健康管理的服务标准项目内容及工作步骤;随机抽取60家社康中心进行现场调查,测定各项服务工作时间、2013年服务量等。结果 60家社康2013年老年人、精神病人、残疾人健康管理累计调整工作时间分别为82 519.6、17 945.8、9 293.7;按调查社康、全市社康、基层专业公共卫生机构当年在编人员平均收入水平和专家建议的4种人力成本价格,得出老年人健康管理人均成本为6.7~8.6元/人年,单位成本为248.4~320.2元/人年;重症精神疾病患者管理人均成本为1.4~1.8元/人年,单位成本为1 567.1~2 034.2元/人年;社区康复人均成本为0.7元~0.9元/人年,单位成本为754.4~978.8元/人年。老年人健康管理、重症精神疾病患者管理、社区康复服务项目分别应占10项基本公共卫生服务总经费的9.6%、2.1%、1.1%。结论政府财政应对社区老年人、精神病人、残疾人等重点人群社区健康管理服务经费予以全额补助。
Purpose To measure the cost of health management services for the elderly, critically ill patients and people with disabilities. To carry out the community health management of these people, to formulate government funding input policy provides a reference. Methods From October to December 2013, an index bank was set up through literature review and panel discussions. After two rounds of consultation with Delphi experts, the content and working procedures of community health management services for key population groups were determined. Center for site surveys, determination of service hours, service volume in 2013 and so on. Results 60 social workers in 2013, the elderly, mental patients, disabled health management cumulative adjustment of working hours were 82 519.6,17 945.8,9293.7; according to the survey of social health, the city’s health, grass-roots public health institutions in the current staff Average income level and expert’s suggested four kinds of labor cost price, the average per capita cost of health management for the elderly is 6.7-8.6 yuan / person-year, and the unit cost is 248.4-320.2 yuan / person-year; the per capita cost for patients with severe mental illness is 1.4 ~ 1.8 yuan / person-year, the unit cost is 1,567.1 ~ 2,034.2 yuan / person-year; the per capita cost of community rehabilitation is 0.7 yuan-0.9 yuan / person-year, unit cost is 754.4-978.8 yuan / person-year. Elderly health management, management of patients with severe mental illness, and community-based rehabilitation services account for 9.6%, 2.1% and 1.1% of the total 10 basic public health services respectively. Conclusion The government finance should provide the full subsidy for the community health management services for the key population such as the elderly, the mentally ill and the disabled.