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目的测算社区儿童健康管理服务成本,为社区儿童健康管理服务经费预算及管理提供科学依据。方法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,确定儿童健康管理服务标准项目内容及工作步骤;随机抽取广东省深圳市60家社康中心进行现场调查,测定儿童健康管理服务工作时间及2013年服务量,并预测2015年儿童健康管理成本。结果社区儿童健康管理项目包括三大类、15项服务内容和58条工作步骤;60家社康中心2013年儿童健康管理服务调整工作时间合计78 646.9 h;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4种人力成本价格得出儿童健康管理服务总成本分别为651.8、659.7、738.3和846.1万元;人均成本分别为6.2、6.2、7.0和8.0元/人年;规范管理一名0~3岁儿童的单位成本分别为134.1、135.7、151.9和174.1元/人年,儿童健康管理服务应占基本公共卫生服务经费的9.2%,预测2015年深圳市社区儿童健康管理服务若需完全达到国家规范标准,需要人均成本分别为10.4、10.6、11.8和13.5元/人年;深圳市全市投入儿童健康管理经费约需1亿元。结论 2013年深圳市儿童健康管理服务人均成本为6.2元/人,高于目前政府财政对儿童健康管理服务的实际投入标准,建议2015年增至人均10.0元/年。
Objective To estimate the cost of community health services for children and provide a scientific basis for the budget and management of community health services. Methods Through the literature research and special discussion to establish an alternative indicator library; after two rounds of consultation with Delphi experts, determine the content of child health management services standards and work steps; randomly selected 60 community health centers in Shenzhen City, Guangdong Province for site investigation, determination Child health management service working hours and service volume in 2013, and forecast 2015 child health management costs. Results There were three types of community health management projects for children, including 15 categories of services and 58 work procedures. In 2013, 60 community health centers adjusted their child health management services in 2013 with a total time of 78 646.9 hours. According to the investigation of social health, The total cost of child health management services of professional public health agencies in the same year as the average income level of staff editors and experts’ suggested four kinds of labor cost prices were 651.8,659.7,738.3 and 8.461 million respectively; the per capita costs were 6.2, 6.2, 7.0 and 8.0 respectively Yuan / person year; standardized management unit cost of a 0-3 year-old children were 134.1,135.7,151.9 and 174.1 yuan / person year, child health management services should account for 9.2% of the basic public health service funding, forecast 2015 Shenzhen The municipal community’s health management services for children need to meet the national standard and require per capita costs of 10.4, 10.6, 11.8 and 13.5 yuan per person per year, respectively; and about 100 million yuan will be spent on child health management in Shenzhen. Conclusion The per capita cost of child health management services in Shenzhen in 2013 was 6.2 yuan per person, which is higher than the actual input standard of government finance for child health management services in 2013. It is proposed to increase the per capita cost of children’s health management services to 10.0 yuan per year in 2015.