湖南省计划免疫工作成本测算研究

目的对湖南省各级计划免疫工作成本进行调查,了解分析目前计划免疫工作成本状况及构成.方法采用多阶段分层随机抽样的方法,采用查帐法和专家估算法,对各级开展计划免疫工作实际成本和开展计划免疫各种活动所需费用进行调查,并估算合理成本.结果全省计划免疫工作人均成本209.36元,省、地、县、乡、村五级人均成本的构成比分别为7.33%、2.65%、13.40%、49.00%、27.62%.总成本中各级业务费用比例分别为8.28%、34.81%、34.29%、19.57%、48.67%.各级计划免疫工作直接成本占总成本的比例均在80%以上.按照规范化开展计划免疫工作的合理人均成本229.64元.流脑和乙脑疫苗纳入计划免疫后,规范化开展计划免疫工作的合理人均成本为276.11元.结论湖南省计划免疫人均成本构成中乡级所占比例最大,其次是村级,县级.根据目前全省计划免疫工作的运行现况及合理成本的估算,各级财政应加大对省、地、县三级实验设备、冷链装备和疾病监测经费的投入,增加乡级疾病监测、督导经费以及村医生的报酬.

Study on the Cost Accounting of Expanded Programme on Immunization in Hunan Province

Objective To investigate the actual cost of expand programme on immunization (EPI) from each management level in Hunan Province, the structure and the total actual cost of EPI project were analyzed. Methods The stratified random sampling was performed in this research. We investigated the actual cost of EPI aroused from each management level and every task by account book checking, and estimated the ideal cost by experts assessing. Results The average cost for each EPI-targeted child in Hunan was $209.36. The proportion of the average costs for each EPI-targeted child in 5 management levels through the provincial, prefectural, county, township and village accounted 7.33%, 2.65%, 13.40%, 49.00% and 27.62%. The proportion of working fee in the 5 management levels was 8.28%, 34.81%, 34.29%, 19.57% and 48.67%, respectively. The direct cost in each management level accounted more than 80% of the total cost. The average ideal cost for each EPI-targeted child in Hunan was $229.64 in term of standardization procedure. The ideal average costs for each EPI-targeted child would be $276.11 in case of bringing the meningitis and Japanese B Encephalitis vaccine into EPI. Conclusions The main contributing factors of EPI cost were the township level, followed by the village and county level. According to the cost structure of EPI and ideal cost assessing, we suggest that the government in each level should increase the investment on experiment equipments , cold-chain facilities, disease surveillance, working supervision and village healthcare providers' payments .