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目的界定农村公共卫生服务项目,测算农村公共卫生服务项目的实际成本和投入标准,为确定农村公共卫生经费保障水平提供参考。方法采用文献归纳分析、专家咨询论证、机构调查、成本核算等方法进行项目界定、项目成本核算和投入标准的测算。结果(1)形成了我国农村公共卫生服务的8类职能、23项类别和59个项目,据此作为农村公共卫生服务项目投入测算的标准;(2)探索并研制了农村公共卫生服务项目投入标准测算的一整套思路与方法,包括“农村”范围的界定、农村公共卫生服务项目的界定、样本地区项目实际成本测算、样本地区单位项目实际成本测算、标准成本测算以及全国项目投入标准测算6步骤;(3)现有国力水平下,如果县、乡、村三级机构的基本医疗服务项目不纳入国家财政补助范围,要求百分之百落实现有项目任务,则需投入696.48亿元,人均50.53元;如果仅将乡、村两级的基本医疗纳入财政补偿范围,则需投入人均84.30元,全国732.84亿元;如果县、乡、村三级的基本医疗成本均列入国家财政补助范围,则需投入人均132.84元,全国1154.87亿元。
Objective To define the public health services in rural areas, measure the actual cost and input standard of public health services in rural areas, and provide reference for determining the level of rural public health funding. Methods The project definition, project cost accounting and input standards were calculated by literature induction, expert consultation and argumentation, institutional investigation and cost accounting. Results (1) 8 kinds of functions, 23 categories and 59 items of public health services in rural areas were formed in our country, which were used as the input standard for rural public health services. (2) The investment of rural public health services was explored and developed A set of ideas and methods of standard measurement, including the definition of “rural area”, the definition of rural public health service project, the actual cost of sample area project, the actual cost of sample project unit area calculation, standard cost calculation and national project input standards (3) Under the current national strength level, if the basic medical services at the county, township and village levels are not included in the scope of state financial subsidies and 100% of the existing project tasks are required, an investment of 69.648 billion yuan will be required, 50.53 yuan. If only the basic medical treatment at the township and village levels is included in the scope of financial compensation, the average need to invest 84.30 yuan per capita and 73.284 billion yuan in the whole country. If the basic medical costs at the county, township and village levels are included in the national financial subsidies , You need to invest 132.84 yuan per capita, the national 115.487 billion yuan.