CAJ | 학술논문

目的研究重庆市基本公共卫生服务标准流程所需的人力时间成本.方法本研究于2012年根据《国家基本公共卫生服务规范(2011年版)》,制定社区实施公共卫生服务的具体操作流程.采取随机抽样的方法在城市及农村分别选取重庆市2个社区卫生服务中心或乡镇卫生院及1所妇幼保健院,调查重点人群与全人群服务项目的标准化流程服务时间与所需的支持性成本.结果重庆市完成基本公共卫生服务1万名各类重点人群所需医务人员数分别为:健康档案需医务人员3.4名,高血压管理需医务人员10.8名,糖尿病管理需医务人员10.6名,老年人管理需医务人员9.2名,儿童保健需医务人员4.6名,孕产妇保健需医务人员24.3名,精神病患者管理需医务人员13.3名,儿童计划免疫需医务人员4.6名.除重点人群以外,全人群服务项目每10万服务对象需医务人员2.4名.完成基本公共卫生服务1名各类重点人群所需人力时间货币成本分别为:健康档案需22.67元,高血压需72.69元,糖尿病需71.34元,老年人需61.50元,精神病患者需74.25元,儿童计划免疫需30.68元,儿童保健需30.88元,孕产妇产前健康管理及产后访视(包括产妇与婴儿)需人力时间货币成本157.15元.提供每10万人的基本公共卫生服务全人群服务需12.49万元.结论现有医务人员编制数量明显不足,基本公共卫生服务需进一步完善社区人员配置.
목적 연구중경시기본공공위생복무표준류정소수적인력시간성본.방법 본연구우2012년근거《국가기본공공위생복무규범(2011년판)》,제정사구실시공공위생복무적구체조작류정.채취수궤추양적방법재성시급농촌분별선취중경시2개사구위생복무중심혹향진위생원급1소부유보건원,조사중점인군여전인군복무항목적표준화류정복무시간여소수적지지성성본.결과 중경시완성기본공공위생복무1만명각류중점인군소수의무인원수분별위:건강당안수의무인원3.4명,고혈압관리수의무인원10.8명,당뇨병관리수의무인원10.6명,노년인관리수의무인원9.2명,인동보건수의무인원4.6명,잉산부보건수의무인원24.3명,정신병환자관리수의무인원13.3명,인동계화면역수의무인원4.6명.제중점인군이외,전인군복무항목매10만복무대상수의무인원2.4명.완성기본공공위생복무1명각류중점인군소수인력시간화폐성본분별위:건강당안수22.67원,고혈압수72.69원,당뇨병수71.34원,노년인수61.50원,정신병환자수74.25원,인동계화면역수30.68원,인동보건수30.88원,잉산부산전건강관리급산후방시(포괄산부여영인)수인력시간화폐성본157.15원.제공매10만인적기본공공위생복무전인군복무수12.49만원.결론 현유의무인원편제수량명현불족,기본공공위생복무수진일보완선사구인원배치.
Objective To explore cost of standard operation procedure of primary public healthcare services.Methods Standard operation procedure of primary public healthcare services was put forward according to national basic public healthcare service standards (2011 edition) in 2012.Random sampling method was used to choose participants from two community sanitary service centers,two township heahhcare centers and one maternity and child heahhcare hospital.Service standard operation procedure was used to measure human cost and supportive cost of public healthcare services.Results Management of 10 thousand patients who had different diseases needed various numbers of medical staff (MS),such as health profile needed 3.4 MS,hypertension management needed 10.8 MS,diabetes management needed 10.6 MS,elderly people care needed 9.2 MS,child care needed 4.6 MS,maternal care needed 24.3 MS,psychosis management needed 13.3 MS,and planned immunity for children needed 4.6 MS.Besides,the people whole covered service projects need 2.4 MS per 100 thousand people.The research showed that managing 1 sample of different kind people needed different human cost,such as health profile needed 22.67 yuan,hypertension management needed 72.69 yuan,planned immunity for children needed 30.68 yuan,diabetes management needed 71.34 yuan,old people management needed 61.50 yuan,child care needed 30.88 yuan,maternal care needed 157.15 yuan,psychosis management needed 74.25 yuan.Besides,the people whole covered service projects needed 124.9 thousand yuan per 100 thousand people.Conclusion For primary public healthcare service project,it should be critical to modify manning regulation and labor costs.