【摘要】 目的 构建基于中国常规卫生统计数据的预防接种服务成本测算工具。方法 梳理国内外相关研究，参考世界卫生组织和哈佛大学成本测算指南，构建“服务环节-资源类型-主体机构”三维成本矩阵，确定各成本要素与常规卫生统计数据的映射关系，最终构建成本测算工具，对示例地区预防接种服务成本进行模拟测算以验证其可行性。结果 预防接种服务成本包括人力、管理、土地、卫生材料、疫苗运输和冷库/冷链6项核心成本要素，其中人力成本按人员经费、参与接种职工数占比和接种门诊开放天数占比修正全职预防接种工时后计算；管理成本采用差额剔除法(总费用扣除人员费用、药品费、卫生材料费和专用材料费)按接种科室面积比例分摊；土地成本按接种科室面积与单位面积租金核算；卫生材料成本按年接种疫苗剂次数与卫生材料单价的乘积计算；疫苗运输成本包括车辆购置年化折旧费(基于原价、利率和年限推算)、运行燃料费和维保费；冷库/冷链成本为冷库和冷链设备的年化建设成本。模拟测算显示，示例地区平均每剂次疫苗的预防接种服务成本为169.20元，其中人力、管理、土地、卫生材料、疫苗运输、冷库/冷链成本分别占总成本的17.35%、80.39%、1.64%、0.18%、0.34%、0.11%。结论 利用常规卫生统计数据可实现预防接种服务成本的快速测算，提升成本测算的可重复性和可比性，为优化免疫规划资源配置提供量化依据。更多还原

【Abstract】 Objective To develop a tool for estimating vaccination services costs using conventional health statistical data in China.Methods We reviewed domestic and international literature; constructed a three-dimensional cost-item matrix of service processes, resource types, and responsible institutions based on cost-estimation guidelines by the World Health Organization and Harvard University; determined cost element correspondence with conventional health statistical data; and developed a tool for estimating costs. We conducted a simulated estimation of vaccination services costs in one area to assess feasibility of the tool.Results Immunization services costs included six core cost elements-human resources, management, land, health materials, vaccine transportation, and cold storage/cold chain. Human resources cost was calculated after adjusting for full-time equivalent of work hours for vaccination based on personnel expenses, the proportion of vaccination staff, and the proportion of open days of vaccination clinics. Management cost was based on the proportion of vaccination area using the residual method(total cost minus the cost of person, drugs, health materials, and special materials). The cost of land was calculated based on the vaccination area and the per-square-meter rent. The cost of health materials was calculated by multiplying the annual number of vaccine doses administered by the per-unit price of health materials. Vaccine transportation costs included annualized depreciation of vehicles(calculated based on the original price, interest rate, and service life) and fuel and maintenance costs. Cold storage/cold chain cost was the annualized cost of cold storage construction and cold chain equipment. With this tool, our simulation estimated that the total cost of vaccination services per dose of vaccine administered was 169.20 yuan, in which costs of human resources, management, land, health materials, vaccine transportation, and cold storage/cold chain accounted for 17.35%, 80.39%, 1.64%, 0.18%, 0.34%, and 0.11%, respectively.Conclusion Rapid estimation of vaccination services costs can be achieved using conventional health statistical data, enhancing the repeatability and comparability of cost estimations and providing a quantitative basis for optimizing allocation of immunization program resources.更多还原