四川省卫生建设项目经济学评估

【作者】 陈昌锋；

【导师】 阎正民；

【作者基本信息】 四川大学 ， 社会医学与卫生事业管理， 2005， 硕士

【摘要】 目的 实施卫生建设项目,是政府促进卫生事业发展的重要手段,是改善基层卫生服务条件的有效途径。本文旨在通过对四川省卫生建设项目评估,揭示卫生建设项目筹资情况、建设效果及影响因素和投入产出效益情况,为今后政府编制项目文件和管理项目提供理论依据和政策建议。 方法 本文依据四川省下达卫生项目文件的建设原则(即以地方为主、规模适宜、经济合理、功能适用和不重复建设的原则),构建项目评估框架,通过模糊数学、柯布一道格拉斯生产函数、逻辑模型和多元线性回归等方法对四川省卫生建设项目进行经济学评估。 结果 通过卫生建设项目的实施,当地卫生事业发展水平与当地的社会经济发展水平和人民群众的卫生需求更加适应;在项目筹资方面,体现了以地方为主,和以公共卫生和农村为重点的建设原则;在建设项目规模控制和筹资的结构方面有待改进,特别是规模控制要进一步细化;经济水平越低的地区,规模效益越好;建设后卫生单位的服务功能和服务条件等有了明显的改善,政府重视程度、政府领导小组、制度建设、审计、招标和质检等因素对卫生项目建设效果有着重要的影响。各级政府和单位对不同项目间的重视程度有所区别。 结论 通过本次评估,建议政府在以后编制项目文件时,充分考虑地方经济水平、服务功能、服务半径等因素,立项重点向农村、公共卫生倾斜。明确资金管理层次,增加政府与下级单位签订项目实施的责任书管理手段。强化督导力度和科学督导方式。更多还原

【Abstract】 Objective Carrying health construction projects into execution is not only an important method on the health development by government, but also an effective way to improve health service situation of grass roots. This article aims at posting the determinants of item financing and construction effect by evaluating health construction items in Sichuan Province, and bringing forward sound financing allocation model, and giving policy advice and theory basis for government to manage item.Methods To follow the construction principles which are mentioned by document of health item in Sichuan Province: to give priority to locality; to be proper scale; to be economic; to have appropriate function; not to repeat construction, author sets up the economics evaluation system to evaluate construction item in Sichuan Province by fuzzy theory, Cobb-Douglas produce function, multiple regression and Logistic model etc.Result Local health development level is more adaptable to local economic developing level and the demands of population after carrying health construction item. The construction principles of giving priority to locality and attaching most importance to public health and country are embodied in item financing. Item is awaited to improve at the structure of financing especially at the control of scale. The return to scale rises with the decline of economic developing level. The construction effectiveness which is greatly affected by many factors such as the government recognition extent,audit and inviting public bidding etc. The recognition extent of all level government and organization is different according to different items.Conclusion Through the evaluation the author advice that when item is planed, the factor of local economic developing level and service function and service radius etc. should be comprehensively taken into account, country and public health should be stressed when item is planed, and found manage level should be fixed on, and the duty should be labeled between government and organization. The guide strength should be consolidated.更多还原