【作者】 王云波；

【导师】 祁秉先； 姜润生；

【作者基本信息】 昆明医学院 ， 社会医学与卫生事业管理， 2005， 硕士

【摘要】 社区卫生服务是城市社区卫生服务体系改革和建设的重要组成部分,是解决问题的有效途径之一,是实现全面建设小康社会的有力保障。研究表明:只有10%的疾病需要在现代化的医院治疗,大量的病人应该在社区得到医疗服务,健康需要从家庭、从社区做起。然而,补偿机制的不健全直接遏制了社区卫生服务的进一步发展,并因此产生了社区卫生服务“重医轻防”的不合理现象。因此,多渠道筹集卫生资金,建立健全其经济补偿机制,完善监督机制,为确保云南省城市社区卫生服务可持续发展提供保障。本研究采用标准成本法通过核算社区卫生服务机构开展公共卫生服务和准公共卫生服务消耗的总成本,并依据总成本和服务人群确定人均补偿金额,旨在为政策制定提供科学的决策依据,以确保社区卫生服务的健康发展。结果显示:1、社区卫生服务的产品分为公共卫生产品、准公共卫生产品、个人产品;2、社区卫生服务机构运行的成本分为人力成本和物质消耗成本,其中人力成本占总成本的63.69%,物质消耗成本占总成本的36-31%;人均补偿金额约为8.0元。 本研究针对以上结果,提出如下建议:对社区卫生服务给予经济补偿是政府的职责;改变资金投入主体单一的局面,实行多元化筹资;改变政府投资的方式,变财政拨款为政府购买;加强对补偿资金及服务质量的监督管理;落实补偿政策,完善社区卫生服务网络建设;各部门协调,避免条块分割,共同促进社区卫生服务的健康发展。更多还原

【Abstract】 The community health service (CHS) is one of the important constitutions that health service system reforms and constructs in city, is one of the efficient approaches that solve many health problems, is a better guarantee that carry out comparatively good living standard society. Research reveal that only ten percent disease should be therapied in modern big hospital and numbers of patients should be cared in community. Health need be carride out from the family and the community. However, the compensation money scarcity holded back the CHS development and bring the irrational phenomenon . Raising health capital, bulking economy compensation mechanism, perfecting supervise machanism is staring in the face for improve the CHS development in yunnan province. The research shows : 1 CHS output include public goods, merit goods and private goods. 2 the cost include human cost and matter cost, thereinto, thehuman cost occupy 63.69 percent and matter cost 36.31 percent. 3 the compensation money is eight yuan one person.The author put forward the following suggestions: giving CHS economy compensation is goverment responsibility; altering single devotion complexion ; the goverment purchase public goods; enhancing the supervise and management for the compensation capital and service quality; carrying out compensation policy and perfect the CHS network .更多还原