【摘要】：目的:測算2012年石河子市社區高血壓、糖尿病健康管理項目實際成本和標準成本，為政府在社區衛生資源配置、合理制定公共衛生服務項目補償政策、評價分析社區衛生服務績效等方面提供參考依據，也為社區衛生服務機構改善管理、提高服務質量和服務效率、降低成本等方面提供參考。 方法:通過文獻研究與專家訪談結合本地區社區高血壓、糖尿病健康管理項目的開展現狀，確定完全成本法、作業成本法和標準成本法為社區高血壓、糖尿病健康管理項目的實際成本和標準成本的成本測算方法；其中通過半結構訪談法了解石河子市現階段社區高血壓、糖尿病健康管理項目的開展現狀及政府財政補償現狀，通過問卷調查法獲得作業工作量、消耗人時、參與人次等基礎數據。 結果: 1.2012年，石河子社區高血壓健康管理項目的總成本為1449305.88元，人均實際成本為6.15元。 2.按實際管理的高血壓、糖尿病患者測算，社區高血壓、糖尿病健康管理項目的標準總成本為1765106.67元，標準人均成本為7.49元。 3.按患病率測算不同管理水平測算的標準成本⑴若100%管理，標準總成本為3068179.76元，人均成本為13.04元。⑵若90%管理，標準總成本為2859060.70元，人均總成本為12.14元。⑶若80%管理，，標準總成本為2649615.47元，人均成本為11.26元。⑷若70%管理，標準總成本為2440170.25元，人均成本為10.37元。⑸若60%管理，標準總成本為2230725.03元，人均成本為9.48元。⑹若50%管理，標準總成本為2021279.80元，人均成本為8.59元。 4.不同管理水平下成本測算模型 本地區人群高血壓患病率為34.08%，糖尿病患病率為10.80%，設管理水平為n%：人均補助標準模型為： y=8.9*n%+4.14，總補償金額模型為：y=2094221.46*n%+974221.315.不同年份的石河子市社區高血壓、糖尿病健康管理項目的財政補償預測模型TC={0.02*W(1+b3)*[0.608*M(1+b1)*n%+N(1+b2)]}/(1+b1)+IC(1+b4)+OC(1+b5) 結論: 1、2012年石河子市人均實際成本為6.15元，不同管理水平的標準成本均高于實際成本，存在財政缺口。2、人力成本是社區高血壓、糖尿病健康管理項目成本的主要構成部分。3、社區高血壓糖尿病健康管理項目的人員配備不合理，缺乏專職人員。4、社區高血壓、糖尿病健康管理項目管理不完善。
[Abstract]:Objective: to calculate the actual cost and standard cost of community hypertension and diabetes health management project in Shihezi City in 2012, so as to rationally formulate the compensation policy of public health service project for the government to allocate community health resources. Evaluation and analysis of the performance of community health services provide reference for community health service institutions to improve management, improve service quality and efficiency, reduce costs and so on. Methods: according to the present situation of community hypertension and diabetes health management project, complete cost method, activity cost method and standard cost method were determined as community hypertension by literature research and expert interview. The method of calculating the actual cost and standard cost of diabetes health management project, among which, through the semi-structure interview method, to understand the present situation of community hypertension, diabetes health management project and the current state of government financial compensation in Shihezi city. The basic data were obtained by questionnaire survey, such as workload, consumption of people and the number of people involved. Results: 1. In 2012, the total cost of hypertension health management project in Shihezi community was 1449305.88 yuan, and the actual cost per capita was 6.15 yuan. 2. According to the actual management of hypertension, diabetes patients, community hypertension, diabetes health management project standard total cost of 1765106.67 yuan, standard per capita cost of 7.49 yuan. If the standard cost is 100%, the total standard cost is 3068179.76 yuan, the per capita cost is 13.04 yuan, if 90%, the standard cost is 2859060.70 yuan, the per capita total cost is 12.14 yuan, and the total cost is 12.14 yuan. 3. 3 if the management is 80%, according to the prevalence rate, the standard cost is 100%, the standard cost is 3068179.76 yuan, the per capita cost is 13.04 yuan. The total standard cost is 2649615.47 yuan, the per capita cost is 11.26 yuan if the management is 70%, the standard cost is 2440170.25 yuan, the per capita cost is 10.37 yuan if 60% management, the standard cost is 2230725.03 yuan, the per capita cost is 9.48 yuan. 6 if the management is 50%. The total standard cost is 2021279.80 yuan, and the per capita cost is 8.59 yuan. The prevalence of hypertension was 34.08, the prevalence of diabetes was 10.80, the standard model of per capita subsidy was: yyang8.9n% 4.14, and the total compensation amount model was: yyyang2094221.46n% 974221.315. the model of cost measurement was 34.08, the prevalence rate of diabetes was 10.80, the standard model of per capita subsidy was: yyyyong 2094221.46n% 974221.315. The prediction model of financial compensation for hypertension and diabetes mellitus health management project in Shihezi city in different years, TC = {0.02W (1b3) * [0.608m (1b1) n% N (1b2)]} / (1b1) IC (1b4) OC (1b5) conclusion: 1. The actual cost per capita in Shihezi city in 2012 was 6.15 yuan. The standard cost of different management level is higher than the actual cost, there is a financial gap of 0.2, the human cost is community hypertension, The main component of the diabetes health management project cost. 3, community hypertension diabetes health management project staffing unreasonable, lack of full-time personnel .4, community hypertension, diabetes health management project management is not perfect.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R197.1

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