The health organ of the community: Can cross thanking to and decrease the greater

The health organ of the community: Can cross thanking to and decrease the greater
The health organ of the community: Can cross thanking to and decrease the greater
The intersection of Nanjing and medical university cure the intersection of policy and the intersection of institute and yellow dawn light in recent years, community hygiene serve, regard as urban the intersection of health care and breach of system reform, get the fast development, has optimized the resource distribution of the hygiene to a certain extent, have relieved resident's seeing the doctor expensively, difficult problem of seeing the doctor. However, still there is very great disparity between community's hygiene service and ideal goal, pass to the economical operation from 2004 to 2007 of Jiangsu Province Nanjing community health Center and compensate description and analysis of the current situation, we find economic compensation mechanism imperfect and government to restrain society's affair hygiene from serving one of the obstacles of development. Increase input, ensure public beneficial the intersection of community and hygiene serve it is government that implement certain social public beneficial service of welfare, should rely on the medical business income to maintain the economical operation of the hygiene service organization of the community. Community's hygiene also has very large outside and information asymmetry to serve, so should be dominated by the government. Population calculates according to the statistics of area of Nanjing in 2007, the funds of personnel of community health organ of government's expenditure should be about 45 yuan, it is only 26 yuan now, accounts for 0.81% of the expenditure; The fixed assets should increase by 10 yuan each person, accounts for 0.2% of the expenditure. That is to say, if the government puts averagely into 50 yuan each person according to the population of the household register in 2007, accounts for 1/5 of hygiene industry expenses of government or 1% of the expenditure, can basically reach the balance between revenue and expenditure. In present cases, adjust government's hygiene and invest the direction, increase the input to community's hygiene service, the compensation of community's hygiene service could be basically finished. For example the government undertakes 80% or more of community's staff member's part of basic wage; Community hygiene serves the increment of the fixed assets ' Average growth rate 5%) Depreciate part ' Average rate of depreciation 5%) Also by government's expenditure. " mend medicine with medicine " The investigation of the income of service organization of community's hygiene reveals in still serious Nanjing 2007, except that the government subsidizes and accounts for 12%, in the income of the hygiene service organization of community of this city, the medicines income is up to 56%, the medical income accounts for 28%, other incomes account for 4%, prove the medical worker labour value fails to be reflected, in a situation that the government puts into uncompletely, serve serious " mends and cures with medicine " in community's hygiene Phenomenon. Nanjing launches in the health organ of the community since 2005 " The dispensary is deposited " A difference rate that reform, in some urban pilot projects in 2007 " to basically use medicine " ,The medicines income though drop year by year while accounting for the proportion of the gross income, not obvious, among 54%~57% all the time, still there is more serious " mend medicine with medicine " Phenomenon. " the dispensary is deposited " The reform made some effects in initial stage, but ranning exposes some questions in the course, for example " the dispensary is deposited " Purpose one of to increase the intersection of medicines and the intersection of zero and difference rate greatly, increase the medicines balance rate of the hospital, push and circulate the expenses of links, is used in community's hygiene service. The investigation result finds medicines balance rate has not increased greatly. So, under the situation that government's compensation mechanism is complete, pursue the national basic medicine system, if " difference rate of zero's of basically using medicine " , call for bid, register for network purchase, provide and deliver in unison, reduce the intersection of medicines and price in unison in unison, really push and circulate the expenses with unreasonable link, reduce the price of medicines, make the patient get safer, lower priced, effectiver medicines. In addition, community hygiene serves under the prerequisite taking government as leading factor and social justice, should pay attention to the efficiency of the hygiene service organization of the community. Base on the premise that the finance is put into increasing, implement two lines of revenue and expenditure, make medical worker's income and department's income, medicines income break off relations, desalinize the economic benefits to drive, transfer working enthusiasm to in order to come on the orbit of masses' health service, fully reflect separation of revenue and expenditure, medicine are separated. But after the economic indicator is cancelled, in order to avoid " mess, poor efficiency " that may appear The question, should also set up the related examination system taking working efficiency, service quality, masses' satisfaction,etc. as main examination content. To increasing and improving the organization of the service, should encourage; To finishing the organizations of quantity of service, quality, should reduce the funds correspondingly. The government can't satisfy the expenditure of personnel of health organ of community to invest far to work more and more at present free, the hygiene service organization of the community should not only guarantee personnel's salary and welfare, also take out quite a lot of fund to set up community resident's health file. Prevention and cure and children of doing a good job of health education, infectious disease, tumour at the same time plan immunity and health care, the manpower of a large number of flowers finishes defending assuaring and floating population filing and investigation in the area. The community works more and more free, has increased the heavy burden for the health organ of the community. Because lack the cost accounting of community's public health service and offer the policy basis of the financial subsidy, the health organ of the community is unable to win the government compensate by norm, the public health is served and allowed the public health to serve and do the morely, suffer the loss big. At present, community the intersection of health organ and the intersection of business and revenue and expenditure balance lead and medical revenue and expenditure to suffer the loss mostly in rate in balance, and have the tendency to aggravate year by year and prove the medical expenses standard is unreasonable. The community bear a large number of free service and public health, serve, therefore economical loss is greater. We think, solve only two outlets of compensation of community's hygiene service, first, depend on charging, second, subsidize by the government finance. The government should confirm expenses standard and subsidy amount of the hygiene service on the foundation of improving service cost accounting of the hygiene. If the government can put to compensate in place, charging can reduce; On the contrary, the government compensates low competence, the expenses standard should be improved. Meanwhile, in examining the public health and serving and allowing index foundations such as quantity of service and quality of the public health,etc., subsidize fully, encourage the community to launch the low, effectual service of the cost actively.


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