Dissertation > Excellent graduate degree dissertation topics show

Study on the Financing and Cost Accounting of Community Prevention and Control of Noncommunicable Chronic Disease

Author: WuRuiXue
Tutor: YeLu
School: Fudan University
Course: Social Medicine and Health Management
Keywords: Chronic Public health services Cost Estimation Financing for
CLC: R197.1
Type: Master's thesis
Year: 2008
Downloads: 153
Quote: 0
Read: Download Dissertation

Abstract

Research background in order to cope with the increasing trends of the epidemic of chronic diseases, disease prevention and control department in recent years stepped up exploration of the prevention and control of chronic diseases in the community. Shanghai Municipal Health Bureau, enacted in 2000, the Shanghai Municipal Center for Disease Control and Prevention and control of chronic non-communicable diseases and long-term planning (2001 -2015), after chronic disease prevention and control in the city's community health services or primary health care work. After more than five years of efforts, the chronic disease community public health services in Shanghai has formed a perfect system and standardize procedures. Songjiang District in 2005 began the coordination of medical reform, to strengthen the public health services, community health agencies, financial investment, and promote the development of community prevention and treatment of chronic diseases, but due to the lack of research on community chronic disease of public health service costs and financial supervision, chronic diseases compensation based on community public health service is still not perfect, financial input and output results and expenditure efficiency evaluation is also a lack of basic information, which is the key to restricting the sustainable development of the prevention and treatment of chronic diseases community. Chronic diseases, Songjiang District Community Public Health Services research purpose of this study cost estimates, forecast as the basis for the next five years, the region's chronic disease community public health services cost, eventually combined with the development of Songjiang District medical and health undertakings the actual situation, the policy proposals put forward to improve the financing for the compensation mechanism sustained and stable funding mechanism and to develop a clear and reasonable compensation policies provide a reference for the establishment of the chronic disease community public health services. The studies present study specific research topics include: Songjiang District, Shanghai chronic disease community public health service development status; Songjiang District, Shanghai chronic disease community public health services work content and project analysis; 3. Songjiang District, Shanghai chronic disease community public health services to the practical cost estimates; Songjiang District, Shanghai chronic disease community public health services 2008-2012 forecast of the required financing costs; Methods This study Songjiang District, Shanghai research site in the area in accordance with the level of economic development to extract four community health service institutions, to understand the chronic diseases of public health services through informant interviews, obtained through access to financial statements and related records in 2006, the agency cost and volume of services, and cost estimation method to the average cost of each service project times and in Songjiang District 2008-2012 total population and changes in the human cost trend estimates based on the amount of funding needed to predict chronic diseases of public health services. Project cost estimation method of this study differ from previous research, the cost of health services research community to follow the path of the medical services project cost is estimated to pay more attention to the specific project costs in the project department internal framework of its commitment calculate. In this study, taking into account the characteristics of the \The main findings of the research results are as follows: 1. Songjiang District Community Health Service Center chronic disease chronic disease community public health services, public health service is consistent with the local prevalence of chronic diseases. Songjiang District of hypertension, diabetes, colorectal cancer, stomach cancer, liver cancer, chronic bronchitis, emphysema, breast disease as a focus of community prevention and treatment of chronic diseases, and a total of 26 public health services. In addition to the popular diseases, some community health service centers are particularly strengthened in accordance with the requirements of the community features planning some chronic disease services. Service efficiency, little difference in the efficiency of inter-regional public health service of the community health service centers chronic diseases. The amount of the service provider, the chronic diseases of public health services provided incomplete total area population. 2006, Yueyang Community, Jiuting Town, Sheshan Town, Mao Gangzhen the household population are 83000, 24800, 34100, 39400, per million population have chronic diseases of public health service time is 692 days, 776 days, 715 days, 1217 days. The results show that the areas of population, chronic diseases of public health services workload is not necessarily followed by the larger. Chronic disease community public health service cost of the project cost estimation results show: chronic disease prevention and treatment times are most of the project cost less than 20 yuan, the times between the same project in different community health service centers are large cost differences. Cost structure, human resource consumption, lower consumption of material resources. 26 projects in nearly 54% of the project times cost less than $ 10, nearly 80% of the project times cost less than 20 yuan. Judging from the various projects, of chronic health education project times the lowest-cost, chronic disease team training for various purposes times the highest cost. In the first 18 projects involving disease management, cardiovascular and cerebrovascular disease cases self-examination, liver cancer high-risk population screening times higher average cost of the two projects, chronic disease information management class project times lower cost. 3. Chronic disease Community Public Health Services funding level of 2006, the actual amount of funding required is estimated to raise a total of slightly less than the amount of financial compensation for the actual consumption of this chronic disease community public health service projects. According to estimates, the funding of the 2006 financial compensation in the prevention of chronic diseases around 84,000 yuan per million, far higher than the required amount of funding for this study to calculate the amount of the actual services provided 7.2 million / million. The actual amount of financial compensation 12,000 yuan / million higher than the amount of funding required to calculate the amount of the actual services provided to calculate the required amount of funding than the standard services provided the amount of 0.4 million / million higher than optimization services calculation of required funding level of at least 02,000 yuan / people. The forecast shows the amount of funding needed in 2008 and 2012: chronic disease community public health service project financing requirements for the next five years will be an average annual growth rate of 8% growth year after year. Standard of service providers, in 2012 chronic disease community public health services required for every million people in the capital raised 116,600 yuan, the Songjiang District region require a total of 6.84 million yuan. Amount of operator services optimized chronic diseases per million population of the community-based public health services in 2012, the amount of funding required is 12.5 million, the region require a total of 7.33 million yuan. With the gradual improvement of the chronic disease community public health services, the deepening of the gradual increase of the health needs of the residents, and the funding level may be lower than predicted by the Institute to carry out community health services actually needed. Policy proposals from the point of view of fiscal revenue and expenditure levels, the Songjiang District can bear the cost of chronic disease community public health services, therefore, the key is to optimize the configuration of public funds to strengthen the use of funds and management, improve the efficiency of fiscal spending. 1. To optimize chronic diseases of public health services, improve First, improving the efficiency of fiscal spending this study suggests that chronic diseases of public health service financial expenditure performance evaluation system, evaluation of the quantity, quality, human resources and equipment, patient satisfaction from the service provider, so that objectivity, impartiality, and the overall operation of the forward-looking reflection of community health agencies chronic diseases of public health services: improving the community chronic disease of public health services, tobacco control, limit alcohol, hepatitis B, physical exercise, mental health, rational nutrition and other factors interventions into service system, strengthen risk factors intervention targeted; service project is to establish the cost-effectiveness of dynamic evaluation system, strengthen the control effect of tracking dynamically reflect the changes in population health status. Increase community research, encourage innovation and R \u0026 D projects in public health; strengthen cost control, to avoid the community chronic diseases of public health waste of resources: Sixth improve community health workers incentives to improve service efficiency. Strengthen chronic disease of public health funding for the use of regulatory protection of the rational use of financial funding this study suggests that the project funding of public health services to the community chronic disease throughout the implementation of budget management, to ensure that funding for public health use of rationality and legality by the full budget management and effective resistance. First, health administrative departments should develop community public health services, financial management manual, to regulate the use of funds; community health agencies chronic diseases of public health services budget for budget items should be done in as much detail as possible, and assessment methods and the objectives and requirements are listed commitment by the person in charge of the health institutions; financial departments to strengthen supervision and, if it is found to misappropriation of funds or abuse to respond in a timely manner, to avoid the waste of financial resources invested; Fourth, the budget end of the financial year, the public health programs post-assessment, the check project implementation and completion of the beginning of the period set goals and commitments, and one as a reference for the next fiscal year's budget. 3 of the floating population chronic disease prevention, improve public health services, fairness floating population age structure is lighter, but it is the invasion of chronic disease risk factors crowd. This study suggests that the increase in community health service institutions chronic disease of public health services budget for the floating population, strengthen health education in floating population in the workplace, neighborhoods, and chronic disease screening program carried out in the case of a conditional. Implementation approach, first, to establish basic information database of the floating population, through the Government Office network, establish a floating population information database, data sharing and accurate knowledge of the basic information of the floating population: the second is to improve public health services, of the floating population of chronic diseases, health service personnel can regular in-depth labor units, construction sites, kilns, Tour chronic health education in the Diaspora floating population; Third, the role of health care contracts, community health service agencies can contact employment units, health care contract signed by labor units floating population , set out in the Health Services and charges, and to promote the utilization of the floating population public health services. Solve the problem of the floating population health services funded compensation funding for prevention and care in Shanghai compensation policy funded by household population and the resident population, the floating population is not included in the financial budget of the column. Shanghai is a labor enter the market, the flow of the total population remained stable, fluctuations more difficult, and therefore can be considered a certain anti-insurance funds according to the number of floating population compensation. Can refer ordinarily resident in the community prevention and care funding solution, shared grant funding from the district, town finances. So that appropriate compensation floating population health service costs of chronic diseases of public health services for the floating population can be made finer, more real.

Related Dissertations

CLC: > Medicine, health > Preventive Medicine,Health > Health care organizations and career ( Health Management ) > Health care systems and institutions > Health care system
© 2012 www.DissertationTopic.Net Mobile