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目的了解我国计划免疫筹资现况,为补偿政策的制定提供参考依据。方法运用卫生经济学成本核算的基本原理,采用现况调查的方法,选择东、中、西部3个省,对省、地区、县、乡、村五级计划免疫服务成本与筹资进行测算。结果省、地区、县、乡、村五级政府投入比例为6%~89%,呈逐级降低的趋势;与人均成本相比,人均财政缺口比例为12%~91%,县、乡、村三级普遍存在缺口,并且缺口比例较高。结论计划免疫的政府筹资主渠道作用弱化,政府对计划免疫的筹资责任未得到充分体现;政府在计划免疫筹资上的缺位,导致社会筹资成为计划免疫的主要筹资渠道。建议加强政府对计划免疫服务筹资责任,丰富筹资渠道,建立计划免疫的成本核算制度,并深入研究成本效率。
Objective To understand the status of planned immunization in our country and provide reference for the formulation of compensation policy. Methods Based on the basic principles of cost accounting in health economics, this paper selects the three provinces of eastern, central and western regions to survey the cost and financing of planned immunization services at provincial, district, county, township and village levels. Results The ratio of five levels of government in provinces, prefectures, counties, townships and villages was 6% ~ 89%, which showed a decreasing trend step by step. Compared with per capita cost, the per capita fiscal gap was 12% ~ 91% There are widespread gaps in village level 3 and a high proportion of gaps. Conclusions The main financing channel for government-funded immunization is weakened. The government’s responsibility for financing immunization is still not fully reflected. The absence of government funding for planned immunization has led to social financing as the main financing channel for planned immunization. It is proposed to strengthen the government’s responsibility to raise funds for planned immunization services, enrich funding channels and establish a cost-accounting system for planned immunization and study cost-effectiveness in depth.