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目的 对中国东、中、西部三类不同经济水平地区计划免疫服务的成本进行测算分析。方法 运用卫生经济学成本核算的基本原理,选择东、中、西部三类地区,对省、地、县、乡、村五级计划免疫服务的实际成本进行测算。结果 贵州、黑龙江、浙江3省计划免疫服务人均成本分别是15.68、29.00、31.09元;针次成本分别是10.99、18.64、16.51元;每名儿童完成全部计划免疫疫苗的全程成本分别是131.88、242.32、280.67元。省、地、县、乡、村五级人员费用比例在成本项目中均居第一位,在48％～77％之间;业务费用居第二位或第三位,在6％～35％之间,基层单位业务费用比例明显偏低。结论 不同经济水平地区间成本差异较大;由于投入总量不足导致成本构成不合理;建议不同地区成本补偿实行分类指导的原则。
Objective To estimate the cost of planned immunization services in three different economic levels in east, middle and west China. Methods Based on the basic principles of cost accounting in health economics, three types of regions including eastern, central and western regions were selected to calculate the actual costs of planned immunization services at provincial, prefecture, county, township and village levels. Results The per capita costs of planned immunization services in Guizhou, Heilongjiang and Zhejiang provinces were 15.68, 29.00 and 31.09 yuan respectively; the cost of stitches was 10.99, 18.64 and 16.51 yuan respectively; the cost of completing all the planned immunization vaccine per child was 131.88,242.32 , 280.67 yuan. The proportion of the staff costs at provincial, prefecture, county, township and village levels ranks the first among all the cost items, ranging from 48% to 77%; the business expenses rank second or third among 6% -35% Between the basic unit cost of business was significantly lower. Conclusion The costs vary greatly between regions with different economic levels. The cost is not reasonable due to the insufficient input. It is suggested that the principle of class guidance should be provided for the cost compensation in different regions.