海洛因成瘾者社区美沙酮维持治疗工作卫生经济学评价:财政投入及费用管理研究  

The Health Economics Evaluation on Community-based Methadone Maintanance Treatment for Heroin-addicts Series two:Research on Financial Input and Management of Methadone Maintenance Treatment Project

作　　者：刘克军[1] 王梅[1] 

机构地区：[1]卫生部卫生经济研究所,北京100191

出　　处：《中国卫生经济》2009年第5期40-43,共4页Chinese Health Economics

摘　　要：目的:通过对首批8家美沙酮维持治疗门诊(以下简称"门诊")和5家美沙酮口服液配置单位(以下简称"药厂")财政投入调查,描述并分析各级财政投入水平、经费来源和流向,及其在门诊和药厂总成本中的构成比,并与定性访谈相结合,发现费用管理工作中存在的问题,为管理层提供相关决策依据。方法:数据来源于卫生部规财司和国家性病艾滋病防治中心,以及各省和市卫生厅局的规财处。借鉴卫生总费用测算的部分方法,计算各级财政投入的数量和比例,描述其使用流向。结果:(1)8个门诊的经费投入中,来自中央财政的构成比约为12%～33%,来自地方财政的构成比约为7%～67%。门诊固定成本和办公成本中,中央财政所占的比例高于地方财政,人力成本中则以地方财政投入为主。(2)中央财政是药厂获得财政补贴的唯一来源。在设备方面,中央财政补助约占5个药厂设备总投入的5%～11%,但在生产性支出方面,中央财政补贴的美沙酮原料购买费用几乎占了整个美沙酮口服液配制生产性支出的一半(33%～69%)。结论和建议:财政对美沙酮工作给予一定的补偿是必要的,但补偿的方式、水平和投入方向应以各地工作成本数据为基础、以工作绩效考核为标准进行相应调整。Objectives： This study is to introduce the financial input level of the central and local public finance into the eight clinics for methadone maintenace treatment （clinics for short） and the five pharmaceutical enterprises for producing methadone oral liquid （enterprises for short） in 2004 and 2005, describe the source and flow of the outlay, and analyze the proportion of the financial input at all levels. The outcomes will be combined with qualitative interview results to find problems exiting in fund management in order to give the suggestions to decision makers on the relative decision. Methods： The data are collected fi＇om the Planning/Finance Department of the Ministry of Health, the National Center for AIDS/STD Control and Prevention, and the planning/finance departments of health bureaus of provinces and cities. The financial input amount, the proportion and the source and flow of all public finance levels will be calculated partly reference to the method of health total expenditures calculation. Results： （ 1 ） Among the total costs of the eight clinics, the proportions of the funds from the central finance are fluctuating between 12% and 33%, and the proportions of those from local finances are fluctuating between 7% and 67%. On the whole, the proporlion of the funds from the central finance is higher than the one from local finances at the aspect of fixed cost and office cost of clinics. But as to manpower cost, the proportion of the funds from local finances is higher. （2） The funds from the central finance is almost the only way from which the enterprises get financial support. In the aspect of equipments, the financial allowances from the central finance are fluctuating between 5% and 11% among the total equipment expenses of the five enterprises. But the expense on purchasing methadone raw material subsidied by the central finance is overall almost a half of the productive cost （33%-69%）. Conclusions： It is necessary that the governments give allowances to methadone main

关 键 词：海洛因成瘾者 美沙酮 卫生经济学评价 财政投入 

分 类 号：R749.64[医药卫生—神经病学与精神病学]