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目的:分析扩大国家免疫规划后预防接种门诊设置和运行的合理性,为浙江省预防接种门诊建设提供参考建议。方法:选择浙江省有代表性的17家预防接种门诊,采用统一设计的调查表进行服务成本及相关信息收集,通过理论测算、焦点小组访谈法对预防接种门诊经济运行模式进行分析。结果:浙江省内的城区、城郊、山区、海岛预防接种门诊服务人口数量、工作量、人员配置、平均每针次服务成本差异较大。从调查的17个预防接种门诊投入预防接种服务的总成本来看,人力成本占投入总成本的主要部分(平均占91.78%)。山区、海岛门诊开设频次较少,工作成本较高;按日接种的门诊平均每针次工作成本(不含人力成本)为1.92元,按周为2.93元,按旬为10.16元。海岛、城区预防接种门诊人员配置水平最高,平均分别达到1.25人/万服务人口和1.23人/万服务人口,城郊地区预防接种门诊人员配置水平最低,仅为0.25人/万服务人口。结论:浙江省预防接种门诊设置和人员配置合理性有待进一步提高,运行模式和开放周期应根据当地服务人口数量和接种工作量进行改善,保障科学性和经济合理性,并满足群众实际需求。
OBJECTIVE: To analyze the rationality of setting up and operating vaccination clinics after enlarging the national immunization program, and to provide reference for the construction of vaccination clinics in Zhejiang Province. Methods: A total of 17 vaccination clinics in Zhejiang Province were selected. The service cost and related information were collected using a unified design questionnaire. The economic operation modes of vaccination clinics were analyzed by theoretical calculation and focus group interviews. Results: The population, workload, staffing, and cost per service of outpatient services in urban areas, suburbs, mountainous areas and islands in Zhejiang Province varied greatly. From the total cost of vaccination services in the 17 vaccination clinics surveyed, labor costs accounted for a major part of the total cost of inputs (an average of 91.78%). The frequency of outpatient visits in mountainous areas and island clinics was lower and the cost of work was higher. The average daily cost per worker (excluding labor costs) for outpatients vaccinated on a daily basis was 1.92 yuan, or 2.93 yuan per week, or 10.16 yuan per ten days. The outpatient level of vaccination clinics in islands and urban areas were the highest, with an average of 1.25 people / 10,000 service population and 1.23 persons / million service population respectively. The outpatient level of vaccination clinics in suburbs was the lowest, only 0.25 people / million service population. Conclusion: The rationality of setting up vaccination clinics and staffing in Zhejiang Province needs to be further improved. The operation mode and opening period should be improved according to the number of local service people and the vaccination workload to ensure scientific and economic rationality and meet the actual needs of the masses.