ABSTRACT
Objective To measure the costs of primary health services in the community for developing government compensation standard and prediction of budget in 201 5.Methods Literature review and panel discussions were used to build the index database.A two-round Delphi expert consultation determined the work to do and steps for community healthcare standards.60 community health centers were sampled by stratified random sampling for survey,and the work hours,workload and service volume of respective services in 2013 were measured according to the service standards of primary care.Results The community primary care consists of the categories of outpatient services,nursing care, laboratory tests and drug management,totaling 20 services and 88 working procedures.The total work hours of primary healthcare service at 60 community health centers were 2 557 187.9 hours,which is adjusted to 2 959 21 5.1 hours based on workload coefficients.Based on the income standards of employees at the community health centers investigated,and the human cost price which was recommended by the experts,the total costs of primary healthcare of the 60 centers were 245 million,248 million and 318 million respectively,and the average cost was 71.0 yuan,71.8 yuan and 92.1 yuan per visit respectively.By such standards,the government should subsidize 38.9 ~ 60.0 yuan per visit to the centers.The total expenditure of primary healthcare of all communities in Shenzhen in 201 5 was predicted to be 314 to 407 million,for which the government is expected to subsidize 1.68~2.58 billion.Conclusion The subsidies for community primary healthcare fall short as the cost per visit runs up in 2013 to 71.0 yuan per visit or more,far above the current subsidy of 32.1 yuan per person.The subsidy per visit should be made 50.0 yuan in 201 5.
ABSTRACT
A clinical emergency skill contest using emergency care simulator (ECS) was carried out on May 2011.Total 30 family physicians in 10 teams from Shenzhen community health centers participated in the contest.The performance and the scores of each item were analyzed.The overall score was 61.3 ± 11.9.The average score for general treatment was 33.0 ± 6.9 with a score rate of 66％ (33/50) ; the average score for cardiopulmonary resuscitation was 23.2 ± 7.2 with a score rate of 57.5％ (23/40) ; the average team score was lowest (5.0 ± 1.1 ) with a score rate of 50.0％ (5/10).The results indicate that family physicians should strengthen clinical skill training of emergency care,particularly in on-site response and teamwork.