Strategy and Empirical Study on Labor Costs in Community Health Service Centers under Comprehensive Budget Management

Abstract

Objective: To calculate the workload of health services in Laoximen Community Health Service Center in Huangpu District, Shanghai, and to construct a calculation method of labor cost under the comprehensive budget management.

Methods: The labor cost of community health services was estimated in three stages from October 2016 to September 2017. Ten heads of departments in Laoximen Community Health Service Center were invited to collect information of ongoing community health services. These services were subdivided according to the principle that one service unit can be completed by one person; two-round questionnaire survey under Delphi method was carried out on physicians from various departments to evaluate three dimensions in terms of workload of health services, including the labor and time consumption, technical difficulties and risks. The standardized workload value of unit services was calculated by results; the unit labor cost of standard workload was calculated by the historical data including workload and staff performance in the community health service center between January and June 2017.

Results: Five types of community health services were carried out in the center: clinics, nursing, medical technology, public health and other categories, with a total of 960 items. The labor cost in the community health service center was ¥0.72/unit standardization workload between January and June 2017. The labor cost of clinics, traditional Chinese medicine, nursing and public health were ¥1.05, ¥0.80, ¥1.13 and ¥0.37/unit standardization workload, respectively.

Conclusion: This study constructs a labor cost calculation method based on the standardized workload of the community health service center, which can be used to guide the community’s budget expenditure management. The budget for labor costs in community public health services is highly underestimated. The community should adjust the budget of each service category based on the results of labor cost measurement in health services.