The Investigation And Analysis Of Major Public Health Service Funds

BackgroundIn 2009, our government put forward a target of basic public health service equalization, which will be realized through the implementation of basic public health project and major public health project. Major project is different from basic project, it existed as special project for many years from 2009. County grass-roots public health institutions is the responsible for the implementation of major project, and aims at disease prevention key crowd and vulnerable groups, including major disease prevention programs, health workers training project.etc. It is funded by governments according to the epidemic situation and financial possibilities. It is an important part of our country's health development.From April 2009 to July 2010,our government has spent＄25,700,000,000 on basic health equalization, these funds took an important part in both the supply of the major project service and the realization of the basic public health equalization. Analyzing the use of these funds and the influencing factors to its use, we can find not only the insufficient and defect of the project running process, but give suggestions of promoting the realization of the equalization goals.Major purposeTo investigate the major project subsidy situations and the concrete project implementations, inspect funds security degree about the supply of major project service, find out the reason why the funds may occur in a low efficiency, and put forward concrete policy suggestions. Methods:this study adopt a comprehensive methods of both theoretical analsis, logical reasoning and summarizing, specially including theoretical analysis, literature review method, field investigation and interviewing key figures.etc.Resultscentral government subsidy policy development of Ningxia major projects:(1) Investment scale:the scale is gradually increasing, from 2007 to 2009, major project quantity annual growth rate is 27.7%; central government subsidy annual growth rate is 80.4%;the central government subsidies accounts for the proportion of the total subsidies of all government levels rose 2.2%.(2)input structure:increasing projects with medical nature, from 2007 to 2009, projects with medical nature proportion rose 3.6%,and its funds annual growth rate is 95.8%; input directions is changed from ability construction to working funds, from 2007 to 2009, ability construction funds decreased at a annual rate 38.3%, the proportion is decreased from 43.2% to 5.1%; however, the working rate is increasing at an annual rate of 133%,the proportion is decreased from 56.8% to 94.9%.(3)input cyclical:from 2007 to 2009,there are 23 projects excluding new project added after the new medical scheme reform,16 projects lasted for 3 years,5 projects lasted for 2 years.Project funds allocations and usage of sampling agencies:(1) officer on secondment numbers is big, occupying agency formation sources, business houses of all 3 CDC didn't reached the standard, maternal and child health-care station in Xiji didn't reach the standard, too.(2)project subsidies play an important part in the sampling CDC, the concrete proportion that the subsidies accounting for in the total incomes of the sampling CDC is respectively 76%,51.8% and 77.5%.(3) central government subsidies put into practice well, it can be reached the sampling agencies after the end of the project implementation, but the local government matching subsidies is in vacancy seriously, in 2009, only tuberculosis project local government matching subsidies reached the agencies in Pengyang and Qingtongxia, other project are not in place until our survey date. The sampling agencies have to spend money on staff fees and traveling fees, which should be supported by the local matching funds.(4) project funds need to obey earmarking principle, however, on one side, there is surplus in some project funds, in 2009,sampling agencies surplus separately are 40,000yuan(CDC in pengyang),25,000yuan(CDC in qingtongxia), 20,000yuan(maternal and child health-care station in xiji)and 10,500yuan(aternal and child health-care station in pengyang);on the other side, staff fees and traveling fees is insufficient. Project funds management and supervision is not perfect, "make accounts"phenomenon exists widely, assessment and supervision become a mere formulation.(5)There are kinds of major projects, and some of them have a same goal with other funds projects, including international funds projects.etc. AIDS prevention projects can be a prime example. And different agencies usually bear a same project, such as folic acid projects.Problems(1)the government lacks a full support of major projects.(2)project subsidy method need to be improved.(3)project account management and supervision need to be normative.(4)projects need to be integrated classification again.(5)implementation agencies lack of a coordination mechanism.Policy Suggestions(1)to strengthen governments'full support of the major projects, besides the financial support, the government should increase grass-roots agencies'staffing formulations to attract talents.(2)define government at all levels, regulating their duties about the major project, and normalize the subsidy methods.(3)standardized both the management and supervision of the projects accounts. Improving their transparency and building a detailed information disclosure mechanism.(4)classify and integrate all the projects again, widen the funds usage appropriately.(5)perfect the coordination mechanism among all the implementation agencies, try to make a best implementation effect within a limited resource conditions.