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Economic Evaluation of Students' Screening Program in the City of Komijan

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Economic Evaluation of Students' Screening Program in the City of Komijan Original Article JQUMS, Vol.16, No.1, Spring 2012, pp.80-86 Economic evaluation of students’ screening program in the city of Komijan (Iran-2009) S. Asefzadeh* A. Rezapour** S. Amini*** *Professor of Health Management, Metabolic Diseases Research Center, Qazvin University of Medical Sciences,Qazvin, Iran **Ph.D. Student of Health Economic, Tehran University of Medical Sciences, Tehran, Iran ***MSc. of Health Management, Arak University of Medical Sciences, Arak, Iran Abstract Background: Economic evaluation is one of the measures of decision making for providing efficient services. Objective: To calculate the cost outcome of students’ screening program in the city of Komijan. Methods: This was a descriptive analytical study carried out on all first grade students of different educational courses including primary schools, guiding schools, and high schools. The cost-unit method was used to calculate the cost followed by analysis of data using the Excel software. Findings: Screening program showed that 0.1% of total students had diabetes, 0.2% cardio-vascular disorders, 0.26% asthma, 3.07% anemia, 32% pediculosis, 0.1% tinea, 18.33% dental caries, 0.54% hearing problems, 6.42% optic problems, 0.8% behavioral (otism) disorder. The total cost of students’ screening program was 164495020 Rials and the average cost equal to 88773 Rials. The minimum cost of detection a single disorder among the students of primary, guiding, and high schools was associated with dental disorders which was equal to 4736, 7037, and 12268 Rials, respectively. The maximum detecting costs for a single disorder were for speech disorders among the students of primary schools (3500301 Rials) and hearing disorders in students of guiding schools (2075018 Rials) and high schools (3900784 Rials). Conclusion: The students’ health screening program within the rural and urban regions of the city of Komijan is cost-effective and thus could be continued. Keywords: Economic evaluation, Cost-outcome, Screening program Corresponding Address: Saeid Amini, Students Health Unit, Komijan Health Center, Markazi Province, Iran Email: [email protected] Tel: +98-918-8567534 Received: 10 Aug 2010 Accepted: 23 Jan 2011 ﻣﺠﻠﻪ ﻋﻠﻤﻲ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ ﻗﺰوﻳﻦ، ﺳﺎل ﺷﺎﻧﺰدﻫﻢ، ﺷﻤﺎره1(ﭘﻲ در ﭘﻲ62)، ﺑﻬﺎر1391/ ﻣﻘﺎﻟﻪ ﭘﮋوﻫﺸﻲ 81 ارزﻳﺎﺑﻲ اﻗﺘﺼﺎدي ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨﻪ داﻧﺶآﻣﻮزان ﺑﺪو ورود ﺑﻪ ﻣﻘﺎﻃﻊ ﺗﺤﺼﻴﻠﻲ ﻣﺨﺘﻠﻒ ﺷﻬﺮﺳﺘﺎن ﻛﻤﻴﺠﺎن (1388) دﻛﺘﺮ ﺳﻌﻴﺪ آﺻﻒ زاده* ﻋﺰﻳﺰ رﺿﺎﭘﻮر** ﺳﻌﻴﺪ اﻣﻴﻨﻲ*** * اﺳﺘﺎد ﻣﺪﻳﺮﻳﺖ ﺧﺪﻣﺎت ﺑﻬﺪاﺷﺘﻲ و درﻣﺎﻧﻲ ﻣﺮﻛﺰ ﺗﺤﻘﻴﻘﺎت ﺑﻴﻤﺎريﻫﺎي ﻣﺘﺎﺑﻮﻟﻴﻚ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ ﻗﺰوﻳﻦ ** داﻧﺸﺠﻮي دﻛﺘﺮاي اﻗﺘﺼﺎد ﺳﻼﻣﺖ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ ﺗﻬﺮان *** ﻛﺎرﺷﻨﺎس ارﺷﺪ ﻣﺪﻳﺮﻳﺖ ﺧﺪﻣﺎت ﺑﻬﺪاﺷﺘﻲ- درﻣﺎﻧﻲ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ اراك آدرس ﻧﻮﻳﺴﻨﺪه ﻣﺴﺆول: اﺳﺘﺎن ﻣﺮﻛﺰي، ﺷﻬﺮﺳﺘﺎن ﻛﻤﻴﺠﺎن، ﺷﺒﻜﻪ ﺑﻬﺪاﺷﺖ و درﻣﺎن ﻛﻤﻴﺠﺎن، واﺣﺪ ﺑﻬﺪاﺷﺖ ﻣﺪارس، ﺗﻠﻔﻦ 09188567534 Email: [email protected] ﺗﺎرﻳﺦ درﻳﺎﻓﺖ: 19/5/89 ﺗﺎرﻳﺦ ﭘﺬﻳﺮش: 89/11/3 ﭼﻜﻴﺪه زﻣﻴﻨﻪ: ارزﺷﻴﺎﺑﻲﻫﺎي اﻗﺘﺼﺎدي ﻳﻜﻲ از ﻣﻌﻴﺎرﻫﺎي ﺗﺼﻤﻴﻢﮔﻴﺮي در ﺧﺼﻮص اوﻟﻮﻳﺖ و ﻛﺎراﻳﻲ ﺧﺪﻣﺎت اراﻳﻪ ﺷﺪه اﺳﺖ. ﻫﺪف: ﻣﻄﺎﻟﻌﻪ ﺑﻪ ﻣﻨﻈﻮر ارزﻳﺎﺑﻲ ﻫﺰﻳﻨﻪ ﭘﻴﺎﻣﺪ ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨﻪﻫﺎي داﻧﺶآﻣﻮزان ﺑﺪو ورود ﺑﻪ ﻣﻘﺎﻃﻊ ﺗﺤﺼﻴﻠﻲ ﻣﺨﺘﻠﻒ اﻧﺠﺎم ﺷﺪ. ﻣﻮاد و روشﻫﺎ: اﻳﻦ ﭘﮋوﻫﺶ ﺗﻮﺻﻴﻔﻲ- ﺗﺤﻠﻴﻠﻲ در ﺳﺎل 1389ﺑﺮ روي ﺗﻤﺎم داﻧﺶآﻣﻮزان ﺑﺪو ورود ﺑﻪ ﻣﻘﺎﻃﻊ ﺗﺤﺼﻴﻠﻲ ﻣﺨﺘﻠﻒ ﺷﻬﺮﺳـﺘﺎن ﻛﻤﻴﺠـﺎن (1854 ﻧﻔﺮ) اﻧﺠﺎم ﺷﺪ ﻛﻪ ﺷﺎﻣﻞ 477 ﻧﻔﺮ اول اﺑﺘﺪاﻳﻲ، 538 ﻧﻔﺮ اول راﻫﻨﻤﺎﻳﻲ و 839 ﻧﻔﺮ اول ﻣﺘﻮﺳﻄﻪ ﺑﻮد. ﺟﻬﺖ ﻣﺤﺎﺳـﺒﻪ ﻫﺰﻳﻨـﻪ ﻫـﺎ از روش ﻫﺰﻳﻨـﻪ واﺣﺪ و ﺟﻬﺖ ﺗﺤﻠﻴﻞ دادهﻫﺎ از ﻧﺮماﻓﺰار Excel اﺳﺘﻔﺎده ﺷﺪ. ﻳﺎﻓﺘﻪﻫﺎ: از 1854 داﻧﺶآﻣﻮز ﻏﺮﺑﺎلﮔﺮي ﺷﺪه، %1/0 دﻳﺎﺑﺖ، %2/0 اﺧﺘﻼلﻫﺎي ﻗﻠﺒﻲ- ﻋﺮوﻗـﻲ، %26/0 آﺳـﻢ ، %07/3 آﻧﻤـﻲ ، %32/0 ﭘـﺪﻳﻜﻠﻮزﻳﺲ ، %1/0ﻛﭽﻠﻲ ﺳﺮ، %33/18 ﭘﻮﺳﻴﺪﮔﻲ دﻧﺪان، %54/0 ﻣﺸﻜﻞ ﺷـﻨﻮاﻳﻲ ، %42/6 درﺻـﺪ ﻣﺸـﻜﻞ ﺑﻴﻨـﺎﻳﻲ و %8/0 اﺧـﺘﻼل رﻓﺘـﺎري داﺷـﺘﻨﺪ . ﻛـﻞ ﻫﺰﻳﻨـﻪ ﻏﺮﺑﺎلﮔﺮي داﻧﺶآﻣﻮزان 164495020رﻳﺎل ﺑﻮد. ﻣﺘﻮﺳﻂ ﻫﺰﻳﻨﻪ- واﺣﺪ ﻣﻌﺎﻳﻨﻪ داﻧﺶآﻣﻮزان اﻳﻦ ﺷﻬﺮﺳﺘﺎن 88773 رﻳﺎل ﺑﻮد. ﻛﻢﺗـﺮﻳﻦ ﻫﺰﻳﻨـﻪ ﺷﻨﺎﺳـﺎﻳ ﻲ ﻫﺮ اﺧﺘﻼل در ﻣﻘﻄﻊ اول اﺑﺘﺪاﻳﻲ، اول راﻫﻨﻤﺎﻳﻲ و اول ﻣﺘﻮﺳﻄﻪ ﻣﺮﺑﻮط ﺑﻪ اﺧﺘﻼلﻫﺎي دﻫﺎن و دﻧﺪان ﺑﻮد ﻛﻪ ﺑﻪ ﺗﺮﺗﻴﺐ ﺑﺮاﺑﺮ ﺑﺎ 4736 رﻳﺎل، 7037 رﻳﺎل و 12268رﻳﺎل ﺑﻮد. ﺑﻴﺶﺗﺮﻳﻦ ﻫﺰﻳﻨﻪ ﺷﻨﺎﺳﺎﻳﻲ ﻫﺮ اﺧﺘﻼل در ﻣﻘﻄﻊ اول اﺑﺘﺪاﻳﻲ ﻣﺮﺑﻮط ﺑﻪ اﺧـﺘﻼل ﻫـﺎي ﮔﻔﺘـﺎري ﺑـﺎ 3500301 رﻳـﺎل و در ﻣﻘﻄـﻊ اول راﻫﻨﻤﺎﻳﻲ و اول ﻣﺘﻮﺳﻄﻪ ﻣﺮﺑﻮط ﺑﻪ اﺧﺘﻼلﻫﺎي ﺷﻨﻮاﻳﻲ و ﺑﻪ ﺗﺮﺗﻴﺐ ﺑﺮاﺑﺮ ﺑﺎ 20750018 رﻳﺎل و 3900784 رﻳﺎل ﺑﻮد. ﻧﺘﻴﺠﻪﮔﻴﺮي: ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨﻪ داﻧﺶآﻣﻮزان در ﺟﻤﻌﻴﺖ ﺷﻬﺮي و روﺳﺘﺎﻳﻲ ﺷﻬﺮﺳﺘﺎن ﻛﻤﻴﺠﺎن ﺑﻪ ﻟﺤﺎظ ﻫﺰﻳﻨﻪ ﭘﻴﺎﻣﺪ ﻗﺎﺑﻞ ﺗﺪاوم اﺳﺖ. ﻛﻠﻴﺪواژهﻫﺎ: ارزﻳﺎﺑﻲ اﻗﺘﺼﺎدي، ﻫﺰﻳﻨﻪ- ﭘﻴﺎﻣﺪ، ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨﻪ ﻣﻘﺪﻣﻪ: ﻛﺸﻮرﻫﺎي ﻛﻢﺗﺮ ﺗﻮﺳﻌﻪ ﻳﺎﻓﺘﻪ ﺑﻪ ﻋﻠﺖ ﻣﺤﺪودﻳﺖ ﻣﻨﺎﺑﻊ اﻳﻦ ﺣﻘﻴﻘﺖ ﻛﻪ ﻧﻈﺎم ﺳﻼﻣﺖ ﻫﻤـﻮا ره از ﻣﻨـﺎﺑﻊ ﻣﺤـﺪودي ﻣﺎﻟﻲ، ﻣﺎﻧﻨﺪ ﻛﺸﻮرﻫﺎي ﺗﻮﺳﻌﻪ ﻳﺎﻓﺘﻪ ﻗﺎدر ﺑـﻪ اراﻳـﻪ ﺗﻤـﺎﻣﻲ ﺑﺮﺧﻮردار اﺳﺖ، ﻣﺘﻮﻟﻴﺎن ﻗﺎدر ﺑﻪ ﭘﻮﺷﺶ و اراﻳـﻪ ﺗﻤـﺎم اﻳـﻦ ﺧﺪﻣﺎت ﺳﻼﻣﺖ ﻧﻴﺴﺘﻨﺪ. ﻋﻼوه ﺑﺮ اﻳﻦ، اﻋﺘﺒﺎر ﻋﻤﻮﻣﻲ اﻳـﻦ ﺧﺪﻣﺎت ﻧﺨﻮاﻫﻨﺪ ﺑﻮد. اﻳﻦ ﻣﺴـﺄﻟﻪ ﺑﺎﻋـﺚ ﺷـﺪه اﺳـﺖ ﻛـﻪ ﻛﺸﻮرﻫﺎ ﺻﺮف ﺧﺪﻣﺎﺗﻲ ﻣﻲﺷﻮد ﻛـﻪ ﺗﻨﺎﺳـﺐ و اﺛﺮﺑﺨﺸـﻲ ﻫﻤﻴﺸﻪ ﻳﻜﻲ از ﻣﻬﻢﺗﺮﻳﻦ ﺗﺼﻤﻴﻢﮔﻴﺮيﻫﺎي ﺳﻴﺎﺳـﺘﮕﺬا ران ﻻزم را ﻧﺪارﻧﺪ، اﻋﺘﺒﺎر در ﻣﺤﻞ ﻧﻴﺎز وارد ﻧﻤﻲﺷﻮد و ﻛﻨﺘـﺮل ﻧﻈﺎم ﺳﻼﻣﺖ اﻳﻦ ﺑﺎﺷـﺪ ﻛـﻪ ﺗـﺎ ﭼـﻪ ﺣـﺪ و ﻛـﺪام ﻳـﻚ از ﭼﮕﻮﻧﮕﻲ ﺻﺮف ﭘﻮل ﺑﺴﻴﺎر دﺷﻮار اﺳﺖ.(1) ﺧﺪﻣﺎت و ﻓﻨﺎوريﻫﺎ را ﺗﺤﺖ ﭘﻮﺷﺶ ﻗﺮار دﻫﻨﺪ.(2) در واﻗﻊ ﻧﻈﺎم ﺳﻼﻣﺖ ﻫﻤﻮاره ﺑﺎ ﭼﻨﻴﻦ ﻣﺸﻜﻠﻲ رو ﺑﻪ رو ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﻳﻦ ﻛﻪ ﺣﺪود 51 درﺻﺪ ﺟﻤﻌﻴﺖ اﻳﺮان زﻳـﺮ اﺳﺖ ﻛﻪ ﺑﺎ اﻓﺰاﻳﺶ ﻓﻨﺎوريﻫﺎي ﺳﻼﻣﺖ و ﺗﻮﻟﻴﺪ روزاﻓﺰون 19 ﺳﺎل ﻫﺴﺘﻨﺪ و ﺗﻌﺪاد زﻳـﺎدي از ﺟﻤﻌﻴـﺖ ، در دورهﻫـﺎي آنﻫﺎ، اﻓﺰاﻳﺶ ﺗﻘﺎﺿﺎ ﺑﺮاي اﺳﺘﻔﺎده از ﻓﻨﺎوريﻫﺎي ﺟﺪﻳﺪ و دﺑﺴﺘﺎن ﺗﺎ دﺑﻴﺮﺳﺘﺎن ﻗﺮار ﻣـﻲ ﮔﻴﺮﻧـﺪ و از آﻧﺠـﺎ ﻛـﻪ دوران 82 ارزﻳﺎﺑﻲ اﻗﺘﺼﺎدي ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨﻪ داﻧﺶآﻣﻮزان.../ دﻛﺘﺮ ﺳﻌﻴﺪ آﺻﻒ زاده و ﻫﻤﻜﺎران ﺗﺤﺼﻴﻞ ﺑﺎ دوران ﺳﺮﻳﻊ و ﺣﺴﺎس رﺷﺪ و ﺗﻜﺎﻣﻞ ﺟﺴﻤﻲ و ﺑﺮﻧﺎﻣﻪ و ﻫﺰﻳﻨﻪﻫﺎي ﺗﺴﻬﻴﻢ ﺷﺪه از واﺣﺪﻫﺎي ﺳﺘﺎدي ﺷﺒﻜﻪ رواﻧﻲ ﻫﻢ زﻣﺎن اﺳﺖ، ﻟﺬا ﻫﺮ ﻧﻮع اﻧﺤﺮاف از ﺣﺎﻟﺖ ﻃﺒﻴﻌـﻲ ﺑﻬﺪاﺷﺖ. و ﺳﻼﻣﺖ در اﻳﻦ دوران ﺑﺎﻳـﺪ در اوﻟـﻴﻦ ﻓﺮﺻـﺖ ﻛﺸـﻒ و ﺟﻬﺖ ﻣﺤﺎﺳﺒﻪ ﻫﺰﻳﻨﻪ ﻛﺎرﻛﻨﺎن (از ﻣﺤﻞ ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨـﻪ درﻣﺎن ﺷﻮد.(3) در ﺣﺎﻟﻲ ﻛﻪ در ﺑﻮدﺟـﻪ ﻫﺰﻳﻨـﻪ ﻫـﺎي ﻛﻠـﻲ داﻧــﺶآﻣــﻮزان)، ﺑــﻪ اﺳــﻨﺎد ﺣﺴــﺎﺑﺪاري ﻣﻮﺟــﻮد در ﺷــﺒﻜﻪ ﻫﻤﺎﻧﻨﺪ ﺣﻘﻮق، ﻣﻮاد و ﻣﻠﺰوﻣﺎت و ﻧﻴـﺰ ﻫﺰﻳﻨـﻪ ﺑﺮﻧﺎﻣـﻪ ﻫـﺎي ﺑﻬﺪاﺷﺖ و درﻣﺎن ﻛﻤﻴﺠﺎن اﺳﺘﻨﺎد ﺷﺪ. اﻳﻦ ﻫﺰﻳﻨﻪ از ﻣﺮﻛـﺰ ﺧﺎص ﻣﺜﻞ ﺳﻼﻣﺖ ﻣﺎدر و ﻛﻮدك در ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪه اﺳﺖ ﺑﻬﺪاﺷﺖ اﺳﺘﺎن ﻣﺮﻛﺰي ﺟﻬﺖ ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨﻪ داﻧـﺶ آﻣـﻮزان وﻟــﻲ در ﺧﺼــﻮص ﻫﺰﻳﻨــﻪ واﺣــﺪ، اﻃﻼﻋــﺎﺗﻲ را ﻧﺸــﺎن در اﺧﺘﻴﺎر ﺷﺒﻜﻪﻫﺎي ﺑﻬﺪاﺷﺖ و درﻣﺎن ﻗﺮار ﮔﺮﻓﺘﻪ ﺑﻮد. ﻧﻤﻲدﻫﻨﺪ، ﺑﺮاي ﻣﺜﺎل در ﺧﺼﻮص ﻫﺰﻳﻨﻪ ﻳـﻚ ﻣﺸـﺎوره در ﺟﻬﺖ ﻣﺤﺎﺳﺒﻪ ﻫﺰﻳﻨﻪ ﺗﺴﻬﻴﻢ ﺷﺪه از ﻣﺤـﻞ ﺣﻘـﻮق و ﻣﺮاﻗﺒﺖ ﺳﻼﻣﺖ اوﻟﻴﻪ ﭼﻴﺰي را ﻧﺸﺎن ﻧﻤﻲدﻫﺪ.(4) ﻣﺰاﻳﺎي ﺳﺎﻟﻴﺎﻧﻪ، ﻛﻞ ﺣﻘـﻮق و ﻣﺰاﻳـﺎ و درﻳـﺎﻓﺘﻲ ﻫـﺎي ﻫـﺮ ﺷﻬﺮﺳﺘﺎن ﻛﻤﻴﺠﺎن در اﺳﺘﺎن ﻣﺮﻛﺰي واﻗﻊ ﺷﺪه اﺳـﺖ ﻧﻴﺮوي اﻧﺴﺎﻧﻲ (ﭘﺰﺷﻚ و ﻛﺎردان ﺑﻬﺪاﺷﺘﻲ) در ﺳﺎل ﻣﻄﺎﻟﻌﻪ و ﺟﻤﻌﻴﺖ آن در اﺑﺘـﺪاي ﺳـﺎل 1389 ﺣـﺪود 47447 ﻧﻔـﺮ ﻣﺤﺎﺳﺒﻪ و ﺑﺮ ﺗﻌﺪاد روزﻫﺎي ﻣﻔﻴﺪ ﻛﺎري ﺳـﺎﻟﻴﺎﻧﻪ ﻫـﺮ ﻧﻴـﺮو (12159 ﺧﺎﻧﻮار) ﺑﻮد. ﻟﺬا اﻳـﻦ ﭘـﮋوﻫﺶ ﺑـﺎ ﻫـﺪف ارزﻳـﺎﺑﻲ ﺗﻘﺴﻴﻢ ﺷﺪ ﻛﻪ ﺣﻘﻮق ﻫﺮ ﻧﻴﺮوي اﻧﺴـﺎﻧﻲ ﺑـﻪ ازا ي ﻫـﺮ روز ﻫﺰﻳﻨﻪ ﭘﻴﺎﻣﺪ ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨﻪﻫﺎي داﻧﺶآﻣـﻮزان ﺑـﺪو ورود ﺑـﻪ ﻛﺎري ﺑﻪ دﺳﺖ آﻣﺪ، ﺳﭙﺲ اﻳﻦ ﻋﺪد در ﺗﻌﺪاد روزﻫﺎﻳﻲ ﻛـﻪ ﻣﻘﺎﻃﻊ ﺗﺤﺼﻴﻠﻲ ﻣﺨﺘﻠﻒ اﻧﺠﺎم ﺷﺪ. ﻫﺮ ﻧﻴﺮوي اﻧﺴﺎﻧﻲ ﺑﻪ ﺑﺮﻧﺎﻣـﻪ ﻣﻌﺎﻳﻨـﻪ در ﻫﺮﻳـﻚ از ﻣﻘـﺎﻃﻊ اﺧﺘﺼﺎص داده ﺑﻮد، ﺿﺮب ﺷـ ﺪ و ﺑـﻪ اﻳـﻦ ﺗﺮﺗﻴـﺐ ﻫﺰﻳﻨـﻪ اﺧﺘﺼﺎص داده ﺷﺪه ﺑﻪ ﺑﺮﻧﺎﻣﻪ از ﻣﺤﻞ ﺣﻘـﻮق و ﻣﺰاﻳـﺎ ﺑـ ﻪ ﻣﻮاد و روشﻫﺎ: اﻳﻦ ﭘﮋوﻫﺶ ﺗﻮﺻﻴﻔﻲ- ﺗﺤﻠﻴﻠﻲ در ﺳﺎل 1389ﺑﺮ روي دﺳﺖ آﻣﺪ. ﺗﻤﺎم داﻧﺶآﻣﻮزان ﺑﺪو ورود ﺑﻪ ﻣﻘـﺎﻃﻊ ﺗﺤﺼـﻴﻠﻲ ﻣﺨﺘﻠـﻒ ﺟﻬﺖ ﻣﺤﺎﺳﺒﻪ ﻫﺰﻳﻨﻪ اﺳﺘﻬﻼك ﺳﺎﺧﺘﻤﺎن ﻣﺤﻞ ﻣﻌﺎﻳﻨﻪ ﺷﻬﺮﺳﺘﺎن ﻛﻤﻴﺠﺎن (1854 ﻧﻔﺮ) اﻧﺠﺎم ﺷﺪ ﻛﻪ ﺷـﺎﻣﻞ 477 داﻧﺶآﻣﻮزان، اﺑﺘﺪا ﻣﺒﻠﻎ اﺟﺎره در ﺳﺎل 1388 ﺑﻪ ﻋﻨﻮان ﻣﺒﻨﺎ ﻧﻔﺮ اول اﺑﺘﺪاﻳﻲ، 538 ﻧﻔـﺮ اول راﻫﻨﻤـﺎﻳﻲ و 839 ﻧﻔـﺮ اول ﻣﺤﺎﺳﺒﻪ ﺷﺪ و اﻳﻦ ﻣﺒﻠـﻎ ﺑـﻪ ﻧﺴـﺒﺖ روزﻫـﺎي اﺳـﺘﻔﺎده از ﻣﺘﻮﺳﻄﻪ ﺑﻮد. ﺗﺴﻬﻴﻼت ﺳﺎﺧﺘﻤﺎﻧﻲ ﺑـﻪ ﺑﺮﻧﺎﻣـﻪ و ﻣﻘـﺎﻃﻊ ﺗﺨﺼـﻴﺺ داده ﺑﺮاي ﺟﻤﻊآوري اﻃﻼﻋﺎت از ﺑﺮﮔﻪﻫﺎي آﻣﺎري ارزﻳـﺎﺑﻲ ﺷﺪ. ﻣﻘﺪﻣﺎﺗﻲ داﻧﺶآﻣﻮزان و ﻣﻌﺎﻳﻨﻪ ﭘﺰﺷﻚ ﺧﺎﻧﻮاده اﺳﺘﻔﺎده ﺷﺪ ﺟﻬﺖ ﻣﺤﺎﺳﺒﻪ اﺳﺘﻬﻼك ﺗﺠﻬﻴﺰات ﻣـﻮرد اﺳـﺘﻔﺎده در ﻛﻪ ﺗﻮﺳﻂ وزارت ﺑﻬﺪاﺷﺖ ﺗـﺪوﻳﻦ ﺷـﺪه اﺳـﺖ . ﻫﻤﭽﻨـﻴﻦ ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨﻪ داﻧﺶآﻣﻮزان، اﺑﺘﺪا از ﻗﺎﻧﻮن ﻣﺎﻟﻴـﺎت ﻣﺴـ ﺘﻘﻴﻢ (5) ﺟ ﻬ ــﺖ ﺟﻤــﻊآوري آﻣــﺎر ﻣــﺮﺗﺒﻂ ﺑــﺎ ﻣﺒﺎﺣــﺚ ﻫﺰﻳﻨــﻪ اي و اﺳﺘﻔﺎده ﺷﺪ و ﻋﺪد ﺣﺎﺻﻠﻪ ﺑﻪ ﻧﺴﺒﺖ ﺗﻌﺪاد روزﻫـﺎﻳﻲ ﻛـﻪ اﻗﺘﺼﺎدي از ﺑﺮﮔﻪﻫﺎي اﻃﻼﻋﺎﺗﻲ اﺳﺘﺎﻧﺪارد اﺳﺘﻔﺎده ﺷﺪ. ﺗﺠﻬﻴﺰات در ﺑﺮﻧﺎﻣﻪ ﻣﻮرد اﺳـﺘﻔﺎده ﻗـﺮار ﮔﺮﻓﺘـﻪ ﺑﻮدﻧـﺪ ﺑـﻪ در ﭘﮋوﻫﺶ ﺣﺎﺿﺮ ﻫﺰﻳﻨﻪﻫﺎ ﺗﺤﺖ دو ﻋﻨﻮان ﻟﺤﺎظ ﺷﺪ: ﻣﻮﺿﻮع ﻫﺰﻳﻨﻪ اﺧﺘﺼﺎص داده ﺷﺪ. ﻫﺰﻳﻨﻪﻫﺎي ﻣﺴﺘﻘﻴﻢ ﺷﺎﻣﻞ ﻫﺰﻳﻨﻪ ﻣﻮاد ﻣﺼـﺮﻓﻲ ﻋﻤـﻮﻣﻲ و ﺟﻬﺖ ﺗﺴﻬﻴﻢ و اﺧﺘﺼﺎص ﻫﺰﻳﻨﻪ واﺣﺪﻫﺎي ﺳﺘﺎدي ﺑـﻪ اﺧﺘﺼﺎﺻﻲ ﺧﺮﻳﺪاري ﺷﺪه و ﻫﺰﻳﻨﻪ ﭘﺮداﺧﺘﻲ از ﻣﺤﻞ ردﻳﻒ ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨﻪ داﻧﺶآﻣﻮزان ﺑﻪ ﺷﺮح زﻳﺮ ﻋﻤﻞ ﺷﺪ: ﺑﺮﻧﺎﻣﻪﻫﺎي ﻣﻌﺎﻳﻨﻪ داﻧﺶآﻣﻮزان ﺑﻪ ﮔﺮوه ﺳﻨﺠﺶ (ﻛﺎردانﻫﺎ 1- ﺑﺮاي ﻣﺤﺎﺳﺒﻪ ﻫﺰﻳﻨﻪ ﻣﻨﺎﺑﻊ اﻧﺴـﺎﻧﻲ واﺣـﺪﻫﺎي ﺳـﺘﺎدي و ﭘﺰﺷــﻜﺎن ﻛــﻪ ﺑــﻪ ﻃــﻮر ﻣﺴــﺘﻘﻴﻢ در ﺑﺮﻧﺎﻣــﻪ ﻣﻌﺎﻳﻨــﻪ اﺑﺘﺪا ﺣﻘﻮق ﻣﻨﺎﺑﻊ اﻧﺴﺎﻧﻲ ﺑﻪ ازاي ﻫﺮ ﺳـﺎﻋﺖ ﻣﻔﻴـﺪ ﻛـﺎري داﻧـﺶ آﻣــﻮزان ﺑﻮدﻧـﺪ ) و ﻫﺰﻳﻨــﻪﻫـﺎ ي ﻏﻴﺮﻣﺴــﺘﻘﻴﻢ ﺷــﺎﻣﻞ ﻣﺤﺎﺳﺒﻪ و در ﻧﻬﺎﻳﺖ در ﺗﻌﺪاد ﺳﺎﻋﺖ ﻛﺎري ﻓﻌﺎل آن ﻧﻴﺮوي ﻫﺰﻳﻨﻪﻫﺎي اﺳـﺘﻬﻼك ﺳـﺎﺧﺘﻤﺎن و ﺗﺠﻬﻴـﺰات ، ﺗﺨﺼـﻴﺺ اﻧﺴﺎﻧﻲ در ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨﻪ ﺿﺮب ﺷﺪ. ﻫﺰﻳﻨﻪﻫﺎي ﻛﺎرﻛﻨﺎن از ﻣﺤﻞ ﺣﻘﻮق و ﻣﺰاﻳـﺎي ﺳـﺎﻟﻴﺎﻧﻪ ﺑـﻪ 2- ﺑﺮاي ﻣﺤﺎﺳﺒﻪ ﻫﺰﻳﻨﻪﻫﺎي اﻧﺮژي، اﺑﺘﺪا ﻫﺰﻳﻨﻪ اﻧﺮژي ﻫﺮ ﻣﺠﻠﻪ ﻋﻠﻤﻲ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ ﻗﺰوﻳﻦ، ﺳﺎل ﺷﺎﻧﺰدﻫﻢ، ﺷﻤﺎره1(ﭘﻲ در ﭘﻲ62)، ﺑﻬﺎر1391/ ﻣﻘﺎﻟﻪ ﭘﮋوﻫﺸﻲ 83 واﺣﺪ ﺑﻪ ﻛﻞ ﺳﺎﻋﺖﻫﺎي ﻣﻔﻴﺪ ﻛﺎري در ﺳﺎل ﺗﻘﺴﻴﻢ ﺷـﺪ و ﻋﺮوﻗﻲ و 26/0 درﺻﺪ ﺑﻪ آﺳﻢ ﻣﺒﺘﻼ ﺑﻮدﻧﺪ. ﺑﻪ ﻧﺴﺒﺖ ﺳﺎﻋﺖﻫﺎي اﺧﺘﺼﺎص داده ﺷﺪه ﺗﻮﺳﻂ ﻛﺎرﺷﻨﺎس ﺑﺮاﺳﺎس ﻧﺘﺎﻳﺞ ﻣﻌﺎﻳﻨـﻪ ﭘﺰﺷـﻚ ﺧـﺎﻧﻮاده ، 07/3 درﺻـﺪ ﻣﺮﺑﻮﻃﻪ ﻫﺰﻳﻨﻪ اﻧﺮژي ﻣﺤﺎﺳﺒﻪ ﺷﺪ. داﻧﺶآﻣﻮزان ﺑﻪ آﻧﻤﻲ، 1/0 درﺻﺪ ﺑﻪ ﺑﺰرﮔﻲ ﺗﻴﺮوﻳﻴﺪ، 0/16 3- ﺑﺮاي ﻣﺤﺎﺳـﺒﻪ ﻫﺰﻳﻨـﻪ ﺗﻌﻤﻴـﺮ و ﻧﮕـﻪ داري ﻋﻤـﻮﻣﻲ از درﺻﺪ ﺑﻪ اﺧﺘﻼلﻫﺎي رﻳﻮي، 05/0 درﺻﺪ ﺑﻪ اﺑﻬﺎم ﺗﻨﺎﺳﻠﻲ ﻓﺮﻣﻮل زﻳﺮ اﺳﺘﻔﺎده ﺷﺪ: و 26/0 درﺻﺪ ﺑﻪ ﻋﺪم ﻧﺰول ﺑﻴﻀﻪ ﻣﺒﺘﻼ ﺑﻮدﻧﺪ. ﺣﻘﻮق ﻓﺮد ﺗﻌﻤﻴﺮﻛﺎر ﺑﻪ ازاي 1ﻣﺘﺮ × ﻣﺘـﺮاژ ﻫﺮ ﻛـ ﺪام از ﻛﻞ ﻫﺰﻳﻨﻪ (ﻣﺴﺘﻘﻴﻢ و ﻏﻴﺮﻣﺴﺘﻘﻴﻢ و ﺳـﺘﺎدي ) ﺑﺮﻧﺎﻣـﻪ واﺣﺪﻫﺎي ﺳﺘﺎدي ﺑﺎﻻﺳﺮي ÷ ﺗﻌﺪاد ﺳﺎﻋﺖ ﻛﺎري ﺗﻌﻤﻴﺮﻛﺎر ﻣﻌﺎﻳﻨﻪ داﻧﺶآﻣـﻮزان ﺷ ﻬﺮﺳـﺘﺎن ﻛﻤﻴﺠـﺎن در ﺳـﺎل ﻣـﻮرد در ﺳﺎل × ﺗﻌﺪاد ﺳﺎﻋﺖ اﺧﺘﺼـﺎص داده ﺷـﺪه ﺗﻮﺳـﻂ ﻫـﺮ ﻣﻄﺎﻟﻌﻪ 164495020 رﻳﺎل ﺑﺮآورد ﺷﺪ. ﻛﺪام از واﺣﺪﻫﺎي ﺑﺎﻻﺳﺮي ﺑﻪ ﺑﺮﻧﺎﻣﻪ ﻣﻌﺎﻳﻨﻪ داﻧﺶآﻣﻮزان. ﻫﺰﻳﻨﻪ ﻣﺴﺘﻘﻴﻢ اﻳﻦ ﺑﺮﻧﺎﻣﻪ ﺑﺮاﺑﺮ ﺑﺎ 66585000 رﻳﺎل ﺑﻮد 4- ﺑﺮاي ﻣﺤﺎﺳﺒﻪ ﻫﺰﻳﻨﻪ ﺗﻌﻤﻴﺮ و ﻧﮕـﻪ داري اﺧﺘﺼﺎﺻـﻲ از ﻛﻪ از اﻳﻦ ﻣﺒﻠﻎ 11200000 رﻳﺎل ﺑـﻪ ﭘﺰﺷـﻜﺎن ﺧـﺎﻧﻮاده و ﻓﺮﻣﻮل زﻳﺮ اﺳﺘﻔﺎده ﺷﺪ: ﻛﺎردانﻫﺎي ﺑﻬﺪاﺷﺘﻲ، 35775000 رﻳﺎل ﺑﻪ ﮔﺮوه ﺳـﻨﺠﺶ 24500000÷(ﻣﺘﺮ)300 × ﻣﺘﺮاژ ﻫﺮ واﺣﺪ ﺑﺎﻻﺳﺮي÷ﺳﺎﻋﺖ ﺳﻼﻣﺘﻲ داﻧﺶآﻣﻮزان و 19610000 رﻳﺎل ﺑﻪ ﻫﺰﻳﻨـﻪ ﻣـﻮاد ﻛﺎري ﺗﻌﻤﻴﺮﻛﺎر در ﺳـﺎل × ﺗﻌـﺪاد ﺳـﺎﻋﺖ اﺧﺘﺼـﺎص داده ﻣﺼﺮﻓﻲ اﺧﺘﺼﺎﺻﻲ و ﻋﻤﻮﻣﻲ ﺗﺨﺼﻴﺺ داده ﺷﺪه ﺑﻮد.
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