title: A model to estimate the cost of the National Essential Public Health Services Package in Beijing, China.
abstract: BACKGROUND
  In order to address several health challenges, the Chinese government issued the National Essential Public Health Services Package (NEPHSP) in 2009. In China's large cities, the lack of funding for community health centers and consequent lack of comprehensive services and high quality care has become a major challenge. However, no study has been carried out to estimate the cost of delivering the services in the package. This project was to develop a cost estimation approach appropriate to the context and use it to calculate the cost of the NEPHSP in Beijing in 2011.
  
  
  METHODS
  By adjusting models of cost analysis of primary health care and workload indicators of staffing need developed by the World Health Organization, a model was developed to estimate the cost of the services in the package through an intensive interactive process. A total of 17 community health centers from eight administrative districts in Beijing were selected. Their service volume and expenditure data in 2010 were used to evaluate the costs of providing the NEPHSP in Beijing based on the applied model.
  
  
  RESULTS
  The total workload of all types of primary health care in 17 sample centers was equivalent to the workload requirement for 14,056,402 standard clinic visits. The total expenditure of the 17 sample centers was 26,329,357.62 USD in 2010. The cost of the workload requirement of one standard clinic visit was 1.87 USD. The workload of the NEPHSP was equivalent to 5,514,777 standard clinic visits (39.23 % of the total workload). The model suggests that the cost of the package in Beijing was 7.95 USD per capita in 2010. The cost of the NEPHSP in urban areas was lower than suburban areas: 7.31 and 8.65 USD respectively.
  
  
  CONCLUSIONS
  The average investment of 3.97 USD per capita in NEPHSP was lower than the amount needed to meet its running costs. NEPHSP in Beijing is therefore underfunded. Additional investment is needed, and a dynamic cost estimate mechanism should be introduced to ensure services remain adequately funded.
authors.affiliation: Capital Institute of Pediatrics, 2 YaBao Road, #328, ChaoYang District, Beijing, 100020, China. deluyin@126.com.|Chinese Center for Disease Control and Prevention, 155 ChangBai Road, ChangPing District, Beijing, 102206, China. deluyin@126.com.|Community Health Association of China, Beijing, China. deluyin@126.com.
authors.forename: Delu
authors.initials: D
authors.lastname: Yin
authors.affiliation: University of British Columbia School of Nursing and Centre for Health Services and Policy Research, 6190 Agronomy Road, #302, Vancouver, BC, V6T 1Z3, Canada. sabrina.wong@nursing.ubc.ca.
authors.forename: Sabrina T
authors.initials: ST
authors.lastname: Wong
authors.affiliation: Beijing University of Chinese Medicine, 11 BeiSanhuan East Road, ChaoYang District, Beijing, 100029, China. cwei214@vip.sina.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Capital Institute of Pediatrics, 2 YaBao Road, #328, ChaoYang District, Beijing, 100020, China. xinqianqian1014@126.com.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Xin
authors.affiliation: Capital Institute of Pediatrics, 2 YaBao Road, #328, ChaoYang District, Beijing, 100020, China. wlh3000@163.com.
authors.forename: Lihong
authors.initials: L
authors.lastname: Wang
authors.affiliation: Capital Institute of Pediatrics, 2 YaBao Road, #328, ChaoYang District, Beijing, 100020, China. bjcmm@126.com.
authors.forename: Mingming
authors.initials: M
authors.lastname: Cui
authors.affiliation: Capital Institute of Pediatrics, 2 YaBao Road, #328, ChaoYang District, Beijing, 100020, China. gouweicao2911@163.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Yin
authors.affiliation: Capital Institute of Pediatrics, 2 YaBao Road, #328, ChaoYang District, Beijing, 100020, China. chacreally@163.com.
authors.forename: Ruili
authors.initials: R
authors.lastname: Li
authors.affiliation: Capital Institute of Pediatrics, 2 YaBao Road, #328, ChaoYang District, Beijing, 100020, China. Xiaoguo_Zheng@163.com.
authors.forename: Xiaoguo
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Capital Institute of Pediatrics, 2 YaBao Road, #328, ChaoYang District, Beijing, 100020, China. yanghuimin85@126.com.
authors.forename: Huiming
authors.initials: H
authors.lastname: Yang
authors.affiliation: Capital Institute of Pediatrics, 2 YaBao Road, #328, ChaoYang District, Beijing, 100020, China. wjujuw@aliyun.com.
authors.forename: Juanjuan
authors.initials: J
authors.lastname: Yu
authors.affiliation: Capital Institute of Pediatrics, 2 YaBao Road, #328, ChaoYang District, Beijing, 100020, China. 1726137684@qq.com.|Community Health Association of China, Beijing, China. 1726137684@qq.com.
authors.forename: Bowen
authors.initials: B
authors.lastname: Chen
authors.affiliation: Chinese Center for Disease Control and Prevention, 155 ChangBai Road, ChangPing District, Beijing, 102206, China. yangwz@chinacdc.cn.
authors.forename: Weizhong
authors.initials: W
authors.lastname: Yang
mesh_terms: D000068476:Beijing; D002681:China; D003151:Community Health Centers / Q000191:economics*; D003365:Costs and Cost Analysis; D005102:Health Expenditures; D006801:Humans; D017059:Models, Econometric; D011320:Primary Health Care / Q000191:economics; D011635:Public Health Administration / Q000191:economics*; D014481:United States; D014492:United States Public Health Service