| Objective Comprehensive prevention and control of AIDS requires combination of much prevention and control means, multi-sectoral coordination, the participation of the whole society. In addition, the investment and utilization of resources are quite complex. As our government continues to increase the investment in AIDS, how to evaluate the process and the effect of the implementation, effectiveness and suitability of the use of resources is the urgent problem currently. The aim of this study is based on a comprehensive analysis of domestic and international health system to build a theoretical framework of regional AIDS prevention and control performance and develop a system of AIDS prevention and control of comprehensive performance evaluation system after a series of theoretical and practice study. Aims at providing theoretical and practical experience for the performance evaluation of regional AIDS prevention and control and giving evidence and political advice to governments evaluation of the regional AIDS prevention and control. Methods In this study, we try to explore the theories,the methods and the practices of the performance evaluation of comprehensive AIDS prevention and control in China. The theories and methods of health statistics and health service management were applied in the way that subjective and objective are combined. the research used many methods, including :1.the way to construct the theoretical framework and screen the performance indicators: Literature research and macroscopic policy, expert consultation and demonstration, Delphi method and test evaluation studies.2. the way to determine the index weight and standardized values: AHP, expert evaluation and literature review.3. the methods for testing Reliability and Validity of indicator system: “Reliability Analysis” and “Factor” in SPSS. 4.the methods for evaluating index system comprehensively : AHP, TOPSIS and RSR.Results By analysing and summering the theories and methods about performance evaluation of health system at home and abroad, combining with our comprehensive AIDS prevention and management practices, on the basis of several rounds of expert consultation and demonstration studies on the scene, we have achieved these following results: 1.constructed the framework about the theory of Regional comprehensive prevention and control of AIDS in the performance evaluation. Firstly, regarding the work of comprehensive prevention and control of AIDS in the special Administrative regions as the subjects, evaluating the whole performance; secondly, we thought that performance was a comprehensive, multi-dimensional category. Combining the practice of preventing and controlling AIDS, we constructed the framework of comprehensive prevention and control of AIDS in the performance evaluation. 2.the manuscript of the index system was determined and the measurement methods and tools. By literature research and policy analysis, and two rounds of expert demonstration and Delphi simplified them were determined, including 5 first grade indexes, 17 second grade indexes and 39 third grade indexes. 3. conducting the pre evaluation in the sample district of Sichuan, Hubei and Zhejiang using the measurement tool and the index system,we modified and perfected the system, and finally,determined the index system,including 5 first grade indexes,17 second grade indexes and 37 third grade indexes.4. the weight coefficient by AHP was determined. Among the first grade indexes,the weight coefficients of the macro background, the capacity of structure,the process and goal of the prevention and control are 0.1262, 0.1106, 0.2696, 0.2822 respectively. And we also got the standardized value via through literature research, policy analysis and expert demonstration. 5. Cronbach’s Alpha coefficient of the indicator system is 0.545(F=43.720, P=0.000), The results of factor analysis are accordant with the expected. On the whole, the indicator system has good validity. 6. the five-years(2009-2013) data of indexes in sample provinces(Sichuan,Guizhou,Hunan,Hubei, Zhejiang, Shandong and Jilin) was collected, and the comprehensive method of AHP、TOPSIS and RSR to evaluate the performance was used. As different method has different results, and the Spearman rating analysis has statistical significance(P<0.00), combined three evaluation results, we can get the sequence of the evaluation more objectively and scientifically.7.the design of the index is scientific and comprehensive because for the use of expert argumentation and the per experiments on the scene. The index system is so feasible and workable that it can provide a scientific basis and quantitative criteria for evaluating the level of the comprehensive prevention and controlling of AIDS and will become the effective tool of the performance evaluation of the comprehensive prevention and control of AIDS in region. Conclusion In this study a comprehensive performance evaluation of the theoretical framework of regional prevention of AIDS is build, and the theory as well as the practice of performance evaluation is enriched; A comprehensive evaluation system of regional AIDS prevention and control and measurement tools are developed which is systematic, objective and feasible; Empirical Study ensures the accuracy and operability of the index system and measurement tools;The determination of the weight of indicators at all levels and the standard values of third class index provide the foundation to the comprehensive evaluation index system. Index system has good validity and reliability; the regional AIDS prevention and control of performance evaluation system from the study can make a comparison between the merits of different regions and influence factors from the perspective of landscape or portrait quantitatively, which has important guidance and practical significance to improve leadership in improving the degree of attention of leadership, strengthening performance management, promoting regional sustainable development of AIDS prevention and control work. Suggestions Establish regular information collection mechanism to standardize data collection and to laid the foundation for the successful implementation of the performance evaluation work; multi-sectoral cooperation ought to strengthening and strengthen providing protections to achieve performance goals; ensuring the measurement of the key indicators as soon as possible; provide technical support for successful implementation of performance evaluation work; enriching the connotation of indicators to improve the sensitivity of indicators in order to make performance evaluation more targeted; consummating the performance evaluation index system constantly to adapt the changes in the epidemic and policy environment which would improve the sustainability of management of performance evaluation; developing comprehensive AIDS research performance evaluation information systems and realizing network management so as to make performance evaluation more automatic and intelligent. Research innovation1. explore and improve the health system performance and performance evaluation theory This study puts the public health system performance measurements at five-dimensional model invented by American scholar Handle into the field of AIDS prevention and control. Build a conceptual model which could fully reflect the regional AIDS prevention and control system performance evaluation, the macro background-structural capacity- Prevention Process- prevention results- prevention framework objectives, the realize system expression of AIDS connotation performance; as the same time, this study explores and improves health system performance and performance evaluation theory. 2. establish a comprehensive evaluation index system of performance of regional AIDS prevention and control workThis study first establish a performance evaluation tool for the prevention and treatment of the whole work in a particular area of AIDS, which includes a complete set of performance evaluation index, the weight coefficients of each indicator and specific evaluation criteria; and has passed the expert evaluation and experimental testing, proved to be scientific, feasibility, operability and good reliability and validity. This evaluation tool can provide a theoretical basis and technical support for AIDS prevention and control to carry out performance evaluation. 3. To use comprehensive evaluation method to quantify regional AIDS prevention and control performance By the means of AHP,Topsis and RSR, we can comprehend the overall performance of government at all levels in comprehensive AIDS prevention and control work. As the same time, performance evaluation can measure the gap between indicators and target values, assess the effectiveness of AIDS prevention and control work, all regions can be graded and sorted by the size of the gap which can truly plays the effect of incentives and promotion. |
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