| BACKGROUNDOccupational health problem is one of the serious problems world widely, which is the product of economic development, especially the industrialization progress. Since it is characterized with public service and externalities, the "invisible hand" of the market mechanism can’t solve it effectively, therefore as a provider of public services; the government has high degree of responsibility in the field of occupational disease prevention and control, which is an important part of government public services. But one-sided development concept and performance evaluation mechanism have restricted the work of occupational disease prevention and control. Therefore, in the field of occupational disease prevention and control, government failure and market failure coexist, while the latter was prominent in poor management and low efficiency.Recently, China is in a period of high incidence and prominent contradictions of occupational disease, both the incidence and death toll of occupational disease patients ranked first in the world, so occupational disease has become a major public health problem and social problem. But the serious situation of occupational disease prevention and control at present forces us to doubt that if the work of occupational disease prevention and control effective and how much is the performance". So what criteria should be used to measure the achievement and how to evaluate the input, output and result of the occupational disease prevention and control objectively and impartially, become the concern of governments, and is also a problem to be solved urgently for theoretical researchers and practical workers. But there are very few researches on performance evaluation of occupational disease prevention and control, which is of extremely significance for strengthening responsibility, monitoring process, defining the success or failure factors and providing empirical basis. So this research is committed to solve this problem, and through the performance evaluation to improve the efficiency of resource utilization and the service quality, and to safeguard the health rights and interests of the workers.OBJECTIVEBased on the above background, this research whose theme is performance evaluation of occupational disease prevention and control aims to address the following questions:1. To construct a performance evaluation system for regional occupational disease prevention and control, including the construction of index system, the establishment of basic database, the determination of evaluation model, and the formation of the evaluation standard, etc.2. To inspect the constructed evaluation model through the empirical study in the sample areas, and then affirm the achievement and diagnosis defects, and to find the weaknesses, so as to provide basis for the implementation of targeted measures.3. To explore the inner reasons restricting the performance of occupational disease prevention.METHODOLOGYAccording to methodological principle of combining common with specialty, theory with practice, system with part, internal aspects with external, and utilizing theoretical method and demonstrating methods, this research evaluates the performance of occupational disease prevention and control in sample areas, and then providing policy and suggestions for further improvement of occupational disease prevention and control system.1. To identify the conceptual model of occupational disease prevention and control performance through the related policy analysis, literature review and thematic interviews. 2. To screen the primary indicators through group discussions, expert interview and field research, and then screen out the final indicators through two rounds of Delphi expert consultations and discrete trend analysis, and then the subjective and objective empowerment method is adopted to determine the weight of each index, and finally determine the standard and collection method of the indicators through expert consultation and demonstration.3. To screen the uncontrollable factors influencing the performance of occupational disease prevention and control through literature review and expert consultations, and then the PLSR method is used to make sure the impact degree and property quantitatively.4. This study selects nine prefecture-level cities in Shandong province as samples, and put the constructed index system into practice. Using the data collected from the sample areas, cronbach coefficient and principal component analysis are applied to test the reliability and validity of the index system. Synthetical index method is used to evaluate the performance of occupational disease prevention and control comprehensively.5. Using the classic principal-agent model and cost-benefit model for reference, the normative analysis method is adopted to analyze the root of poor performance of the occupational disease prevention in China.RESULTSThe main results of this research are as follows:1. The concept model of occupational disease prevention and control performance has been constructed, including input, activity, output, the results and environment.2. The index system for performance evaluation of the occupational disease prevention and control has been constructed, including three first-level indexes, that is input, output and result; and the input dimension includes two secondary indexes, that is tangible inputs and intangible inputs, the output dimension includes three secondary indexes, that is service provide, administration according to law, self-discipline, the result dimension includes two secondary indexes, that is health promotion and social impact, all in all22third-level index. The weight and standard of each index are also determined.3. hi order to ensure the transverse comparison of the performance evaluation results of occupational disease prevention and control, this study constructs a uncontrollable factors model for occupational disease prevention and control, including the dimensions of political, economic, social, technology and so on with a total of10indicators. Per capita GDP, industrial added value of ten thousand Yuan, fiscal deficit, the proportion of secondary industry, urban registered unemployment rate and the occupational-disease-inductive factors contact rate are negatively correlated with the performance of occupational disease prevention and control, and the proportion of R&D investment in GDP, the proportion of high and new technology industry in gross value of industrial output over the scale, the number of health and technical personnel per thousand people, the proportion of college degree or above diploma are positively correlated with the performance of occupational disease prevention and control. Through calculating the "environmental benefit degree" for each sample areas, the performance results are adjusted.4. The guidelines for index system for performance evaluation of the occupational disease prevention and control has been constructed, in which the specific measurement formula, data collection method and evaluation standard for the third-level index are listed.5. With the constructed index system, this study carries on empirical study in nine cities in Shandong province, the evaluation results are as follows:The performance order from high to low in turn is Jinan, Weifang, Liaocheng,Yantai, Laiwu, Jining, Weihai, Zaozhuang and Heze. The performance level in this study is divided into good, relatively good, general, relatively poor and poor, so the performance level of occupational disease prevention and control for the former seven cities is general, and the level for Zaozhuang and Heze is relatively poor.6. Because of the information asymmetry between the central government and local government as well as the inconsistent objective function, there are serious agency problems exist in the field of occupational disease prevention and control. The local governments tend to relax the occupational disease prevention, and even directly intervene in the occupational disease prevention and control work, becoming the umbrella of some illegal enterprises.7. The employers lack the enthusiasm of carrying out the work of prevention and control of occupational disease consciously because of the imperfect system and institution for the prevention and control of occupational diseases.CONCLUSIONS&SUGGESTIONSThrough theoretical analysis and empirical research, combined with relevant policies in China, this paper puts forward the following suggestions:1. To implement the responsibility of the government and relevant departments at all levels and strengthen organizational leadership is the premise.2. To strengthen the ability construction of of occupational disease prevention and control is the foundation.3. To strengthen the supervision employers, and guarantee their main responsibility body status is the emphasis.4. To improve the intrinsic motivation of each related responsibility body for occupational disease prevention and control through policy guidance is the key pomt.(1) To give full play to the role of the industrial policy guidance and market mechanism, so as to encourage and guide the employers to use the advanced technology, equipment and process.(2) To improve the transfer payment mechanism between the central government and local government, and establish special fund for occupational disease prevention and control, the central government returns a certain proportion tax to the local government according to its policy implementation.(3) To improve the work injury insurance system in our country, and reform the using range of work injury insurance, and construct the elastic work injury insurance system.(4) To construct a stricter inspection and responsibility system, and strictly carry out the target appraisal system for for all levels of government, the relevant functional departments and the companies, and check the completion of the annual index of occupational disease prevention and control, and establish corresponding system of rewards and punishments.(5) To implement publicity and commitment system of occupational health for the companies, and the companies must publicize the basic information of the occupational health regularly.INNOVATIONS&LIMITATIONSThe innovations of this research are as follows:1. theoretical innovationAt present the discussion about the the cause of the poor occupational health status in China is numerous, but most of them are superficial. This study is largely inspired by the classical economics principle, and principal-agent and cost-benefit theory are used respectively to explore the intrinsic motivation of the government and company to carry out the work of occupational disease prevention and control; so as to determine the the internal origin of the poor occupational health condition in our country, that is both the local government and companies are "economic man", they all lack the enthusiasm of carrying out the occupational-disease-prevention activities consciously.2. practice innovationAt present, the studies focus on the effect of occupational disease prevention and control for companies, but this study targets at performance evaluation of regional occupational disease prevention and control, and has constructed a set of scientific and reasonable performance evaluation system of occupational disease prevention and control, and this study has conducted empirical study, which is of extremely practical significance for strengthening responsibility, monitoring process, defining the success or failure factors and providing empirical basis.3. methodology innovationHow to eliminate the influence of environmental factors has always been a difficult problem in the field of evaluation, this study has constructed the regression equation between uncontrollable factors and performance of the occupational disease prevention and control by the PLS model, and the internal influencing factors model is used to measure the uncontrollable factors quantitatively, and calculate the "environmental benefit" of each areas, in order to eliminate the impact of these uncontrollable environmental factors, and realize the transverse comparison between regions.But the performance evaluation of occupational disease prevention and control is a complex systematic engineer, and because of the complexity of the problem and limitations of the author, this study still exist some shortcomings that need further research and improvement. The limitations of this research are as follows:1. Due to occupational disease is a general concept, it contains many kinds of diseases, and different prevention measures are needed to taken for different occupational disease hazards, therefore the resources needed are also different accordingly. This study failed to consider this, therefore we should make further improvement to optimize it.2. The "environmental benefit degree" is used to adjust the performance of occupational disease prevention and control, but this is just limited to the comprehensive index, and no adjustment of the third-level indicators.3. Although this study eliminated the interference of some uncontrolled factors, this study aims to evaluate the administrative areas, therefore, we cannot take the method of experimental or quasi-experimental research for the strict causal reasoning, although this is due to the limited conditions, but is still missing.4. At present poor occupational health situation in our country is influenced by the restriction of political, economic, social and cultural aspects, this study only explores it from the perspective of economics. |
PDF Full Text Request