| Purpose:Henan is one of the provinces which AIDS epidemic are serious in CHINA.Judging from the trend of AIDS epidemic, Henan is now faced with a very grim situation: though infections caused by blood collection has been decreasing significantly, those caused by sex and drag are gradually increased. And if prevention action are not effective or efficient, then serious consequences are just around the corner. Aiming to determine the efficiency of township health canters'DEA evaluation of AIDS prevention indicators, this study uses DEA to analyze the relative efficiency of Henan Province's AIDS prevention work as well as that on the county-level, thus providing the health policy-making departments with data and suggestion for allocation of resources and developments of AIDS policy decisions.Methods:Methods of health economics, health statistics, the theory and methods of social medicine, and combination of subjective side and objective side are used in this study to evaluate the efficiency of Henan's county medical institutions. Research methods include: 1. literature study; 2. empirical study; 3. Cluster Analysis; 4. correlation analysis; 5. Variation coefficient; 6. DEA; 7. Theoretical analysis.Results:Basic situation County Hospitals are now faced with: the size of Queshan County is the smallest, but the hospital beds take the biggest percentage of it. Staff at AIDS prevention in this hospital works 12 hours on average, and so the satisfaction of them is only 32.5%. Times of receiving superior training and related technical guidance, and host of AIDS-related meetings of Shangcai County People's Hospital is significantly more than those of the other two hospital; The main duty of Shangcai County People's Hospital is to give anti-viral treatment to AIDS patients.Basic situation of County Center for Disease Control and Prevention for AIDS: the number of people who has received antiretroviral therapy is 4423, and there are 45 rooms for HIV / AIDS work only as well as 29 rooms which it shares with other work. Average working time here is more reasonable and the satisfaction of the stuff is almost 80. There is also staff that is specialized in AIDS research and management and they have been studying AIDS for five years, with 6 articles published. But things are not as good in Queshan County, lacking equipment for AIDS cure, it only has some cars for transportation, but its expenditure ratio is the highest. Meantime, lagging of equipment, poor economic situation and no guarantee of the security of the stuff all contribute to the unsatisfactory of the stuff which is only 68.57. So we should see that gap is still very big between these three counties.Situations in county MCH: Because the MCH's main work isn't preventing AIDS, the amount of hospital beds for AIDS cure are few in general, and most of the beds are shared with other work, indeed there are just a few doctors who only works on AIDS. Among those MCHs, Shangcai MCH does not belong to government-designated hospital for AIDS prevention, so its work with AIDS isn't very much, causing the facts that it doesn't have many hospital beds for AIDS only. Queshan MCH has a relatively sufficient funds and it takes part of the work of HIV knowledge consultation.DEA Assessment Index: 17 indexes which can reflect the efficiency of township health centers AIDS prevention were determined through combination of literature research and management expertise, covering the size, quality, benefit and efficiency of the county hospitals. Then, by cluster analysis, we divide those candidate indicators into 5 major categories, next, we use correlation analysis and coefficient of variation of the DEA method to determine the final evaluation: the assessment indexes of BCC model input efficiency are identified as periodic follow-up rate, 2009 AIDS Expenses, AIDS information network system construction, the number of AIDS prevention and control personnel; output-oriented BCC model efficiency index were identified as periodic follow-up rate, patient satisfaction, AIDS expenditures in 2009, the number of AIDS prevention and control personnel.Judging from the input-oriented DEA evaluation model's calculation results, 75% of the township hospitals'returns to scale are in the best conditions, but Shaodian hospital and Baiji hospital don't are not the efficient DEA unit, all caused by pure technology and scale efficiencies'relatively invalid.Judging from the output-oriented DEA evaluation model's calculation results, only 37.5% of township hospitals'returns to scale are in the best condition and the other hospitals belong to non-DEA efficient units, including Sanlihe hospital and Lugang hospital of which the current low efficiency is mainly caused by the inefficiencies of the scale. There are also 5 township hospitals which are in the state that the returns to scale are decreasing.Of cause, due to internal factors and external environment, differences still exist between township hospitals'efficiencies of AIDS prevention in Henan Province, for these non-DEA efficient township hospitals, we should mainly enlarge its size to raise its efficiency for those low scale efficiency hospitals while improve its own abilities related to AIDS for those low technical efficiency hospitals.Conclusion:Establishing AIDS prevention and controling model's standard ------ policy system standard as well as ways of AIDS prevention between different township hospitals standard.Protecting the workers in AIDS prevention work: stuff in AIDS prevention and control should carefully study and strictly enforce the hospital's infection management system: the government should implement the compensation system for those who is infected by iatrogenic spread of AIDS and sexually transmitted of blood in AIDS treatments as well as compensation and insurance system for those who is infected for occupational reasons.Increasing the funds for AIDS prevention and strengthen the management: To increase the prevention and control funding, with facilities to improve the prevention and control conditions; strengthening of local government investment, expand financing channels of funds, to attract and encourage private sector investment; to have the audit and the relative Independent expert assessment of funding applications to sexual activity and effectiveness; project investment is not only the surface of the contents of bills, line-item expenditure of its funds and results must be open to the public oversight.Allocating the health resources for AIDS efficiently ,and enhancing staff professional degree: we must allocate the health resources for AIDS efficiently, and improve resource allocation mechanisms of county health agencies, in particular for those hospitals which are very week in AIDS prevention, so that we can improve the efficiencies of AIDS prevention; rationalizing the structure of human resources, enhancing staff full-time rate, and establishing good human resources and a good team make health workforce configuration become scientific, rational, economic, and promote efficiency.Strengthening the construction and use of network information of AIDS prevention: we need to strengthen the construction and use of network information of AIDS prevention, and improve the utilization of network information. |
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