Research on the Efficiency of HIV/AIDS Prevention to Township Hospitals in Henan Province Based on Data Envelopment Analysis
|School||Huazhong University of Science and Technology|
|Course||Social Medicine and Health Management|
|Keywords||AIDS Data envelopment analysis Combat efficiency County-level medical institutions|
Objective of the AIDS epidemic in Henan Province is the more serious one of the provinces, from the AIDS epidemic trend point of view, the AIDS situation is very grim faced: previous blood transfusion causes AIDS, the number of infections has decreased significantly, but through sexual transmission and drug use spread of cases began a gradual upward trend, if not prevention work force or efficiency is not high, but the consequences would be like. This study aimed to determine the efficiency of township hospitals AIDS DEA evaluation, using data envelopment analysis township hospitals in Henan AIDS comparative analysis of the relative efficiency, while on the county-level medical institutions AIDS situation analysis for the government and health policy department to adjust the allocation of resources and the development of AIDS to provide data to support policy decisions and opinions and suggestions. Methods In this study, health economics, health statistics and social medicine theory and methods, using a combination of subjective and objective, county and township medical institutions in Henan AIDS efficiency evaluation. The main research methods include: 1. Literature research; 2. Empirical research method; 3. Cluster analysis; 4. Correlation analysis; 5. Variation coefficient method; 6. Data envelopment analysis; 7. Theoretical analysis method. Findings county hospitals AIDS basic situation: the relative size of the smallest county used People's Hospital, AIDS accounted for the number of beds dedicated the highest percentage of the number of hospital beds, Ai anti-personnel daily average working time of 12 hours, the staff satisfaction, only 32.5% . Shangcai County Hospital received superior training, technical guidance related to the number of meetings and the convening of AIDS-related significantly higher than other hospitals; Shangcai County People's Hospital, is mainly responsible for anti-viral treatment of AIDS patients. County Center for Disease Control AIDS basic situation: Shangcai CDC receiving HIV antiretroviral therapy total number of 4423 people, combating HIV / AIDS work up to 45 private rooms, in combination with other medical work has 29 rooms, AIDS personnel is 49.5, the average working time is more reasonable, staff satisfaction, nearly 80%, with specializing in AIDS research and management staff, nearly five years to carry out four AIDS-related research, a total of six published articles. Queshan CDC AIDS outdated facilities, poor economic conditions, lack of diagnostic equipment and treatment equipment, but the highest proportion of its expenditure; Ai anti-personnel satisfaction was 68.57%, the survey knowledge, Ai can not guarantee the safety of anti-personnel, and want to get formal The training, which needs to be further improved. Different County Center for Disease Control Prevention efficiency there is a big difference. County MCH AIDS basic situation: MCH AIDS-specific number of beds in general small, multi-use prevention and treatment of HIV / AIDS work in combination with other medical work between forms, the majority of HIV AIDS prevention officers are also responsible for other than medical services. Which is not AIDS Shangcai MCH hospitals, so there is no HIV-specific number of beds, less its AIDS-related businesses. Queshan MCH funding for AIDS prevention is relatively abundant, bear some of the HIV knowledge consulting work. DEA evaluation to determine: through expert advice and literature study selected 17 rural hospitals can comprehensively reflect the efficiency of candidate AIDS prevention, the indicator system covering the township scale, quality, effectiveness, efficiency and other comprehensive status. Cluster analysis of the candidate indicators are divided into five categories, then the use of correlation analysis and coefficient of variation of the DEA method to determine the final evaluation indicators: input-oriented BCC model of efficiency evaluation is determined to be regularly follow-up rate, 2009 AIDS Expenses, AIDS information network system construction, the value of AIDS prevention personnel; BCC output-oriented efficiency evaluation model is determined to be regularly follow-up rate, patient satisfaction, 2009 Expenses of AIDS, AIDS prevention and control personnel values. DEA efficiency measurement using software DEAP Version 2.1 efficiency indicators have been selected DEA analysis: from input-oriented DEA evaluation model calculation results, 75% of the returns to scale township hospitals in the best condition, Shao shop hospitals and White Set hospitals are non-DEA effective decision-making unit, and are made of pure technical efficiency and scale efficiency caused relatively ineffective. From the output-oriented DEA evaluation model calculation results, only 37.5 percent of rural hospitals in the best condition returns to scale, other township hospitals belong to the non-DEA effective decision-making unit, which sanlihe health centers and health posts reed hospital currently operating efficiency is low, mainly due to the low efficiency of scale caused five rural hospitals are at the stage of decreasing returns to scale. Henan AIDS efficiency township there are differences, which is determined by internal factors and external environment common cause for these non-DEA effective township has its corresponding optimization objectives, in order to improve its combat efficiency, increase the relative efficiency value, for those with lower values ??scale efficiency of township hospitals should be primarily from scale angles, focusing on the development of township hospitals AIDS size, to maximize its intrinsic economic rationality, thereby protecting the economies of scale to improve its overall efficiency, pure technical inefficiency township hospitals should also strengthen its own AIDS-related with the technical aspects of the upgrade. Conclusion of the study to establish a standardized model for AIDS prevention: one from a policy institutionally unified; other medical institutions should control the content of different aspects of unity. AIDS workers effectively protect their own safety: AIDS workers should earnestly study and strict implementation of good hospital infection management system; Government should implement AIDS treatment process iatrogenic spread of AIDS and sexually transmitted kinship system of compensation and occupational causes AIDS compensation and insurance system. The input of funds to strengthen AIDS prevention and supervision: to increase prevention funding, improve facilities and conditions with AIDS; strengthening local government investment, expand financing channels funds to attract and encourage private sector investment; should be relatively independent audits and The expert assessment of funding applications to sexual activity and effectiveness; projects Tendering not only the surface content, the line-item expenditure of funds and results must be open for public supervision. AIDS efficient allocation of health resources, improve staff full-time degree: AIDS efficient allocation of health resources, improve the county medical institutions, resource allocation mechanisms, in particular the allocation of resources to strengthen the weak efforts to support rural hospitals can effectively improve the prevention and treatment of AIDS prevention agency efficiency; human resource structure to rationalize and improve the rate of full-time staff to establish good good human resources team, the health workforce configuration scientific, rational, economy, promoting AIDS prevention work efficiency. Strengthen AIDS prevention and effective use of network information building: to strengthen AIDS prevention information network construction, improve the utilization of network information.