本文選題：政府購(gòu)買服務(wù) + HIV/AIDS�。� 參考：《中國(guó)疾病預(yù)防控制中心》2015年博士論文

【摘要】：背景我國(guó)艾滋病疫情雖處于低流行態(tài)勢(shì),但是MSM人群傳播比例持續(xù)增高。社區(qū)組織逐漸參與到MSM人群艾滋病防治工作中并發(fā)揮了重要作用。在全國(guó)大力推廣政府購(gòu)買服務(wù)之際,政府購(gòu)買MSM社區(qū)組織艾滋病防治服務(wù)是必然趨勢(shì),但是具體的“政府購(gòu)買服務(wù)模式”還需要進(jìn)一步探索。目的基于艾滋病防治項(xiàng)目實(shí)踐和對(duì)MSM社區(qū)組織的深入分析,了解其生存發(fā)展?fàn)顩r、工作內(nèi)容及效果、成本支出,從而確定政府購(gòu)買服務(wù)內(nèi)容、價(jià)格標(biāo)準(zhǔn),提出政府購(gòu)買社區(qū)組織MSM人群艾滋病防治服務(wù)的參考模式。方法本研究以中蓋艾滋病項(xiàng)目為數(shù)據(jù)收集平臺(tái),結(jié)合現(xiàn)場(chǎng)調(diào)查,采用定量研究和定性研究相結(jié)合的方法,對(duì)MSM草根社區(qū)組織進(jìn)行了深入分析,采用德?tīng)柗品ù_定模式構(gòu)建核心步驟及影響因素,結(jié)合研究結(jié)果,構(gòu)建政府購(gòu)買服務(wù)模式。定量研究,一是分析2008-2012年中蓋艾滋病項(xiàng)目的MSM社區(qū)組織的工作產(chǎn)出及效果、獲得的單位經(jīng)費(fèi)支持標(biāo)準(zhǔn)；二是自行設(shè)計(jì)調(diào)查問(wèn)卷,通過(guò)現(xiàn)場(chǎng)調(diào)查收集分析MSM社區(qū)組織的生存發(fā)展現(xiàn)狀,并測(cè)算2013年MSM社區(qū)組織的運(yùn)行成本。定性研究,自行制定訪談提綱,根據(jù)研究目的確定訪談對(duì)象,進(jìn)行面對(duì)面深入訪談,疾控部門共訪談27人,MSM社區(qū)組織共訪談26人。資料分析采用扎根理論邊收集資料、邊進(jìn)行編碼分析,最后對(duì)社區(qū)組織的發(fā)展過(guò)程及工作現(xiàn)狀進(jìn)行總結(jié)歸納,并收集測(cè)算其工作直接成本支出。結(jié)果2008-2012年,14項(xiàng)目城市及上海、杭州和重慶的社區(qū)組織MSM人群HIV動(dòng)員檢測(cè)人次數(shù)和感染者關(guān)懷人數(shù)均逐年增加,對(duì)當(dāng)?shù)豈SM人群HIV陽(yáng)性發(fā)現(xiàn)的累計(jì)貢獻(xiàn)率分別達(dá)到54.1%、46.9%、54.7%和55.8%,協(xié)助篩查陽(yáng)性結(jié)果告知、確認(rèn)檢測(cè)、新發(fā)現(xiàn)陽(yáng)性結(jié)果告知的比例均在80.0%以上。草根社區(qū)組織的貢獻(xiàn)占到50.0%以上。本研究現(xiàn)場(chǎng)調(diào)查的11個(gè)MSM社區(qū)組織,均為草根社區(qū)組織,2012年動(dòng)員檢測(cè)人次數(shù)分別占到當(dāng)?shù)厝可鐓^(qū)組織的53.8%、57.4%和76.6%。11個(gè)MSM社區(qū)組織中,3個(gè)工商注冊(cè)、1個(gè)民政注冊(cè)；人員以兼職人員和志愿者為主,招募方式以活動(dòng)中加入和社會(huì)招聘為主；經(jīng)費(fèi)主要來(lái)源于國(guó)際合作項(xiàng)目,各項(xiàng)資源整合使用；其生存模式可分為項(xiàng)目依賴型和相對(duì)獨(dú)立型,以相對(duì)獨(dú)立型發(fā)展比較成熟。社區(qū)組織參與的MSM人群艾滋病防治工作內(nèi)容以干預(yù)、HIV動(dòng)員檢測(cè)和感染者關(guān)懷為主,各項(xiàng)工作基本形成了固定模式。2013年MSM社區(qū)組織的運(yùn)行成本從2.7萬(wàn)元到43.54萬(wàn)元不等,不同地區(qū)MSM社區(qū)組織的運(yùn)行成本不同。重慶MSM社區(qū)組織HIV動(dòng)員檢測(cè)工作直接單位成本平均為110.0元/人次(中位數(shù)),上海MSM社區(qū)組織開(kāi)展感染者關(guān)懷工作直接單位成本約492.6元/人/年。通過(guò)內(nèi)容規(guī)劃、經(jīng)費(fèi)核算與管理、工作督導(dǎo)與評(píng)估三個(gè)相互關(guān)聯(lián)的關(guān)鍵環(huán)節(jié),本研究構(gòu)建了以產(chǎn)出為導(dǎo)向,依托規(guī)劃、引入績(jī)效、過(guò)程與結(jié)果并重的政府購(gòu)買MSM社區(qū)組織艾滋病防治服務(wù)的參考模式,該模式的核心即將購(gòu)買內(nèi)容界定為MSM人群“干預(yù)及HiV動(dòng)員檢測(cè)”和“感染者關(guān)懷及治療促進(jìn)”兩個(gè)服務(wù)包,通過(guò)“關(guān)鍵指標(biāo)”“動(dòng)員檢測(cè)人次數(shù)”、“新發(fā)現(xiàn)陽(yáng)性人數(shù)”和“建立個(gè)人隨訪檔案并接受CD4檢測(cè)人數(shù)”考核服務(wù)工作產(chǎn)出,預(yù)期目標(biāo)為每年動(dòng)員檢測(cè)人次數(shù)增加3%,新發(fā)現(xiàn)人數(shù)增加6%,購(gòu)買價(jià)格標(biāo)準(zhǔn)為HIV動(dòng)員檢測(cè)100元/人、從中新發(fā)現(xiàn)陽(yáng)性者500元/人、感染者關(guān)懷550元/人,總經(jīng)費(fèi)中給予10-20%支持組織運(yùn)行成本支出,經(jīng)費(fèi)撥付采用報(bào)賬制,并由第三方審計(jì)監(jiān)督實(shí)際使用,同時(shí)加強(qiáng)干預(yù)過(guò)程督導(dǎo)與效果評(píng)估以指導(dǎo)工作方向和購(gòu)買策略。結(jié)論參與過(guò)中蓋艾滋病項(xiàng)目的MSM社區(qū)組織部分已發(fā)展比較成熟,已基本具備參與“政府購(gòu)買服務(wù)”的承接能力,承接內(nèi)容包括MSM人群“干預(yù)及HIV動(dòng)員檢測(cè)”和“感染者關(guān)懷”。本研究提出了政府購(gòu)買社區(qū)組織MSM人群艾滋病防治服務(wù)的以產(chǎn)出為導(dǎo)向,依托規(guī)劃、引入績(jī)效、過(guò)程與結(jié)果并重的參考模式,明確界定了購(gòu)買內(nèi)容和考核指標(biāo),采用績(jī)效經(jīng)費(fèi),明確了對(duì)組織運(yùn)行成本支出的經(jīng)費(fèi)支持及比例,提出過(guò)程督導(dǎo)與結(jié)果評(píng)估并重。
[Abstract]:Background although the epidemic situation of AIDS in China is in a low epidemic situation, the spread ratio of the MSM population continues to increase. Community organizations gradually participate in the AIDS prevention and control work of the MSM population and play an important role. The government purchase of the MSM community to organize AIDS prevention and control service is an inevitable trend, but the specific trend, but specific, is specific. The "government purchase service model" needs further exploration. Objective based on the practice of AIDS prevention and control projects and the in-depth analysis of MSM community organization, to understand its survival and development status, work content and effect, cost expenditure, so as to determine the government purchase service content, the price standard, and put forward the government to purchase the community organization MSM population AIDS prevention and control. In this study, based on the data collection platform of the medium cover AIDS project, combined with the field investigation and the method of combining quantitative research and qualitative research, the MSM grass root community organization was deeply analyzed, the core steps and the influencing factors were constructed by Delphy Fa's determination model, and the government was constructed with the results of the study. Purchase service mode. Quantitative research, one is to analyze the work output and effect of MSM community organization of AIDS project in 2008-2012 years, obtain the standard of unit fund support, two is self-designed questionnaire, collect and analyze the present situation of MSM community organization through field survey, and calculate the operation of MSM community organization in 2013. In the qualitative study, the interview outline was formulated by ourselves. The interview subjects were determined according to the purpose of the study. The interview was conducted in depth. 27 people were interviewed by the disease control department, and 26 people were interviewed by the MSM community organization. The data analysis was collected by the theory of grounded theory, and then the coding analysis was carried out. Finally, the development process and work status of the community organization were summed up. For 2008-2012 years, the number of HIV mobilized people and the number of people infected with MSM in the 14 project cities and Shanghai, Hangzhou and Chongqing were increased year by year, and the cumulative contribution rate of HIV positive findings to local MSM population was 54.1%, 46.9%, 54.7% and 55.8%. The sex results were informed that the proportion of the positive results was more than 80%. The contribution of the grass-roots community organizations was over 50%. The 11 MSM community organizations investigated in this study were grass-roots community organizations, and the number of people mobilized in 2012 accounted for 53.8%, 57.4% and 76.6%.11 MSM communities in the local community organizations, respectively. In the organization, 3 industrial and commercial registrations and 1 Civil Affairs registrations are given mainly by part-time personnel and volunteers. The recruitment methods are mainly involved in activities and social recruitment. The funds are mainly derived from international cooperation projects and the resources are integrated. Their survival patterns can be divided into project dependent and relatively independent type, which are relatively independent development. The content of AIDS prevention and control of the MSM population involved in the community organization is intervention, HIV mobilization testing and the concern of the infected people. The work has basically formed a fixed mode.2013 MSM community organization operating costs ranging from 27 thousand yuan to 435 thousand and 400 yuan, and the operating costs of MSM community organizations in different regions are different. The HIV movement of the MSM community organization in Chongqing The average cost of the direct unit is 110 yuan per person per person (median). The direct unit cost of the MSM community organization in Shanghai is about 492.6 yuan per person / year. Through the content planning, the accounting and management, the work supervision and evaluation of the three key links, the study constructs the output oriented and supporting rules. The government purchased the MSM community to organize the reference model of AIDS prevention and control service in the MSM community. The core of the model was defined as the MSM crowd "intervention and HiV mobilization testing" and "infection care and treatment promotion", and "key indicators", "mobilizing the number of people", " The number of newly discovered positive people "and" the establishment of personal follow-up files and the number of CD4 testing people "was used to assess the service output. The expected target was to increase the number of people to mobilize the test 3%, the number of new discoveries increased by 6%, the purchase price standard was 100 yuan per person for HIV mobilization, from which 500 yuan per person was discovered and the total cost of the infected person was 550 yuan per person. 10-20% supports the operation cost of the organization, the appropriation of funds is used, and the third party audit supervision is actually used. At the same time, the supervision and effect evaluation of the intervention process are strengthened to guide the work direction and purchase strategy. Conclusion the MSM community group, which has participated in the middle cover AIDS project, has developed more mature and has been basically involved. The acceptance of "government purchase service", including "intervention and HIV mobilization testing" and "concern for infected people" of MSM population, proposed a reference model that government purchase of community organization MSM population to AIDS prevention and control services, relying on planning, introducing performance, both the process and the results, clearly defined the purchase. Buying content and assessment indicators, adopting performance funds, and clarified the financial support and proportion of organization operation cost expenditure, and put forward equal emphasis on process supervision and result evaluation.
【學(xué)位授予單位】：中國(guó)疾病預(yù)防控制中心
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2015
【分類號(hào)】：R512.91

【相似文獻(xiàn)】

相關(guān)期刊論文 前7條

1 劉軍;戴秀蘭;趙晨希;;中蓋艾滋病項(xiàng)目經(jīng)費(fèi)運(yùn)用與管理的探討[J];現(xiàn)代物業(yè)(中旬刊);2011年12期

2 馬海玲;譚紅專;李時(shí)習(xí);;社會(huì)組織參與中蓋艾滋病項(xiàng)目的實(shí)踐[J];中國(guó)公共衛(wèi)生管理;2014年01期

3 冷志偉;王們;;中蓋艾滋病項(xiàng)目以快速檢測(cè)推動(dòng)高危人群檢測(cè)策略的效果評(píng)估[J];現(xiàn)代預(yù)防醫(yī)學(xué);2014年09期

4 伊赫亞;辛美哲;;中蓋艾滋病項(xiàng)目對(duì)廣州市男男性接觸人群社區(qū)組織干預(yù)檢測(cè)能力的影響[J];中國(guó)預(yù)防醫(yī)學(xué)雜志;2012年05期

5 范陽(yáng);張靖;孫點(diǎn)劍一;譚曉東;許俊;周旺;;中蓋艾滋病項(xiàng)目覆蓋區(qū)域中高危人群干預(yù)效果的評(píng)價(jià)分析[J];公共衛(wèi)生與預(yù)防醫(yī)學(xué);2011年02期

6 張翔;喻榮彬;張衛(wèi)紅;朱正平;;中蓋艾滋病項(xiàng)目中綜合醫(yī)院開(kāi)展PITC的經(jīng)驗(yàn)[J];中國(guó)艾滋病性病;2013年04期

7 ;[J];;年期

相關(guān)會(huì)議論文 前1條

1 李希光;顧小琛;景軍;鈕晨琳;李貝思;;針對(duì)我國(guó)男同性戀(MSM)群體艾滋病傳播的網(wǎng)絡(luò)干預(yù)研究——以“中蓋艾滋病項(xiàng)目”為例[A];2012年度中國(guó)健康傳播大會(huì)優(yōu)秀論文集[C];2012年

相關(guān)重要報(bào)紙文章 前4條

1 王麗艷;中蓋艾滋病項(xiàng)目在青啟動(dòng)[N];青島日?qǐng)?bào);2008年

2 張?zhí)K民;�？趩�(dòng)中蓋艾滋病項(xiàng)目[N];海南日?qǐng)?bào);2008年

3 記者 陳力;昆明市相關(guān)機(jī)構(gòu)均可提交申請(qǐng)[N];昆明日?qǐng)?bào);2008年

4 特約記者 楊鳳;青島購(gòu)買非政府組織艾防服務(wù)效果好[N];健康報(bào);2012年

相關(guān)博士學(xué)位論文 前1條

1 付曉靜;基于項(xiàng)目實(shí)踐探索政府購(gòu)買男同社區(qū)組織服務(wù)模式研究[D];中國(guó)疾病預(yù)防控制中心;2015年

，

本文編號(hào)：1937822