| 1.Objective and significance(1)To meet the need of government function transformationWith the redefinition of roles and functions of the Government,the relationship betweenthe Government and the public has changed,from the relationship of the governor and thegoverned to that of a public service provider and consumers.The purpose of the Government'sexercise of public power is for the effective delivery of public services,as well as the publicbenefit to achieve the public interest.Hence,the Government's performance is evaluatedwhether the provision of public services and public goods is according to the needs of thepublic,the assessment of government's performance in accordance with the public's satisfactionon public services,etc.A significant feature of modern government is to perform its publicservice functions,while the core of modern government management issues is to improve thework performanceThe government's economic function and its role assumed have gradually made majoradjustment with the success of Chinese Macro-economic reform.It is required that theGovernment's in all levels by our party and the people in the new ear should adhere to thescientific development,the full implementation of"economic regulation,market supervision,social management and public service".The"suggestions on further developing the reform ofthe administrative system"issued by the 2nd Plenary Session of 17th Central Committee of theCommunist Party of China clearly attached the importance to"fully carry out the functions ofthe government";to"pay attention to public service and strive to promote the healthydevelopment of social undertakings such as education,health,culture,as well as to establishand improve a fair,equitable,sustainable public service system that is beneficial to all and withmoderate development to promote the equalization of basic public services";to"develop theGovernment's performance management and administrative accountability system and toestablish a scientific and rational assessment indicator system and assessment mechanism ofgovernment performance"to promote the establishment of a service-oriented government with"accurate positioning,scientific organization,standardized behaviors and clear responsibility."To achieve this goal,it is necessary that to establish a government performance evaluationsystem adapted to the market economic system to promote the transformation of the Government's functions.(2)To meet the need of construction and development of disease control and preventionsystemThe Government's performance is not a simple conception referring to barely achievementin one's post,it also includes government cost,government efficiency,political stability,socialprogress and development expectation.Generally,it covers the following three aspects:economic performance,social performance and political performance.Public health,as a veryimportant government function,that provides public goods and pure public service orquasi-public services to the public,should also be included in the Government performanceevaluation system.Severe acute respiratory syndrome (SARS),broke out suddenly in China at 2003,not onlyhad throated peoples' health,but also had impacted China's economic development,socialstability and foreign relations.It also revealed the problems in china's Disease Control andPrevention system (DCPS) such as its inefficiency,etc.In order to effectively carry out publicfunctions for Disease Control and Prevention and to improve its performance,Premier WenJiabao claimed in"National Conference on SARS prevention and control"conference in July2003 to establish a sound public health mechanisms to treat emergencies,disease control andprevention system and the law enforcement supervision system in about 3 years;17th CentralCommittee of the Communist Party of China proposed to"strengthen the governmentresponsibility and input,to improve the national health policies,to encourage societyparticipation and to develop a public health service system,health care service system,medicalinsure system and drug supply security system that covered both urban and rural residents toprovide a safe,effective,convenient and inexpensive medical and health services to the masses."Among them,for the public health system,the most important task was to"perfect majordiseases prevention and control system to improve public health emergency contingencydisposal capacity".In this context,it was inevitably the focus of government and society tostrengthen the performance evaluation of disease control and prevention,to scientificallyevaluate its effectiveness on implementation of public functions,as well as its communityresponse for public goods.(3) To continue the research of Chinese disease control and prevention systemWith a prudent analysis of the internal and external environments of DPCS and constraints,the disease control and prevention system Research Group put forward the system constructionideas and strategies in 2003,which were based on a wide range of researches and feasibilitystudies for Centers for Disease Prevention and Control (CDC) at all levels.The construction of DCPS was a systematic project and a long-term development goal.It might be in accordancewith the plan and steady progress in stages.The key lied in answering these questionssystematically"What DCPS should do? How to do? What are the conditions? What is theoverall effect?",as well as a series of other issues.It could be divided into three stages:During the first phase,the research group focused on the internal and external environmentanalysis and construction of DCPS.They had clearly defined public functions of DCPS,hadcalculated the staff,finance,facilities,equipment standards and the input which theGovernments in all levels should invest in DPCS.A stable and appropriate input mechanismshould be established to enhance the operational efficiency of CDC.These had answered thequestion of"What DPCS should do and what are the conditions".During the second phase,the research group focused on standardizing services andcapacity-construction.They emphasized on how to integrate resources and raise efficiency andservice capabilities,and how to make the public function of DCPS in place.That was to solvethe problem"how to do".During the third phase,the research group focused on the performance assessment.How toassess the performance of DCPS and form the relations between performance and input werethe most important job in this stage.In the basis of the public functions and taking account into social environments,workingconditions,working processes,system results and health outcomes,the study made theframework and indicators of the performance assessment of CDC system,which was used togenerally evaluate the work capacity and efficiency.By the means of the performanceassessment tools,the DCPS should supply more qualified services on public health.2.Research methods and Data SourcesWith the guidance of systematic theory and the"structure-process-result"idea,this studydeveloped the research approach on performance evaluation of DCPS,and to establishperformance evaluation indicator system of regional disease control and prevention system,byusing hierarchical structure analytic theory,qualitative-quantitative multiple demonstration,analytic hierarchy process (AHP) and fuzzy comprehensive evaluation,through the steps of"build the evaluation framework-systematizing and hierarchizing the framework-collectingindicators-screening indicators-defining indicators-determining the indicator weight-comprehensive evaluation on the performance of regional disease control and preventionsystem".And then,this study chose eleven provinces as simple to conduct the pre-pilot to make sure the evaluation methods,basic steps and procedures operable.At last,the research analyzedthe pre-pilot results to explicate the weak factors in order to improve the performance.Data-collecting methods included literature induction and analysis,experts' consultation,focus group discussion,brainstorm and pre-pilot.The experts includes those from DiseaseControl and Prevention Bureau of Ministry of Health,the provincial health department (bureau)officer in charge from 30 provinces (autonomous regions and municipality city) of and theXinjiang Production and Construction Corps,responsible persons and operational director ofthe office from the Chinese Center for Disease Control and Prevention and 30 provincialcenters for disease control and prevention.The sample for pre-pilot included Beijing Hebei,Shanxi,Liaoning,Jilin,Jiangsu,Shandong,Guangxi,Sichuan,Yunnan and Qinghai.3.Main ResultsThis research has formed two results as"logical thoughts,acknowledged methodology,operable procedures and accessible results":one was the research approach,procedure andmethodology on the performance evaluation of DCPS,the other was the performanceevaluation indicator system of the regional disease control and prevention system (RDCPS).The research focused on domanstrating the results systemtic,scientific and operable.(1) Develop a scientific research approach on the performance evaluation of DCPSThis research had resolved the obstacles of scientifically and systematically reflecting theperformance of DCPS,and developed a methodology on the performance evaluation of DCPS,including approaches,procedures and methods.A) Master the conceptions on the performance evaluation of DCPS throughresearches and practicesBy using"performance","Performance Evaluation"and others as key words to search theChina Academic Journal Full-text Database and Pub med Database from 1998-2007,thisresearch had systematically collected more than 2100 journal papers,research reports,books,government documents,as well as government web sites at home and abroad in various fieldsrelated to performance evaluation.On the base,this research had mastered the conceptions onperformance,performance evaluation,and performance evaluation of DCPS through researchesand practices,clearly assessed the originals,applications,developments and shortcomings onthe performance evaluation of the governments and public sectors,especially on the field ofhealth sectors and DCPS.At last,this research had recognized the role and significance ofperformance evaluation:It had been recognized as an effective measure for the government toimprove the management of public affairs,to provide public services more efficiently and to strengthen the relationship between the Government and the public.DCPS was of no exceptionas an important component of the government public sectors.B) Define the conception of performance evaluation of DCPS comprehensively andsystematicallyThis research had defined the conception of performance evaluation of DCPSas follows:theperformance in this paper was the working process the agency had engaged in and theachievement agency had gained under the current conditions.It included four meanings:1) theobjectives or functions of disease control and prevention;2) behaviors and processes to achieveobjectives or to carry out their functions;3) the achievements and results achieved duringcarrying out their functions;4) conditions provided under certain conditions,namely,competence.The performance evaluation of DCPS was to establish evaluation indicator systemand use scientific methods to express the functions the agency had carried out.C) Develop the research approach,procedure and methodology on the performanceevaluation of DCPSBy using scientific and accepted methods,this research had developed the researchapproach,procedure and methodology on the performance evaluation of DCPS as"logicalthoughts,acknowledged methodology,operable procedures and accessible results".It hadresolved several key technical challenges of the performance evaluation of DCPS.1) With the guidance of systematic theory,the"structure-process-result"idea and thehierarchical structure analytic theory,this research had comprehensively expressed theperformance of DCPS as the following aspects:social environments,working conditions,working processes,system results and health outcomes.2) On the basis of the systematized and hierarchized evaluation framework,through foursteps of"collecting indicators-screening indicators-defining indicators-determining theindicator weight",this research had resolved several key technical challenges as follows:howto select indicators,how to choose indicators,whether these selected indicators representative,how to scientifically determine the indicator weight.a) Indicator collecting.Using the methods of literature analysis and expertsconsultation,focusing on the established evaluation framework,this research hadcomprehensively,systematically collected and identified more than 1,000 indicators,about138,000 words.b) Indicator screening:According to the principle of"easy-to-understand,concise andaccurate,representative,scientific,balanced and oriented,operable,comparable",this researchhad completed the selection of indicators,by the methods of expert consultation (5 rounds & 445 persons),feasibility studies,and pilots.c) Indicator defining:This research had defined the conception of the indicators fromthe following aspects:interpretation,definitions,calculation formula,the information and theinspection data which should be provided,the basic situation,ways to collect data,as well asindicator standards.At the same time,this research had improved the definition of indicatorsthrough the pre-pilot from a practical view.d) Determining indicator weight:With the guidance of the Analytic HierarchyProcess (AHP),this research had confirmed the combination weights of the indicators based onthe consistency test,by consulting 512 experts from the provincial health department (bureau)officers in charge from 30 provinces (autonomous regions and municipality city) of and theXinjiang Production and Construction Corps,the directors,deputy directors,responsiblepersons and operational director of the office from 30 provincial centers for disease control andprevention.3) Using expert consultation,this research had identified the evaluation criteria of eachindicator.And then,by conducting a sample survey to obtain the indicator data,this researchhad used the fuzzy comprehensive evaluation to build a comprehensive evaluation model tocalculate the performance scores.(2) Establish a performance evaluation indicator system of RDCPSFollowed the research approach,procedure and methodology on the performanceevaluation of DCPS,this research had established a performance evaluation indicator system ofregional disease control and prevention (RDCP),including 6 categories and 17 indicators toevaluate the performance on the prevention and control of communicable diseases,theprevention and control of chronic non-communicable disease,the disposal of public healthemergencies,monitoring and evaluation of health hazards,health education and healthpromotion,operation guarantee.With the application of the indicator system,it can meet the needs of three areas includinggovernment's evaluation of health sectors,superior to subordinate,and self-evaluation:1) tohelp governments from all levels make an objective assessment of the region's working abilityand situation of disease control and prevention,and to find out the advantages anddisadvantages of the social environments,working conditions,working processes,systemresults and health outcomes;2) to help health administration and business sectors guide thelower level regions more definitely;3) to make the governments and sectors of disease controland prevention of specific areas more easily understand themselves and improve the work.(3) Strive to grasp the operability of the result of the performance evaluation on DCPS The research was an applied policy research.The operable and applicable of the resultswas the most important of the study.Otherwise,the research would lose its meaning of guidingthe construction and improving of DCPS.Therefore,the research had focused on the followingaspects to grasp the operability of the result of the performance evaluation on the diseasecontrol and prevention system.Firstly,this research had emphasized on the applicable of the study.The experts wereconsisted of three groups:the first were professionals working through the disease control andprevention for long periods;the second were administrative staffs rich of disease control andprevention expertise,especially management experience;the third were professionals andmanagerial personnel long-term engaged in the preventive medicine.Secondly,combined with the urgent needs of the construction of DCPS and the weakness ofthe work of disease control and prevention,the research made the indicator system ofperformance evaluation for RDCP as the emphasis of this study objective,to assess the overallworking ability of specific areas of disease control and prevention.To achieve research goals,the research focused on logical thinking,the process that can be operated,results easy to assessto ensure that the course of the study can be operational.Thirdly,the operability of the performance evaluation indicator system was grasped.Theresearch ensured the operable of the evaluation indicator system from the following aspects:The approaches,procedures and methods were clear,some complex computing processes areformulated;many times of the demonstration and validation (the identified rates of regionalperformance evaluation indicator system were all over 80%);taking advice from every provincein the whole nation (getting about 300 advices);small sample pre-pilot and 11 provincesconcrete practice and so on.All the above indicated that the evaluation indicator system andmethods used in this study are feasible.4.Main exploration and innovation in the research(1) This research had developed a scientific research approach on the performanceevaluation of disease control and prevention system which is feasible and adapted to thesituation of our country.It provided the scientific foundation and the technical support for thedevelopment and application of performance evaluation of the disease control and preventionsystem.Through the steps of"build the evaluation framework-systematizing and hierarchizing theframework-collecting indicators-screening indicators-defining indicators-determining theindicator weight-comprehensive evaluation of the performance of RDCPS",this research had developed the research approach on performance evaluation of DCPS.And this research hadformed a process of evaluating the performance of DCPS in China,and formed the methods forframework building,indicator weight determining,evaluation criteria identifying,andperformance comprehensive evaluating.(2) With this thought,procedure and method,the research has explored the performanceevaluation on disease control and prevention in a certain region,and established a performanceevaluation indicator system and the criteria.
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