| BackgroundChina is one of 22 highest TB burden countries around the world and the number of TB patients is in the second place in the world. The new cases accounted for 16% of the world, which had a huge impact on the economic and social development. During 2001-2010 Shandong province took effect the tuberculosis control program of Shandong province (2001-2010) "(hereinafter referred to as the" plan"). This article uses "planning" implementation check assessment data, uses the cost-utility, cost-benefit and the data envelopment analysis to measure county of Shandong province TB prevention and control center (hereinafter referred to as the TB prevention institutions at the county level) running cost, utility, cost, benefit and efficiency, to explore the differences between the 2001 and 2010 and the differences between different economic development levels where institutions located aimed to explore tuberculosis prevention and control institutions at the county level difficulties and problems, to put forward the corresponding policy recommendations.Objectives1. Measuring the cost-utility of 2001 and 2010, the writer wants to understand the cost-utility of the county in Shandong province and the cost-utility of different economic development level of county in order to know the cost-utility general trends.2. Measuring the cost-benefit of 2001 and 2010, the writer wants to understand the cost-benefit of the county in Shandong province and the cost-benefit of different economic development level of county in order to know the cost-benefit general trends.3. Measuring the efficiency of the TB prevention and control work of 2001 and 2010, the writer wants to understand the comprehensive efficiency, pure technical efficiency and the scale efficiency of the county and different economic development level of county in Shandong province in order to know the Operation efficiency.ResultsThe TB prevention institutions at the county level in Shandong provincial cost-utility in 2010 was higher than it in 2001, which means saving a DALY should pay more cost in 2010 than it in 2001. Compared with 2001, all the TB prevention institutions at the county level costs-utility ratio rose 21.57 yuan/DALY and the growth rate was 29.75% in 2010; Compared with 2001, the poverty counties' TB prevention institutions costs-utility ratio rose 26.16 yuan/DALY and the growth rate was 45.10% in 2010; Compared with 2001, the non-poverty counties' TB prevention institutions costs-utility ratio rose 19.76 yuan/DALY and the growth rate was 25.37% in 2010. The growth rate of the costs-utility of the poverty counties' TB prevention institutions was higher than it of the on-poverty counties' TB prevention institutions.The TB prevention institutions at the county level in Shandong province's cost-benefit in 2010 was lower than it in 2001, which means paying one yuan carried out lower social value in 2010 than it in 2001. Compared with 2001, all the TB prevention institutions at the county level cost-benefit ratio decreased 2.31 and the growth rate was -3.00% in 2010; Compared with 2001, the poverty counties' TB prevention institutions cost-benefit ratio decreased 9.65 and the growth rate was-1.70% in 2010; Compared with 2001, the non-poverty counties' TB prevention institutions cost-benefit ratio rose 0.34 and the growth rate was 0.41% in 2010.Compared with 2001, the TB prevention institutions at the county level in Shandong province's input and output improved significantly in 2010. By Data Envelopment Analysis calculation, all the TB prevention institutions' operating efficiency rose and the comprehensive efficiency, pure technical efficiency and scale efficiency rose. Due to the technical level, the scale efficiency rose slowly, which made the comprehensive efficiency rose slowly. In 2001,3 TB prevention institutions' efficiency achieved the optimal structure. In 2010,15 TB prevention institutions' efficiency achieved the optimal structure after using GDP related index calculated the input and output. Compared with 2001, in 2010 all the TB prevention institutions at the county level's comprehensive efficiency rose 0.40 on average and the growth rate was 210.53%; the pure technical efficiency rose 0.31 on average and the growth rate was 79.49%; the scale efficiency rose 0.25 on average and the growth rate was 42.37%. Compared with 2001, in 2010 the poverty counties'TB prevention institutions comprehensive efficiency rose 0.46 on average and the growth rate was 184.00%; the pure technical efficiency rose 0.30 on average and the growth rate was 60.00%; the scale efficiency rose 0.31 on average and the growth rate was 54.39%; Compared with 2001, in 2010 the non-poverty counties'TB prevention institutions comprehensive efficiency rose 0.39 on average and the growth rate was 229.41%; the pure technical efficiency rose 0.31 and the growth rate was 86.11%; the scale efficiency rose 0.24 and the growth rate was 40.68%. By the economic level of 2010, if increasing input, there were 80 TB prevention institutions' scale benefit would decrease.12 of them located in poor counties and 68 of them located in non-poor counties.ConclusionInput of TB control work exits imbalance among regions. The channel of fund-raising is too single. Exploring other channels to raise money except government funding and project funding is needed. Many institutions are lack of some equipment which may affect daily work. We should equip necessary equipment.Compared with 2001, the TB prevention institutions at the county level in Shandong province's cost-utility rose and cost-benefit decreased which Shows saving a DALY should pay more cost in 2010 than it in 2001 and paying one yuan carried out lower social value in 2010 than it in 2001. The TB prevention institutions should pay attention to the usage of funds and the rational allocation of funds and eliminates the influence of GDP development to understand the cost-utility and cost-benefit which aims to decrease cost-utility ratio and increase cost-benefit in order to create more social benefits.Compared with 2001, the TB prevention institutions at the county level in Shandong province' efficiency rose in 2010, but the number of optimal efficiency are still less. According to the specific situation of TB prevention and control institutions at the county level, the institutions should use different methods to improve its efficiency in order to achieve optimal efficiency. |
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