基于结构方程模型的艾滋病卫生服务利用影响因素及策略干预研究

项目名称： 基于结构方程模型的艾滋病卫生服务利用影响因素及策略干预研究

项目编号： No.71473046

项目类型： 面上项目

立项/批准年度： 2015

项目学科： 管理科学

项目作者： 王颖

作者单位： 复旦大学

项目金额： 62万元

中文摘要： 艾滋病严重威胁人类健康和社会发展。2013年WHO发布，有效防治结合措施尤其高效抗逆转录治疗（HAART）规范早期启动，治疗效果显著且能大幅降低HIV传播。然而，包括HAART在内的艾滋病相关卫生服务利用的好坏成为这一效果实现的关键。不容乐观的我国利用现状严重影响这一效果达成。 国外理论模型已较成熟，但国情差异下能否适合我国不得而知；数学模型尚无法揭示涉及社会、心理的潜在变量，无法估计多因-多果关系及多因素间的相互作用；缺乏基于前瞻性试点的策略干预与评价研究。为弥补国内研究的缺憾，研究集成政策制定科学程序、Andersen模型、结构方程、横断面调查、干预-对照研究、专家咨询及深入访谈等方法，构建适合我国国情的理论与数学模型，明确我国艾滋病卫生服务利用现状及影响因素；通过政策研制、可行性评价、干预试点、评价，与优化，构建并最终推荐改进策略及措施。为切实保障卫生服务利用及其效果提供科学依据

中文关键词： 艾滋病；影响因素；卫生服务利用；政策干预；结构方程模型

英文摘要： Human health and social development are facing a serious threat from HIV/AIDS. It was reported by World Health Organization in 2013 that measures integrating prevention into treatment, especially Highly Active Antiretroviral Therapy (HAART) for early stage, is going to bring a remarkable effect on HIV prevention and treatment. However, whether HIV-related health service, including HAART, is utilized very well plays a key role in bringing about these supposed effects. However, the undesirable utilization of HIV-related health services in China is impeding this impact recently. Though the theoretical model based on foreign researches on factors associated with utilization is more mature compared with domestic researches, this based on other countries mightn't suit to China's national conditions. The developed mathematical model can't reveal the potential variables in term of social and psychological, estimate the interaction among these variables and Multi-factor and multi-result relationship. Fewer researches focus on policy intervention and evaluation through prospective pilot study. During carry outing the comprehensive research, a variety of methods is going to be used to build theoretical and mathematical models suiting to Chinese actual situation, including Scientific Program of Policy Making, Andersen Model, Structural Equation Model, Cross-sectional Survey, Intervention-control Study, Delphi Method and In-depth Interviews, etc. The current situation and factors associated with HIV-related health service utilization will be discovered. Strategies and relativemeasures shall be developed through alternative formulation, feasibility study, intervention trial, evaluation and optimization to improve utilization and achieve the effects declared by WHO.

英文关键词： HIV/AIDS;influencing factors;health service utilization;policy intervention;structural equation model