CAJ | 학술논문

目的：研究社区卫生服务机构开展各项艾滋病防治服务的人力配置需求，为加强基层艾滋病防治能力建设提供政策和科学依据。方法于2012年在广州市、上海市、南京市、长沙市、重庆市及杭州市每个城市选择4家艾滋病防治服务开展得较好的社区卫生服务机构，研究对象为社区卫生服务机构的负责人、艾滋病防治工作人员。运用作业成本法建立社区卫生服务机构艾滋病防治服务的作业中心，确定各项艾滋病防治服务的作业流程、作业对象及作业动因；通过现场工作记录和回顾性调查相结合的方法收集社区卫生服务机构开展各项艾滋病防治服务的人力时间，结合两种方法综合测算得到社区卫生服务机构需配备的艾滋病防治人力数量。结果社区卫生服务机构艾滋病防治服务作业中心包括HIV健康教育、高危人群干预、 HIV咨询检测、 HIV感染者／患者随访管理及支持性工作5个1级服务项目。广州市、上海市、南京市、长沙市、重庆市及杭州市每家社区卫生服务机构完成2012年所有艾滋病防治服务的总人力时间分别为202798.6、407875.4、255039.0、123717.0、213724.0、384069.0 min，需要的标准人力分别为2.0、4.0、2.5、1.2、2.1、3.8人，平均为2.6人。结论各地社区卫生服务机构的艾滋病防治人力仍无法有效满足防治服务下沉后的工作需求，需要卫生行政部门在下沉艾滋病防治服务的同时加强其艾滋病防治队伍建设，增强各地社区卫生服务机构从事艾滋病防治服务人员的配置，从长远上保障基层艾滋病防治服务的可持续开展。
목적：연구사구위생복무궤구개전각항애자병방치복무적인력배치수구，위가강기층애자병방치능력건설제공정책화과학의거。방법우2012년재엄주시、상해시、남경시、장사시、중경시급항주시매개성시선택4가애자병방치복무개전득교호적사구위생복무궤구，연구대상위사구위생복무궤구적부책인、애자병방치공작인원。운용작업성본법건립사구위생복무궤구애자병방치복무적작업중심，학정각항애자병방치복무적작업류정、작업대상급작업동인；통과현장공작기록화회고성조사상결합적방법수집사구위생복무궤구개전각항애자병방치복무적인력시간，결합량충방법종합측산득도사구위생복무궤구수배비적애자병방치인력수량。결과사구위생복무궤구애자병방치복무작업중심포괄HIV건강교육、고위인군간예、 HIV자순검측、 HIV감염자／환자수방관리급지지성공작5개1급복무항목。엄주시、상해시、남경시、장사시、중경시급항주시매가사구위생복무궤구완성2012년소유애자병방치복무적총인력시간분별위202798.6、407875.4、255039.0、123717.0、213724.0、384069.0 min，수요적표준인력분별위2.0、4.0、2.5、1.2、2.1、3.8인，평균위2.6인。결론각지사구위생복무궤구적애자병방치인력잉무법유효만족방치복무하침후적공작수구，수요위생행정부문재하침애자병방치복무적동시가강기애자병방치대오건설，증강각지사구위생복무궤구종사애자병방치복무인원적배치，종장원상보장기층애자병방치복무적가지속개전。
Objective To measure the manpower allocation demand of HIV /AIDS prevention services in community health service centers (CHSCs) so as to provide policy suggestions and scientific references for HIV /AIDS prevention capacity improvement at community level.Methods In 2012, we selected 4 CHSCs that had better performance in the services of HIV/AIDS prevention and treatment from each of 6 following cities: Guangzhou, Shanghai, Nanjing, Changsha, Chongqing and Hangzhou.The research subjects were persons of charge of CHSCs and personnel of HIV/AIDS prevention and treatment.Using an activity-based costing method , an activity center for the services of HIV/AIDS prevention and treatment in CHSCs was set up with well -defined activity procedure , activity object and activity driver.Information about manpower time was collected through on -site records and a retrospective survey and the needed manpower allocation for HIV /AIDS prevention services in CHSCs was calculated combining the two methods.Results The activity center for HIV/AIDS prevention services in CHSCs incorporated five first -class service items: HIV health education , intervention on high -risk population , test on HIV consultation, follow -up management of HIV infected persons/patients and supportive work.The total time spent in all the HIV/AIDS prevention services in the CHSCs in Guangzhou , Shanghai, Nanjing, Changsha, Chongqing and Hangzhou was 202 798.6,407 875.4, 255 039.0, 123 717.0, 213 724.0 and 384 069.0 minutes respectively, and the manpower needed was 2.0, 4.0, 2.5, 1.2, 2.1 and 3.8 people respectively, averagely 2.6 people.Conclusion The current manpower for HIV/AIDS prevention services is not sufficient to fulfill the demand of HIV/AIDS prevention services in CHSCs after the downward shift of HIV/AIDS prevention services , so it is highly advocated that health administrative departments should strengthen the HIV/AIDS prevention work team construction in the process of downward task -shifting and allocate more HIV/AIDS health service personnel in CHSCs so as to make the HIV/AIDS prevention services sustainable in the long run.