Objective To construct an effect-oriented comprehensive evaluation index system for national basic public health services, and to provide methods and tools for innovating evaluation method of basic public health projects and promoting the transformation from process evaluation to health outcome evaluation.
Methods Primary, secondary and tertiary indexes were constructed and selected with literature review, field interview of senior professionals, expert Delphi consulting and logical analysis; subjective and objective weights of the indexes were calculated through analytic hierarchy process and entropy weight method.
Results Through literature analysis and interview consultation, an index pool consisting of 3 first-, 25 second- and 104 third-level indicators was preliminarily formed, including 47 third-level indicators reflecting health effects. For the first round of expert Delphi consultation on indicator screening, the positive coefficient of experts is 97.5%, the expert authority coefficient is 0.82, and the expert familiarity coefficient is 0.88. The final comprehensive evaluation index system consists of three first-level indexes of project investment, implementation and health effect, with the weights of 11.35%, 26.48% and 62.18%, along with 20 second- and 54 third-level indexes. Among the health effect indicators, the weight of awareness of and satisfaction to health services was the highest (16.39%), followed by the weight of health management in chronic disease patients (14.97%), children′s health management (12.42%), maternal health management (12.42%), and health education (5.43%). Among the three-level effect indexes, the weight of residents′ satisfaction to health service was the highest (7.25%), followed by the incidence of hypertension and diabetes complications in the managed population (5.35%) and the incidence of diabetes complications in the managed population (5.27%). Besides the health statistics from routine monitoring system in China, the electronic health records in residents′ information system can be used as a main data source for health effect indicators.
Conclusion The comprehensive index system constructed in this study for the evaluation on essential national public health service is effect-oriented and can be used for regular and periodical evaluation on the basis of making full use of residents′ health records in the basic public health information system.
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