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基本公共卫生服务项目效果评价概念框架与指标体系构建

Development of a conceptual framework and indicator system for evaluating basic public health service projects: a literature review and expert consultation study

  • 摘要:
    目的 构建基本公共卫生服务项目效果评价概念框架和指标体系,为实施基本公共卫生服务项目效果评估提供科学思路与工具。
    方法 于2021 — 2022年,课题组以健康产出为导向,根据公共卫生服务特点和我国基本公共卫生服务项目内容,以及相关的理论模型,对基本公共卫生服务项目效果评价基本维度进行阐释,并据此构建概念框架。经个别深入访谈、德尔菲专家咨询和专家座谈会筛选、建立效果评价指标体系,此后采用层次分析法确定指标权重。
    结果 我国基本公共卫生服务项目效果评价概念框架包括居民健康素养水平提升、健康状况改善、环境危险因素减少、相关卫生政策制度创新与完善、供需双方满意度提高5个方面。专家咨询结果显示,德尔菲专家熟悉程度系数为0.92,判断系数为0.88,权威系数为0.9。本研究最终建立了包含5个一级维度、18个二级指标、52个三级指标的基本公共卫生服务项目效果评价指标体系,指标数据可通过卫生信息监测系统和线上调查获得。在一级维度权重方面,健康状况权重最高(0.4482),其次为健康素养权重(0.2058)。
    结论 本研究构建的基本公共卫生服务项目效果评价概念框架和指标体系突出了健康结果价值导向,具有较高的科学性和可靠性;能够充分利用卫生信息监测资料,具有较好的可操作性;指标体系内容涵盖全面,可作为开展基本公共卫生服务项目效果评估的科学工具。

     

    Abstract:
    Objective To develop a conceptual framework and a system of indicators for evaluating the effectiveness of basic public health services projects, and to provide scientific approaches and tools for such evaluations.
    Methods Guided by the health output, and considering the characteristics of public health services and the content of China′s basic public health service projects, as well as relevant theoretical models, we elaborated on the basic dimensions of evaluating the effectiveness of basic public health service projects and constructed a conceptual framework based on the elaboration between 2021 and 2022. Through in-depth individual interviews, Delphi expert consultations, and expert panels, an indicator system for evaluating the effectiveness of a basic public health services project was developed and the weights of the indicators were determined using the analytical hierarchy process.
    Results The conceptual framework developed to evaluate the effectiveness of China′s basic public health projects includes five aspects: improving population health literacy, improving health status, reducing environmental risk factors, innovating and improving related health policies and systems, and increasing supply and demand satisfaction. The results of the expert consultation showed that the Delphi experts′ familiarity coefficient was 0.92, the judgment coefficient was 0.88, and the authority coefficient was 0.9. Ultimately, the study created an indicator system for evaluating the effectiveness of basic public health projects that includes 5 primary dimensions, 18 secondary indicators, and 52 tertiary indicators. Data relevant to the indicators could be collected through health information monitoring systems and online surveys. Regarding the weights of the primary dimensions, the highest weight was assigned to health status (0.448 2), followed by health literacy (0.205 8).
    Conclusion The conceptual framework and indicator system for evaluating basic public health service projects constructed in this study emphasize a value-oriented approach to health outcomes with high accuracy and reliability. This system fully utilizes available health information monitoring data, demonstrates good operability, and comprehensively covers evaluation contents, positioning it as a scientific tool for evaluating the effectiveness of basic public health service projects.

     

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