健康贫困测度工具开发：评价指标体系与多维测度指数构建

赖勇强; 李叶; 吴群红; 张曦宇; 孙宏; 梁立波; 李红雨; 田雨露

doi:10.11847/zgggws1141547

健康贫困测度工具开发：评价指标体系与多维测度指数构建

Establishment of an index system and multidimensional indexes for health poverty measurement: a literature review and Delphi method study

摘要

摘要:
目的突破现有健康贫困测度工具缺乏的研究局限，构建以“健康能力 – 健康权利 – 健康风险”为内容维度的健康贫困评价指标体系与多维测度指数，为健康贫困测度提供相应工具集。
方法通过文献研究初步确定健康贫困评价指标体系，采用德尔菲专家咨询法和定性访谈法征询来自健康贫困较为严重的边境地区以及在健康扶贫实践方面处于领先水平地区的10名资深专家的意见对指标进行筛选，采用层次分析法进行指标权重的计算，从多维角度构建健康贫困测度工具集，并采用关键绩效指标法及“双界限法”构建多维健康贫困测度指数。
结果 2轮专家咨询的积极系数均为100%，专家咨询的权威系数分别为0.815和0.867；第1、2轮二级指标和三级指标专家意见的协调系数分别为0.342和0.233、0.487和0.353（均P < 0.05），专家意见的协调性较好；经过2轮专家咨询及定性访谈后，以健康权利、健康能力和健康风险作为框架构建了包含3个一级指标、11个二级指标和39个三级指标的健康贫困评价指标体系，并通过关键绩效指标法及“双界限法”构建了包含健康权利、健康能力和健康风险3个维度10个具体指标的多维健康贫困测度指数。
结论本研究构建的集“评价指标体系 – 关键绩效指标体系 – 多维测度指数”为一体的健康贫困测度工具集，实现了对多维健康贫困测度、时空分布格局描绘和健康贫困人群的特征刻画，为多维健康贫困的消除提供了理论方法与测度工具的支撑。

Abstract:
Objective To establish an index system with three dimensions of health capacity, right and risk and multidimensional indexes for the measurement of household health poverty.
Methods An indicator system for evaluating health poverty was preliminary established through reviewing 225 relevant studies published in Chinese or English from 1983 till 2023. Delphi qualitative interview and two rounds of consultation were conducted among 10 senior experts working in regions with higher prevalence of health poverty or better implementation of healthy poverty alleviation to screen the identified indicators. The weights of the selected indicators were calculated using hierarchical analysis and a set of multidimensional health poverty indexes was constructed using the key performance indicator method and the Alkire-Foster method.
Results For the two rounds of expert consultation, the positive coefficient was 100% and the authority coefficients were 0.8145 and 0.8667; the coordination coefficients of the experts′ opinions on the second/third level indicators were 0.342/0.233 and 0.487/0.353 for the first and second round of consultation, respectively (all P < 0.05), indicating a good coordination between the expert opinions. According to the results of the expert consultations and qualitative interviews, a health poverty evaluation index system was constructed; the index system includes 3 primary, 11 secondary, 39 tertiary indicators covering the three dimensions (health right, capability and risk) for health poverty measurement; in addition, 10 specific indicators were screened out from all the indicators for the measurement of multidimensional health poverty using key performance indicator method and double threshold method based on Alkire-Foster model.
Conclusion The study establishes the index system and multidimensional indexes for household-based measurement on health poverty and multidimensional health poverty and the index system could provide a reference to the promotion of healthy poverty alleviation in China.

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