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

  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.