Establishment of an evaluation index system for public health responsibilities of secondary and tertiary medical institutions under the integration of medical services and prevention: a case study in Nanjing

Objective To establish an evaluation index system for public health responsibilities in secondary and tertiary medical institutions, thus strengthening the public health functions of medical institutions and enhancing the collaboration between regional medical and public health institutions.

Methods In 2023, in line with China's national and Jiangsu provincial policies and decisions on strengthening the implementation of public health responsibilities in medical institutions, a framework for the evaluation index system was initially developed through interviews, expert discussion, and policy-literature analysis. The Delphi method was then applied with 20 experts across relevant fields over two consultation rounds to establish the evaluation index system for the public health responsibilities in secondary and tertiary medical institutions. The analytic hierarchy process (AHP) was employed to determine the weight of each index.

Results The recovery rates of questionnaires reached 100% in both rounds, with an expert authority coefficient of 0.88 and the coefficient of concordance meeting the criteria (P<0.001). The evaluation index system consisted of 8 first-level indexes, 23 second-level indexes, and 72 third-level indexes. The mean importance scores, appropriateness scores, and total scores for all levels of indexes were not less than 4.00, with a coefficient of variation below 20%. The AHP results revealed that public health safety management (0.194), infectious disease prevention and control (0.147), and immunization services (0.136) are key areas of public health responsibilities for medical institutions.

Conclusions The evaluation index system for public health responsibilities of secondary and tertiary hospitals helps medical institutions clarify key points of public health responsibilities, strengthen the public health responsibilities, optimize the integration paths of medical services and prevention, and enhance the systems and mechanisms for public health services and disease prevention and control.