二级及以上公立综合医疗机构公共卫生任务评估指标体系构建

摘要

Objectives: To make an evaluation index and weight system of public health for secondary and above level hospitals based on the analysis of public health roles in secondary and above hospitals in Zhejiang province. Methods: The indexes were filtered by the method of literature analysis and Delphi method. Analytical hierarchy process (AHP) was used to calculate the weights of each index. Results: The positive coefficient of experts was 100％, the expert authority coefficient was 0.858. The Kendall coordination coefficient was 0.324, P<0.001, the average of importance of each index was above 8.00, and the variation coefficient was less than 0.30 after two rounds of experts consultation. According to the comprehensive score of experts and application of AHP to determine weights of all indexes, the evaluation index system of public health mission of secondary and above medical institutions including 8 first-level indexes, 28 second-level indexes and 63 third- level indexes. According to the weight coefficient, the top three first-level indexes were public health organization and management, diagnosis and management of infectious diseases, lawful practice, which is in line with the actual practice of second grade and above medical institutions. Conclusions: The establishment of the evaluation index system of public health mission will provide guaranteed for medical institutions better to carry out the public health mission, and provide basis for further study of public health work cost estimates of secondary grade and above medical institutions.%目的:结合浙江省二级及以上公立综合医疗机构开展公共卫生工作实际,梳理二级及以上公立综合医疗机构公共卫生任务,构建评估指标体系并计算各指标权重.方法:利用德尔菲专家咨询法和层次分析法,选择恰当的二级及以上公立综合医疗机构公共卫生任务指标建立评估指标体系,并确定各指标权重.结果:专家咨询积极系数为100％,权威系数为0.858,经过2轮专家咨询后Kendall's W=0.324,P<0.00l,各指标重要性均值都在8.00以上,变异系数均小于0.30.构建二级及以上公立综合医疗机构公共卫生任务评估指标体系,包括8个一级指标、28个二级指标和63个三级指标.权重系数排前三位的一级指标为公共卫生组织与管理、传染病与重点传染病诊疗管理和依法执业,符合二级及以上公立综合医疗机构开展公共卫生工作实际.结论:选择符合实际的指标建立二级及以上公立综合医疗机构公共卫生任务评估指标体系,为医疗机构更好地开展公共卫生工作提供保障,也为深入研究二级及以上公立综合医疗机构公共卫生成本测算提供依据.