突发公共卫生事件监测预警制度框架体系核心要素研究

The study on building the frame of public health emergencies monitoring and early-warning system with Delphi method

目的:通过德尔菲法对突发公共卫生事件监测预警制度框架体系的核心内容进行筛选和修订,初步建立监测预警制度框架体系,为制度建设提供参考依据。方法:在文献研究和专题小组讨论的基础上,拟定监测预警制度三级框架体系,建立专家咨询量表,采用Delphi法对20名专家开展两轮专家咨询,对框架的重要性和可操作性两个维度进行评价。结果:两轮调查的专家积极系数分别为85%和80%。结合首轮专家咨询的分析结果及专家研讨,删除7个核心环节,并新增3个关键要素及4个核心环节内容。经过两轮专家咨询,最终确立了包括4个概念模块,19个关键要素及39个核心环节的三级监测预警制度框架体系。结论:两轮调查结果表明,专家一致认为在制度设计与建设过程中要优先考虑制度的可操作性;监测、风险评估、预警和制度保障是公共卫生突发事件监测预警制度的四个核心要素;研究建立的制度框架体系具有较强的适用性和科学性,能够为后期的制度建设提供参考依据。

Objective： To establish the initial frame of monitoring-warning system after screening and revising the framework of monitoring and early-warning system of public health emergency monitoring through Delphi method, therefore, provide references for the system construction. Methods： Firstly, we drew up a three-level framework of monitoring-warning system and built an expert questionnaire through the method of literature review and focused group discussion; and then, the two round Delphi investigations were conducted on 20 experts in order to evaluate the im- portance and operability of these indexes. Results： Positive coefficients in these two round investigations were 85 % and 80% respectively. In the first investigation, 7 core links were canceled, and added 3 key elements and 4 core links. After two rounds of expert consultation, and finally established the three-level monitoring and early warning system framework which include 4 concepts model, 19 key elements and 39 core links. Conclusion：After two round investigations, it was indicated that the operability had a prior consideration in formulating the system; and the four core elements of public health emergencies monitoring and early-warning system were consisted of monitoring, risk as- sessment, early-warning and system-guaranteeing. The system framework is scientific, feasible and applicable, which will provide reference and guideline for further research.