国家基本公共卫生服务抽样考核Ⅰ型和Ⅱ型错误概率估算

A study on the estimation of typeⅠand type Ⅱ error of national basic public health services supervision through random sampling

目的估算应用国家基本公共卫生服务抽样考核方案进行结果推论时可能犯的Ⅰ型和Ⅱ型错误概率。方法设定一系列被考核地区考核指标总体值,按考核方案规定的样本量和考核标准进行抽样结果推论,应用超几何分布和二项分布原理计算Ⅰ型错误概率和Ⅱ型错误概率。结果当被考核地区指标总体值等于考核标准时,造成由合格误判为不合格的Ⅰ型错误概率如下:健康档案动态使用率为0.41、健康档案合格率为0.26、儿童系统管理率为0.32、产后访视率为0.32、老年人健康体检表完整率为0.35、高血压/糖尿病患者规范管理率为0.37、高血压患者血压控制率为0.34、糖尿病患者血糖控制率为0.43、重性精神疾病患者规范管理率为0.50。当被考核地区指标总体值低于考核标准0.05时,上述各指标由不合格误判为合格的Ⅱ型错误概率分别为0.41、0.54、0.53、0.53、0.51、0.50、0.57、0.47和0.38。结论现行各项考核指标的样本量容易将不合格地区误判为合格地区,为避免误判,应提高指标抽查考核的样本量。

Objective Estimate type I and type II error probability （α,β）of sampling deduction,using sample size set in national basic public health services supervision.Methods Assuming a series of population indicator value of supervised area,αand βwas calculated based on binomial ＆amp; hypergeometric distribution theory according to the sample size and indicator requirements set in supervision plan.Results When the population indicator value of supervised area was just equal to indicator requirements,probability of type I error was as follows,health record utilization rate（0.41 ）,health record qualification rate（0.26）,children systematic management rate（0.32）,postpartum visit rate（0.32）,the elderly health examination form completion rate （0.35 ）,standard administration rate of patients with hypertension or diabetes （0.37）,control rate of blood pressure of hypertension patients（0.34）,control rate of blood glucose of diabetes patients （0.43）,standard administration rate of severe mental illness patients（0.50）.When the population indicator value of supervised area was 0.05 lower than indicator requirements,probability of type II error of those indicator was as follows, 0.41,0.54,0.53,0.53,0.51,0.50,0.57,0.47,0.38.Conclusion Current sample sizes of all indicators result in weak sensitivity of unqualified area detection.In order to avoid mistake,the sample size should be improved.