县域医共体公共卫生工作绩效评价指标体系构建

Construction of evaluation index system for public health performance of county medical community

目的构建县域医疗卫生服务共同体(县域医共体)公共卫生工作绩效评价指标体系,为评价县域医共体公共卫生工作绩效提供依据。方法根据《2019年度浙江省公共卫生工作任务书(县域医共体版)》及县域医共体公共卫生工作现状制订指标体系框架;邀请高等医学院校、疾病预防控制中心和县域医共体的专家20人,采用2轮专家咨询构建指标体系,并采用层次分析法确定指标权重。结果专家年龄为(46.10±6.41)岁,工作年限为(23.85±7.37)年,均为本科及以上学历,18位专家具有副高级及以上专业技术职称。2轮专家咨询表回收率均为100.00%;专家权威系数为0.811;肯德尔和谐系数(W)均有统计学意义(P<0.05),且第二轮咨询的W值均大于第一轮咨询。最终构建了包含10个一级指标,32个二级指标和120个三级指标的县域医共体公共卫生工作绩效评价指标体系;一级指标“重点疾病监测管理”权重最大,为0.1657;二级指标权重前三位依次是“食源性疾病监测”“传染病与突发公共卫生事件报告”“传染病与突发公共卫生事件处置”,分别为0.0715、0.0647和0.0638;三级指标权重前三位依次是“食品安全事故报告及时率”“传染病报告率”“传染病疫情与突发公共卫生事件及相关信息处置率”,分别为0.0394、0.0221和0.0217。结论本次德尔菲法构建的县域医共体公共卫生工作绩效评价指标体系可为卫生行政部门开展评价考核提供参考。

Objective To construct the public health performance evaluation index system for the county medical community,so as to provide reference for the assessment of the public health work in the county medical community.Methods According to the 2019 Public Health Tasks of Zhejiang Province and the current status of the county medical community's public health work,a framework was developed.Twenty experts from universities,CDCs,and county medical community were invited to construct the index system after two rounds of Delphi expert consultation,and the index weight was determined by the analytic hierarchy process.Results The experts aged(46.10±6.41)years and worked for(23.85±7.37)years,all of whom had a bachelor degree or above,and 18 had associate senior titles or above.The response rates of two rounds of consultation was both 100.00%;the authority coefficient was 0.811;the values of Kendall's W all had statistical significance(P<0.05),which in the second round were higher than those in the first round.The public health performance evaluation index system for county medical community finally included 10 first-level indexes,among which priority diseases surveillance and management weighed most(0.1657);32 second-level indexes,among which food-borne diseases surveillance,infectious diseases/public health emergencies reporting and infectious diseases/public health emergencies response weighed the top three(0.0715,0.0647,0.0638);120 third-level indexes,among which the timely reporting rate of food safety incidents,the reporting rate of infectious diseases and the information response rate of infectious diseases/public health emergencies weighed the top three(0.0394,0.0221,0.0217).Conclusion The public health performance evaluation index system of the county medical community has been established,which can provide reference for the health administrative departments.