新疆县级医院突发公共卫生事件应急能力评估体系的构建

Construction of capability evaluation system of public health emergency response of county-level hospitals in Xinjiang

目的构建适用于新疆县级医院突发公共卫生事件的应急能力评估体系。方法在文献回顾、突发事件调查报告分析及专家咨询的基础上,拟建立评估体系框架,邀请15位专家使用Delphi法为各级指标制定两轮重要性评审,并提出修正建议,按照专家的权威系数对各指标得分进行校正。结果第一轮和第二轮的专家咨询协调系数分别为0.636、0.515,专家的权威程度平均为0.783。本研究的应急能力评估体系含9个一级指标、22个二级指标和52个三级指标。评估体系Cronbach’sα系数为0.922,表明评估体系调查表信度良好。得到的应急能力评估体系的一级指标及其权重分别为应急制度0.1217、应急机构0.1201、疾病预警与监测0.1189、现场救援和医疗救治0.1255、后勤保障0.1065、应急培训与演练0.1143、公众宣传教育0.0835、危机沟通与心理支持0.1057、评估与改进0.1040。运用该体系评估昌吉州14所医疗机构应急能力,按弱、中、强分级,分别占21.43%、50.00%和28.57%。结论昌吉州领域内医疗机构的应急能力有待进一步提升。本研究构建的应急能力评估体系内容广泛,涉及突发事件的各个方面,具有良好的适用性。

Objective To develop the capability evaluation system of public health emergency response of county-level hospitals in Xinjiang.Methods On the basis of literature review,analysis of emergency investigation reports and expert consultation,the framework of emergency capability evaluation system was formulated.Two rounds of consultation among 15 experts were conducted by Delphi method to assign points to the importance of indicators at all levels.The score was adjusted in combination with the authority coefficient of experts.Results The coordination coefficient of the two rounds of expert consultation was 0.636 and 0.515,respectively,and the authority degree of the experts were 0.785.The emergency capability evaluation index system consists of 9 first-level indexes,22 second-level indexes and 52 third-level indexes.The Cronbach’sαcoefficient of the evaluation system was 0.922,indicating that the reliability of the survey scale was good.The first-level indicators and their weights were respectively 0.1217 of emergency system,0.1201 of emergency agency,0.1189 of disease warning and monitoring,0.1255 of on-site rescue and medical treatment,0.1065 of logistics support,0.1143 of emergency training and drill,0.0835 of public publicity and education,0.1057 of crisis communication and psychological support,and 0.1040 of evaluation and improvement.The system was used to evaluate the emergency response capability of 14 medical institutions in Changji prefecture,according to the classification of capability,showing that 3 institutions ranked as weak(21.43%),7 institutions as medium(50.00%)and 4 institutions as strong(28.57%).Conclusions The emergency capability of medical institutions in Changji prefecture needs to be further improved and the evaluation system of public health emergencies established by this research covers all aspects of emergency response capability and has strong applicability.