基于熵值TOPSIS法对四川省县级基本公共卫生服务项目实施效果的综合评价

Basic public health services at county level in Sichuan Province based on entropy TOPSIS method comprehensive evaluation of health management effect

目的了解2021年四川省县级地区基本公共卫生服务健康管理现状与项目实施效果差异。方法采取熵值TOPSIS法对2021年四川省县级地区基本公共卫生服务项目实施情况进行综合评价。通过分层随机抽样在四川省所辖21个地区选取1个县(市区),再从中各选取2个基层机构为代表进行编号处理,借助四川省基本公共卫生服务管理平台等,等距随机抽取管理人群获取工作指标数据,使用熵值法计算出重点人群健康管理中各工作指标所占权重,使用TOPSIS法对项目实施效果进行综合评价,通过聚类分析进行合理分档,各组间差异采用单因素方差检验,以P<0.05具有统计学意义。结果重点人群的健康管理中,慢性病健康管理所占权重较高,其中高血压患者规范管理率权重最高,变异程度最大;TOPSIS法综合评价21个地区项目实施差异,结果显示泸州市合江县评价结果为优秀,表明项目实施情况最佳,县级地区间项目实施存在差异。结论四川省县级地区以高血压患者健康管理为代表的慢性病健康管理具有一定难度,需要采取多种手段加强慢性病管理;县级地区之间项目实施存在一定差异,尤其要重视民族地区项目实施能力提升,需要进一步强化项目管理,逐步缩小项目实施的地区差异,推进基本公共卫生服务均等化目标实现。

Objective To understand the health management status of basic public health services and the difference of project implementation effect in county areas of Sichuan province in 2021.Methods The entropy TOPSIS method was adopted to comprehensively evaluate the implementation of basic public health service projects at county areas in Sichuan province in 2021. Through stratified random sampling method,one county(urban area) was chosen from 21 areas of sichuan province,then two base agencies were selected as a representative for number processing,with the help of Sichuan Basic Public Health Services Management Platform, managment population were abstracted by isometric random sampling method, so that to get their job indicator data, various indexes of work of health managment in key crowd were calculated by entropy method and weighted, TOPSIS method was used to comprehensively evaluate the implementation effect of the project,and reasonable classification was carried out through cluster analysis. One-way variance test was used to test the differences among groups,and P<0.05 was considered statistically significant.Results In the health management of the key population, the weight of chronic disease health management was high, among which the weight of standardized management rate of hypertension patients was the highest, and the variation degree was the largest. TOPSIS method was used to comprehensively evaluate the differences of project implementation in 21 regions. The results showed that Hejiang county of Luzhou city had excellent evaluation results, indicating that the project implementation was the best, and there were differences in project implementation among countylevel regions. Conclusions The health management of chronic diseases represented by the health management of hypertensive patients in county areas in Sichuan province is difficult to some extent, and it is necessary to take various measures to strengthen the management of chronic diseases. There are certain differences in project implementation among county areas, and special attention should be paid to improving project implementation capacity in ethnic minority areas.Project management should be further strengthened, and regional differences in project implementation should be gradually reduced to promote the realization of equal access to basic public health services.