全球卫生安全指数评估有效性分析

Effectiveness analysis of global health security index(GHSI)assessment

目的研究全球卫生安全指数(Global Health Security Index,GHSI)与COVID-19疫情的关系,探索GHSI的价值。方法对来自公开数据库的159个国家(地区)进行横断面研究。用Spearman分析GHSI与COVID-19大流行的相关性,并绘制相关性矩阵。拟合多元线性回归模型控制各国社会经济及健康状况等因素,进一步研究GHSI与COVID-19大流行相关指标的关联。结果159个国家(地区)2021年GHSI总分平均(41.19±13.41)分,最小值16.10分(也门),最大值75.90分(美国)。截至2021年12月31日159个国家(地区)COVID-19粗病死率0.02(0.01,0.03),最小值<0.01(不丹),最大值0.20(也门)。每百万人口总确诊病例数50844.42(5807.88,101572.70)例,最小值22.26(瓦努阿图共和国),最大值251608.38(斯洛伐克)。每百万人口总死亡病例数590.71(105.66,1533.20),最小值3.10(布隆迪),最大值6075.95(秘鲁)。多元线性回归分析显示,GHSI检测报告评分与每百万人口总确诊病例呈负相关(β=-0.34,P=0.038),与每百万人口总死亡病例呈负相关(β=-0.42,P=0.025);GHSI国际规范评分与每百万人口总确诊病例呈负相关(β=-0.49,P=0.041),GHSI卫生系统评分与每百万人口总死亡病例呈正相关(β=0.65,P=0.003),GHSI风险环境评分与粗病死率呈负相关(β=-0.91,P=0.044)。结论GHSI在评估各国家(地区)应对COVID-19大流行的能力方面缺乏有效性,但仍存在一定价值。

Objective To investigate the correlation between Global Health Security Index(GHSI)and the epidemic situation of COVID-19 and to explore the value of GHSI.Methods A cross-sectional study of 159 countries from an open database was conducted.Analyze the correlation of GHSI with the COVID-19 pandemic with Spearman and plot the correlation matrix.Fitted multiple linear regression models controlled for variables such as socioeconomic and health conditions in countries,and further studied the association of GHSI with COVID-19 pandemic outcome indicators.Results The mean total GHSI score of the 159 countries in 2021 was(41.19±13.41),with a minimum of 16.10(Yemen)and a maximum of 75.90(The United States).As of 31 December 2021,the crude case fatality rate of COVID-19 in 159 countries was 0.02(0.01,0.03),with a minimum<0.01(Bhutan)and a maximum of 0.20(Yemen).The total number of confirmed cases per million population was 50844.42(5807.88,101572.70),with a minimum of 22.26(Republic of Vanuatu)and a maximum of 251608.38(Slovakia).The total number of deaths per million population was 590.71(105.66,1533.20),with a minimum of 3.10(Burundi)and a maximum of 6075.95(Peru).Multiple linear regression analysis results showed that the Detect score of GHSI was negatively correlated with the total confirmed cases per million population(β=-0.34,P=0.038)and the total deaths per million population(β=-0.42,P=0.025);the Norms score of GHSI was negatively correlated with the total confirmed cases per million population(β=-0.49,P=0.041),and the Health score of GHSI was positively correlated with the total deaths per million population(β=0.65,P=0.003).Risk score of GHSI was inversely correlated with case fatality rate(β=-0.91,P=0.044).Conclusion The GHS Index has limited value in assessing a country’s capacity to respond to the COVID-19 pandemic.Nevertheless,it has potential value in others.