公共卫生体系绩效评估的概念性框架

A Conceptual Framework of Performance Assessment for Public Health System

文章提出了一个评估公共卫生系统绩效的概念性框架 ,该框架将整个系统分为全国、地区两个层次 ,以Donabedian的理论为基础 ,将系统目标与持续性质量改善模式中的结构、过程、产出和结果及外部环境 5个部分联系在一起。该评估框架可以用来监测公共卫生系统、具体的机构及项目的绩效。尽管目前测量公共卫生系统绩效还存在一定的困难 ,但相信随着评估技术的不断改进 ,公共卫生系统的绩效将会得以改善 ,最终改善人群的健康状况。

This paper proposes a conceptual framework for public health system as a way to facilitate the measurement of public health system performance on the basis of the work of Donabedian. The framework is differentiated at national and local levels. It consists of five components that structural capacity, processes, outcomes, mission and macro context and there are relationships to each other. Although the availability of measurements for each of these components varies, the framework can be used to examine the performance of public health systems as well as that of agencies and programs. Although there are some obstacles in the performance assessment for public health system, it will be improved as the assessment technique is developed in future. Hence, people's health status will be improved.