我国健康农村(县)综合评价指标体系构建研究

目的初步构建一套科学的、适合我国国情的、具有可推广性的"健康农村"(县级层面)综合评价指标体系,为农村地区健康发展建设及评估提供科学参考。方法通过文献研究和专家会议法,确定指标体系框架和指标备选库;在此基础上,进行3轮专家咨询,前2轮采用德尔菲法确定评价指标体系的指标内容;最后一轮采用层次分析法确定指标权重。结果32位相关领域专家参与专家咨询,2轮德尔菲咨询的专家积极系数分别为94.12%和100%,专家权威系数为0.86, 2轮协调系数的显著性检验均P<0. 05。层次分析的判断矩阵一致性比率在0~0.0645,均低于0.1。经过德尔菲咨询和层次分析,构建了以人群健康、健康生活、健康服务、健康环境、健康社会、组织保障为主要结构框架的具有层次性的"健康县"综合评价指标体系,包括6个一级指标、15个二级指标和30个三级指标。一级指标中人群健康所占权重最高,为0.3227,其次为健康生活,为0.1976;人均期望寿命、居民健康素养水平为权重最高的2个三级指标,权重分别为0.1088和0.0941。结论本研究的专家咨询结果可信度较高。构建的指标体系具有较高的科学性、可落地性和可推广性,为政策制定者推进"健康农村"建设提供了一定的科学参考。

Establishment of comprehensive evaluation index system for healthy countryside(county-level) in China

Objective To establish a scientific, suitable, popularized and comprehensive evaluation index system for healthy countryside (county-level), and to provide a scientific reference for construction and evaluation of health development in rural area in China.Methods After literature review and expert discussion for the index system framework and alternative index pool, the content of index system was determined by Delphi method and the index weight was determined by analytic hierarchy process.Results 32 experts were selected into Delphi consultation, the effective response rates of 2 rounds of Delphi consultation were 94.12% and 100% respectively, and experts? authoritative coefficient was 0.86, the significance test of coordination coefficients of 2 rounds of Delphi consultation showed P<0.05.The consistency ratio of judgment matrix of analytic hierarchy was between 0 and 0.0645, all below 0.1.Through 2 rounds of Delphi consultation and 1 round of hierarchical analysis, a hierarchical and comprehensive evaluation index system for healthy county was established, of which framework was composed of health status of population, healthy living, healthy service, healthy environment, healthy society and organizational guarantee, including 6 primary indicators, 15 secondary indicators and 30 tertiary indicators.Among the primary indicators, the weight of health status of population was the highest ( 0.3227 ), followed by healthy life (0.1976).Average life expectancy and residents^ health literacy level were the two three-level indexes with the highest weight, which were 0.1088 and 0.0941 respectively.Conclusion The results of expert consultation were believable.The study established a scientific and comprehensive index system for evaluation of healthy countryside, which could be put into practice and promoted, providing policy makers with scientific references in promoting healthy countryside in China.