城乡一体化背景下公共卫生服务体系绩效评价指标的构建研究

摘要:目的　以城乡一体化为背景，从公共卫生投入、产出和效果三个维度构建公共卫生服务体系绩效评价指标。方法　采用专家咨询方法，经过两轮专家咨询，建立评价指标框架。结果　两轮专家咨询回收率分别为83.3%和93.3%，权威程度分别为0.557和0.709，协调系数分别为0.173和0.486（χ2＝803.654，P＜0.01），差异具有统计学意义。确立了以投入、产出和效果为主体框架的城乡公共卫生服务体系绩效评价指标，包括一级指标3个，二级指标13个，三级指标33个，3个一级指标的权重分别为0.2080，0.5791和0.2129。结论　该指标框架的可靠性和可信性程度较高。投入指标突出了城乡公共卫生服务的政府职能，产出指标涵盖了城乡公共卫生服务的重要内容，强调了公共卫生服务过程，效果指标契合了WHO卫生系统目标的价值取向，具有很强的代表性、实用性和可操作性。

Performance evaluation indexes of public health service system under the background of integration of urban and rural areas

Abstract: Objective Under the background of integration of urban and rural areas, the performance evaluation indexes of the public health service system was constructed from public health input, output and effect three dimensional. Methods The method of expert consultation was adopted. Through two rounds of expert consultation, the framework of the performance evaluation indexes was built. Results The rates of experts response were 83.3% and 93.3%, and the weights of experts' authorities were 0.557 and 0.709. The corresponding coefficients of experts' opinions were 0.173 and 0.486 respectively. The difference was statistically significant (χ2=803.654, P<0.01). Regarding input, output and result as the main body frame, the performance evaluation indexes for urban and rural public health service system were established including 3 indexes at the first level, 13 indexes at the second level and 33 indexes at the third level. The weights of the 3 indexes at the first level were 0.2080, 0.5791 and 0.2129, respectively. Conclusion The reliability and credibility of the index framework are high. Input indexes highlight the government's functions of urban and rural public health service. Output indexes cover the important contents of urban and rural public health services and emphasize the public health service process. Result indexes correspond to the orientation of value of the health system target which WHO has defined. The index framework is scientific, practical and operational.