基于TOPSIS法与RSR法结合的湖北省基本公共卫生服务质量综合评价

目的 综合评价在新冠疫情背景下湖北省基本公共卫生服务开展情况，为卫生部门决策提供参考。 方法 采用TOPSIS法（Technique for Order Preference by Similarity to an Ideal Solution，TOPSIS）对湖北省17个市州2020年基本公共卫生服务工作质量进行综合评价，利用多元逐步回归分析探讨主要影响因素，并结合秩和比法（Rank-sum ratio，RSR）对评价结果进行分档。结果 TOPSIS结果显示，湖北省17个市州中，排名前三位的分别是荆门市、天门市与仙桃市，排名后三位的分别是襄阳市、黄石市与神农架林区，多元逐步回归分析结果显示，X4（基本公共卫生服务知晓率）、X5（高血压患者规范管理率）、X9（儿童健康管理率）、X13（含麻疹成分疫苗接种率）、X14（新冠患者2周复查率）、X15（新冠患者4周健康监测率）与X16（新冠患者半年随访率）等7个指标是评价结果的主要影响因素，结合RSR法将结果分档，荆门市、天门市与仙桃市为较好档次，黄石市与神农架林区为较差档次，剩余12个为中等档次。结论 湖北省各市州间基本公共卫生服务质量存在差异性，应加强基本公共卫生服务宣传，提升居民认识程度，关注高血压、儿童与新冠患者等重点人群的健康管理工作，提升居民健康质量。

Comprehensive evaluation of basic public health services in Hubei based on TOPSIS and RSR methods

Objective To comprehensively evaluate the quality of basic public health services in Hubei province against the background of COVID-19, and to provide references for health departments to make decisions.]Methods TOPSIS (Technique for Order Preference by Similarity to an Ideal Solution) method was used to comprehensively evaluate the basic public health service quality of 17 cities in Hubei province in 2020. Multiple stepwise regression analysis was applied to explore the main impact indicators of comprehensive evaluation, and RSR（Rank-sum ratio） method was used to classify the evaluation results.]Results The results of TOPSIS method showed that among 17 cities of Hubei, Jingmen city, Tianmen city and Xiantao city had the front ranking, and Xiangyang city, Huangshi city and Shennongjia Forestry District had the back ranking. Multiple stepwise regression results showed that the X4 (basic public health service awareness), X5 (hypertension health management rate), X9 (children health management rate), X13 (Measles vaccination coverage rate), X14 (COVID-19 patients review rate in 2 weeks), X15 (COVID-19 patients management rate in 4 weeks) and X16 (COVID-19 patients management rate in half year) were the main influencing factors. Combined with the RSR method, the evaluation results were divided into three grades, with Jingmen city, Tianmen city and Xxiantao city as good grades, Huangshi city and Shennongjia Forestry as poor grades, and other 12 cities as medium grades.]Conclusion There are differences in the quality of basic public health services among different cities in Hubei province. It is necessary to strengthen the publicity of basic public health services and to improve the awareness of residents, and it is important to pay attention to the health management of key groups such as hypertension, children and COVID-19 patients, and to improve the health of residents.