国家卫生指标体系:概念框架与基本属性

目的:建立一套既适合我国国情,又能与国际接轨的卫生统计指标体系的概念框架。方法:通过现场调研和访问相关网站,进行国内外相关文献的收集与检索;分别在国家和省级两个层面,通过组建专家组、召开研讨会和函询的方式完成指标筛选;用UML作为建模语言,描述框架的基本属性。结果:概念框架由健康状况、卫生系统和环境与行为影响因素3个维度组成,其中健康状况维度包括人口特征、发病与患病、失能与残障、营养与发育、死亡5个类;卫生系统维度包括疾病预防与控制、医疗服务、妇幼保健、卫生监测、卫生资源5个类;环境与行为影响因素维度包括地理与环境因素、社会经济因素、医疗保障、危险因素5个类。在670个指标组成的基础卫生统计指标体系最终遴选了其中211个指标作为各个类的基本属性,构成卫生统计指标集。指标集的每一个指标均反映了健康状况及其影响因素的特定方面。用UML视图展示了国家卫生统计指标概念框架三个维度之间的关系,以及三个维度内部的指标分类及类间关系。结论:本研究所确定的211个统计指标对于开发基于网络直报的国家卫生信息系统具有重要的指导意义。经过进一步补充完善,可作为国家层面卫生统计信息的基本指标集,应用于反映人民健康状况、卫生系统工作绩效和卫生管理和卫生服务的辅助决策。

Defining Chinese National Health Indicators:a Conceptual Framework and Attributes

Objective: To present a draft set of health indicators. The set is suited with the characteristics of health sector of China and conformable with international normal about health information. Methods: A systematic review of health information need at national and international (provincial) level was carried out. Two working groups of experts were organized at national and local (provincial) level. The diagrams in UML were used to define the high level interactions of the selected indicators related to health. Results: We identified 670 health indicators after a review of the information collected at the national and international level. 211 of 670 were defined as a minimum set of the national health indicators. Each of them represented a specific aspect of health status and factors related to health. The UML diagrams showed the relationship among the indicators. Conclusions: All of 211 health indicators chosen are crucial for developing a web based reporting system. After overcoming the limitations that emerged, the set of health indicators will allow to be carried out in China.