Wang Hai-jun, Jin Shui-gao, Liu Li-hua
National Center for Public Health Surveillance and Information Service, Chinese Center of Disease Control and Prevention, Beijing, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2007 Sep;41(5):348-52.
To develop a conceptual framework for decision-making data elements (indicator) in public health through determining its dimensions, sub-dimensions and their interrelationships.
On the basis of literatures review, conceptual analysis and health determinant models, a conceptual framework was set up. This framework construction followed five principles: evidence-based, applicable, public health relevant, systemic and extensible. While, with the principles of conceptualization, objective-orientation, independence, and number-restriction, the domain and subdomains were also developed.
A conceptual framework consisting of five domains and 20 sub-domains was developed. The 5 domains were health status, non-medical health determinants, public health system performance, the resources of public health system, and characteristics of community and assurance system. The health outcome included three subdomains of health status, functional status, and death; Non-medicine health determinants domain consisted of health behavior, working and living conditions, personal resources and environmental factors; performance domain was made up of effectiveness, accessibility, efficiency, responsibility and safety; resources domain had institution resources, human resources, financial resources, equipment resources and information resources; The characteristics of community and assurance system domain was the last domain which comprises characteristics of community, public health related policy and assurance system. The complicated relationship between these domains was also described.
As the abstraction of public health system, this conceptual framework comprehensively depicts the components of public health system and complicated process of public health system. This framework conforms to the medical care quality model which is made up of structure, process, intermediate results and outcomes.
通过确定公共卫生决策数据元素(指标)的维度、子维度及其相互关系,构建一个概念框架。
在文献综述、概念分析和健康决定因素模型的基础上,建立了一个概念框架。该框架构建遵循五个原则:循证、适用、与公共卫生相关、系统和可扩展。同时,按照概念化、目标导向、独立性和数量限制的原则,确定了领域和子领域。
构建了一个由五个领域和20个子领域组成的概念框架。这五个领域分别是健康状况、非医学健康决定因素、公共卫生系统绩效、公共卫生系统资源以及社区和保障系统特征。健康结果包括健康状况、功能状态和死亡三个子领域;非医学健康决定因素领域由健康行为、工作和生活条件、个人资源和环境因素组成;绩效领域由有效性、可及性、效率、责任和安全性组成;资源领域包括机构资源、人力资源、财务资源、设备资源和信息资源;社区和保障系统特征领域是最后一个领域,包括社区特征、公共卫生相关政策和保障系统。还描述了这些领域之间的复杂关系。
作为公共卫生系统的抽象,这个概念框架全面描述了公共卫生系统的组成部分和公共卫生系统的复杂过程。该框架符合由结构、过程、中间结果和结果组成的医疗质量模型。