Gonzalez-Bautista Emmanuel, Morsch Patricia, Gonzalez Cynthia, Vega Enrique
Gerontopole Toulouse University Hospital Toulouse France Gerontopole, Toulouse University Hospital, Toulouse, France.
Health Systems and Services Pan American Health Organization Washington, D.C. United States of America Health Systems and Services, Pan American Health Organization, Washington, D.C., United States of America.
Rev Panam Salud Publica. 2023 Aug 2;47:e103. doi: 10.26633/RPSP.2023.103. eCollection 2023.
The objective of this article was to provide a consensus-based short list of effective indicators to measure health system responsiveness to the needs of older adults which would be relevant to informing public policy. An e-Delphi study was done with no direct interaction between respondents. Virtual surveys were sent to 141 participants with experience in analysis and monitoring of health indicators, management of health systems, and health care of older adults. A baseline list of 24 previously published indicators was used. The criteria for selection as high priority indicators were: usefulness as a tracer of health system responsiveness and usefulness to inform policy. Consensus was defined as: ≥70% agreement among the participants that the indicator was very high or high priority; plus being benchmarked by ≥50% of respondents as having a higher relative weight than other indicators; plus being in the top 10 in the ranking list. The first round of the process included 38 participants with varied professional backgrounds. Consensus was reached for seven indicators after two rounds. Five indicators were related to distal outcomes (mortality, disability, or healthy life expectancy), one to monitoring functional assessments, and one to poverty levels. Health systems professionals should consider these comprehensive priority indicators in their efforts to provide a better health system for older people.
本文的目的是提供一份基于共识的有效指标简短清单，以衡量卫生系统对老年人需求的响应能力，这将有助于为公共政策提供参考。开展了一项电子德尔菲研究，参与者之间没有直接互动。向141名在卫生指标分析与监测、卫生系统管理以及老年人医疗保健方面有经验的参与者发送了虚拟调查问卷。使用了一份包含24个先前已发表指标的基线清单。选为高度优先指标的标准是：作为卫生系统响应能力的追踪指标有用，以及对政策制定有参考价值。共识的定义为：≥70%的参与者认为该指标为非常高或高优先级；加上≥50%的受访者将其作为比其他指标具有更高相对权重的基准；加上在排名列表中位列前十。该过程的第一轮有38名专业背景各异的参与者。两轮之后就七个指标达成了共识。五个指标与远端结果（死亡率、残疾率或健康预期寿命）相关，一个与功能评估监测相关，一个与贫困水平相关。卫生系统专业人员在努力为老年人提供更好的卫生系统时应考虑这些综合优先指标。
