Dai Xin, Jiang Yiru, Li YingYing, Wang XiaoXue, Wang Rongrong, Zhang Yuanyuan
School of Public Health, Dalian Medical University, Dalian, Liaoning Province, China.
Arch Public Health. 2023 Aug 17;81(1):149. doi: 10.1186/s13690-023-01151-x.
By analyzing 23 evaluation indicators included in 14 national basic public health service programs in a region of Hohhot City, Inner Mongolia Autonomous Region, China, the performance of basic public health services in the region in 2021 were analyzed to clarify the implementation and conduct of relevant programs. We also use this study as a basis to radiate the work of municipal basic public health services centered on the region and the outstanding problems reflected and to provide theoretical contents and suggestions that can be referred to for the same regions in central and western China as well as worldwide.
Using the TOPSIS method as the basis for the data analysis method, the evaluation indexes are ranked in terms of their proximity to the idealized target, and combined with the entropy value method, Technique for order preference by similarity to an ideal solution (TOPSIS) and rank-sum ratio (RSR) were used to rank 14 basic health care providers by grade. A comprehensive evaluation of the performance of basic public health services in a region of Hohhot City, Inner Mongolia Autonomous Region in 2021 was conducted through a joint model of entropy -weighted TOPSIS and RSR, making full use of the characteristics and advantages of the fuzzy joint, and conducting a comprehensive analysis from the perspective of the ratio weight and the method of graded calculation, making the study more distinguishable and measureable.
In this study, for the regional basic public health services, a total of 23 evaluation indicators of basic public health service projects were included, among which the top three indicators with the weight of the entropy value method indicators were found to include the rate of Chinese medicine health management for the elderly, the rate of health management for the elderly, and the BCG vaccination rate after the analysis of the weight of the indicators; After the entropy-weighted TOPSIS evaluation showed that the Ci values of the regions were found to be between 0.378 and 0.715 through the calculation of the positive and negative ideal values of each indicator; RSR staging method evaluation showed that three community health centers (X2, X10, X12) had excellent evaluations of basic public health services; The number of evaluations as poor and moderate are 2 (X3, X9) and 9 (X1, X4, X5, X6, X7, X8, X11, X13, X14), respectively; Finally, the results of the entropy-weighted TOPSIS method and the fuzzy joint model of RSR staging method are basically consistent with the overall trend of the above two methods, and the reliability and credibility of the research results are high.
The entropy-weighted TOPSIS and RSR joint model can evaluate the effectiveness of basic public health services in a more comprehensive and holistic way. The results of the RSR staging results and the related weight ratio analysis show that the basic public health service programs in Hohhot, Inner Mongolia Autonomous Region are relatively balanced, but there are some differences; The same genus of elderly Chinese medicine health management rate, health management rate of the elderly, BCG vaccination rate several indicators accounted for a higher weight, its correlation with the key population-related items is high, suggesting that the future key population health service items should be focused on, and future research should be suggested from two key research.
通过对内蒙古自治区呼和浩特市某地区14项国家基本公共卫生服务项目中包含的23项评价指标进行分析,剖析该地区2021年基本公共卫生服务的绩效,以明确相关项目的实施与开展情况。我们还以此研究为基础,辐射以该地区为中心的市级基本公共卫生服务工作及所反映的突出问题,并为中国中西部以及全球的同类地区提供可参考的理论内容与建议。
以逼近理想解排序法(TOPSIS法)作为数据分析方法的基础,依据评价指标与理想化目标的接近程度进行排序,并结合熵值法,运用逼近理想解排序法(TOPSIS)和秩和比(RSR)对14家基层医疗卫生机构进行等级排序。通过熵权TOPSIS与RSR的联合模型,对内蒙古自治区呼和浩特市某地区2021年基本公共卫生服务绩效进行综合评价,充分利用模糊联合的特点与优势,从比值权重和分级计算方法的角度进行综合分析,使研究更具区分度和可测性。
本研究针对该地区基本公共卫生服务,共纳入23项基本公共卫生服务项目评价指标,经指标权重分析发现,熵值法指标权重排名前三的指标包括老年人中医药健康管理率、老年人健康管理率、卡介苗接种率;经熵权TOPSIS评价,通过计算各指标的正、负理想值,得出该地区的Ci值在0.378至0.715之间;RSR分级法评价显示,有3家社区卫生服务中心(X2、X10、X12)基本公共卫生服务评价为优秀;评价为差和中等的数量分别为2家(X3、X9)和9家(X1、X4、X5、X6、X7、X8、X11、X13、X14);最后,熵权TOPSIS法与RSR分级法的模糊联合模型结果与上述两种方法的总体趋势基本一致,研究结果的可靠性和可信度较高。
熵权TOPSIS与RSR联合模型能够更全面、整体地评价基本公共卫生服务的成效。RSR分级结果及相关权重比分析结果表明,内蒙古自治区呼和浩特市基本公共卫生服务项目相对均衡,但存在一定差异;同属老年人中医药健康管理率、老年人健康管理率、卡介苗接种率几个指标占比较高权重,其与重点人群相关项目的关联性较大,提示未来应重点关注重点人群健康服务项目,且建议未来研究从两个重点方面开展。