Cheng Kangyao, Xu Ziwei, Zhang Yanyan, Chen Rujie, Gui Li
School of Nursing, Naval Medical University, No.800 Xiangyin Road, Shanghai, 200433, China.
School of Nursing, Shanghai University of Traditional Chinese Medicine, No.1200 Cailun Road, Shanghai, 201203, China.
BMC Public Health. 2025 Apr 10;25(1):1337. doi: 10.1186/s12889-025-22549-y.
The frequent outbreak of infectious diseases has presented unparalleled challenges to hospitals globally. The pressure exerted on healthcare systems during these crises accentuates the imperative need for enhanced management and resource allocation, further emphasizing the pivotal role of hospital resilience. As the vanguard in combating infectious disease outbreaks, bolstering hospital resilience has become a strategic imperative to fortify healthcare systems against the unpredictable and volatile landscape of global health threats. Consequently, in this study, we aimed to develop an index system for the comprehensive evaluation of hospital resilience in response to emerging infectious diseases.
Drawing on the World Health Organization "Action Framework" for responding to infectious disease outbreaks, the Delphi method was implemented to identify the core evaluation index of hospital resilience in the context of emerging infectious diseases. In this method, we assembled a panel of 16 health experts specializing in medical statistics, infectious disease prevention and control, emergency medicine, hospital management, and public health administration. The panel evaluated the importance of the proposed indicators using a five-point Likert scale, supplemented by their qualitative feedback. To ascertain the weights of these indicators, the Analytic Hierarchy Process and the Precedence Chart were integrated.
After two rounds of expert consultation on the evaluation index system, a consensus was reached. The system contained five first-level indicators (hospital command and coordination capacity, hospital monitoring capacity, hospital risk communication capacity, hospital medical response capacity, and hospital health management capacity) affiliated with 13 second-level indicators and 32 third-level indicators. Among the primary indicators, hospital command and coordination capacity had the highest weight, followed by hospital medical response capacity. The expert authority coefficient of consultation was 0.96. The Kendall's concordance coefficients of the total indicators were 0.223 and 0.342, respectively. The differences were statistically significant (P < 0.05).
The evaluation index system for hospital resilience to emerging infectious diseases, developed using the Delphi method in this study, is comprehensive and possesses high scientific reliability. The widespread application of this index system can assist hospitals in identifying and ameliorating weaknesses in their resilience capabilities, thereby enhancing their rapid response and adaptability to potential future outbreaks.
传染病的频繁爆发给全球医院带来了前所未有的挑战。在这些危机期间，医疗系统所承受的压力凸显了加强管理和资源分配的迫切需求，进一步强调了医院韧性的关键作用。作为抗击传染病爆发的先锋，增强医院韧性已成为加强医疗系统抵御全球健康威胁不可预测和多变局面的战略要务。因此，在本研究中，我们旨在建立一个用于综合评估医院应对新发传染病韧性的指标体系。
借鉴世界卫生组织应对传染病爆发的“行动框架”，采用德尔菲法确定新发传染病背景下医院韧性的核心评估指标。在该方法中，我们组建了一个由16名健康专家组成的小组，他们专门从事医学统计学、传染病预防与控制、急诊医学、医院管理和公共卫生管理。该小组使用五点李克特量表评估所提出指标的重要性，并辅以定性反馈。为确定这些指标的权重，综合了层次分析法和优先图法。
经过两轮关于评估指标体系的专家咨询，达成了共识。该体系包含五个一级指标（医院指挥协调能力、医院监测能力、医院风险沟通能力、医院医疗应对能力和医院健康管理能力），隶属于13个二级指标和32个三级指标。在主要指标中，医院指挥协调能力权重最高，其次是医院医疗应对能力。咨询的专家权威系数为0.96。总指标的肯德尔和谐系数分别为0.223和0.342。差异具有统计学意义（P<0.05）。
本研究采用德尔菲法建立的医院应对新发传染病韧性评估指标体系全面且具有较高的科学可靠性。该指标体系的广泛应用可帮助医院识别并改善其韧性能力的薄弱环节，从而提高其对未来潜在疫情的快速反应和适应能力。
