Cheng Kangyao, Xie Rui, Xu Ziwei, Zhang Yanyan, 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 Infect Dis. 2025 Apr 27;25(1):612. doi: 10.1186/s12879-025-10993-5.
Major emerging infectious diseases often trigger the "medical run", presenting significant challenges to health systems. Developing hospital resilience is crucial for enhancing the capacity to manage such crises. Therefore, this research aimed to construct an element system of hospital resilience to medical run in major emerging infectious diseases.
Utilizing the 4R conceptual model and literature content analysis, a preliminary draft for hospital resilience was developed. Subsequently, a two-round Delphi survey involving 18 Chinese experts across various fields refined this system. The Standard for Conducting And Reporting Delphi Studies (CREDES) guided this process. The weights of each element were determined using the analytic hierarchy process.
The effective recovery rate for both Delphi rounds were 100% (18/18), with an authority coefficient of 0.9159. The first round revealed a Kendall's concordance coefficient for total elements of 0.136 (P < 0.05); the second round showed a coefficient of 0.214 (P < 0.05). The final element system included four primary elements (Resourcefulness, Redundancy, Robustness, Recovery), 21 secondary elements, and 65 tertiary elements, with weights of 0.2908, 0.2056, 0.4348, and 0.0688, respectively.
This study constructed the element system of hospital resilience to medical run in major emerging infectious diseases. The results are designed to elucidate the components of hospital resilience in the context of major emerging infectious disease, which can help mitigate the impact of medical run. The study will provide hospitals with a checklist and assessment program for enhancing resilience, offering significant implications for the development of hospital training and management strategies.
重大新发传染病常引发“医疗挤兑”，给卫生系统带来重大挑战。提升医院应对能力对于增强管理此类危机的能力至关重要。因此，本研究旨在构建重大新发传染病医院应对医疗挤兑的要素体系。
利用4R概念模型和文献内容分析法，制定医院应对能力的初步草案。随后，对来自不同领域的18位中国专家进行了两轮德尔菲调查，以完善该体系。《德尔菲研究实施与报告标准》（CREDES）指导了这一过程。使用层次分析法确定各要素的权重。
两轮德尔菲调查的有效回收率均为100%（18/18），权威系数为0.9159。第一轮显示总要素的肯德尔和谐系数为0.136（P<0.05）；第二轮显示系数为0.214（P<0.05）。最终要素体系包括四个主要要素（资源丰富性、冗余性、稳健性、恢复力）、21个次要要素和65个三级要素，权重分别为0.2908、0.2056、0.4348和0.0688。
本研究构建了重大新发传染病医院应对医疗挤兑的要素体系。研究结果旨在阐明重大新发传染病背景下医院应对能力的组成部分，有助于减轻医疗挤兑的影响。该研究将为医院提供一份增强应对能力的清单和评估方案，对医院培训和管理策略的制定具有重要意义。
