美国(县)健康排名体系构建方法及对我国的启示  

Construction methods of America's health rankings and county health rankings: Implications for China

作　　者：宋益喆 尤莉莉[1] 赵琪[1] 刘晓宁[1] 沈冰洁 郭婧[1] 苏夏雯 刘远立[1] SONG Yi-zhe;YOU Li-li;ZHAO Qi;LIU Xiao-ning;SHENBing-jie;GUO Jing;SU Xia-wen;LIU Yuan-li(School of Public Health,Chinese Academy of Medical Sciences Peking Unioo Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院公共卫生学院,北京100730

出　　处：《中国卫生政策研究》2017年第11期20-26,共7页Chinese Journal of Health Policy

基　　金：国家自然科学基金项目(71473270);国家自然科学基金重点项目(71532014)

摘　　要：本文采用文献资料法,对美国健康排名和县健康排名指标体系的内容和方法进行总结和比较。美国健康排名和县健康排名是现行应用较广的人群健康评价指标体系,分别在州、县层面上对人群健康进行排名,其评估内容包括健康结局和健康决定因素两个方面,各指标的选取原则包括可靠性、可获得性、稳定性、可干预性等,指标权重分配综合考虑了文献综述、历史回顾、模型拟合以及利益相关方的参与度等方面。通过比较发现,美国健康排名和县健康排名的主要优势在于按人群特征和地理区域进行了细致划分。我国健康城市和健康村镇的评价更为复杂,特别是对健康村镇指标评价体系的研究较少,本文对美国健康州县的评价方法进行回顾评述,以期对我国健康城市和健康村镇评价体系的研究提供参考。This review summarised and compared the contents and methods of America＇s Health Rankings（ AHR） and the County Health Rankings（ CHR） in the United States by using literature review. AHR and CHR are the currently widely used population health assessment index ranking systems in the United States,respectively,which provided an analysis of population health on a state-by-state basis and a county-by-county basis by evaluating a historical and comprehensive set of health outcomes and health determinants data to determine the health benchmarks and state/county rankings. The selection criteria of each indicator take into account of reliability,availability,stability,and intervention. The determination of weights of each indicator took into considerations the literature review,a historical perspective,weights used by other rankings,internal analyses of the variation in outcomes explained by each factor,and pragmatic issues involving communications and stakeholder engagement. By comparison,it was found that AHR and CHR have a higher level of accuracy in the classification as they are well-defined by population demographics and geography respectively. The evaluation of health cities and health villages and towns in China is more complicated.There are few studies on village and town health rankings systems. This article reviewed the evaluation methods of AHR and CHR with a view to providing a reference for research on the evaluation system of City Health Rankings and the Village and Town Health Rankings in China.

关 键 词：健康村镇 健康城市 健康结局 健康决定因素 美国 

分 类 号：R197[医药卫生—卫生事业管理]