基于ISM模型的慢性病防控影响因素分析  

Analysis on influencing factors of chronic disease prevention and control based on ISM model

作　　者：贾小梅 凯赛尔·阿不都克热木 王敏[1] 吴雪莹 叶晨航 姚萱 JIA Xiao-mei;Kaisaier·Abudukeremu;WANG Min;WU Xue-ying;YE Chen-hang;YAO Xuan(School of Public Health,Xinjiang Medical University,Urumqi Xinjiang,830011,China;Party and Government Office,Xinjiang Medical University,Urumqi Xinjiang,830011,China;Academic Affairs Office,Xinjiang Medical University,Urumqi Xinjiang,830000,China;Department of Medical Affairs,Xinjiang Uygur Autonomous Region People’s Hospital,,Urumqi Xinjiang,830011,China;School of Medicine,Shanghai University,Shanghai,200444,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830011 [2]新疆医科大学党政办,新疆乌鲁木齐830011 [3]新疆医科大学教务处,新疆乌鲁木齐830011 [4]新疆维吾尔自治区人民医院医务部,新疆乌鲁木齐830000 [5]上海大学医学院,上海200444

出　　处：《职业与健康》2021年第19期2657-2661,共5页Occupation and Health

基　　金：国家自然科学基金(71964033)。

摘　　要：目的梳理慢性病防控影响因素,构建慢性病防控影响因素解释结构模型(interpretive structural model,ISM),探讨影响因素间层级结构和影响关系,为慢性病防控一体化体系建设提供对策建议。方法2020年4—7月收集慢性防控相关资料,通过文献分析及ISM小组打分法确定13个影响因素的二元关系并建立邻接矩阵,利用Matlab软件计算可达矩阵并进行层级分析,最终建立ISM模型。结果ISM模型结果显示慢性病防控的影响因素呈现"四层阶梯结构",外部动力影响因素L4={2,3,9}、资源配置影响因素L3={1,4,8}、内部机制影响因素L2={5,6,7,10,12}、个体协同影响因素L1={11,13}。各层级间通过"外部动力-资源配置-内部机制-个体协同"逐层递进,共同影响慢性病防控效果。结论慢性病防控是一个复杂的社会系统,涉及顶层设计、制度保障及社会协同等方方面面。政府宏观政策及财政投入等外部动力为资源配置水平提供保障;医疗资源配置水平及公共卫生服务项目的供给水平为完善慢性病管理内部机制奠定基础;慢性病健康宣教活动、慢性病防控方式、医务人员参与、居民认知、居民参与等活动为促进个体参与、慢性病管理效果提供了可能。在资源有限的环境下,根据慢性病防控影响因素不同层级结构和路径特点完善慢性病防控体系与制定防控策略,合理有效利用资源是提升慢性病防控效果的有效途径。Objective To sort out the influencing factors of chronic disease prevention and control,construct an interpretive structural model(ISM)of chronic disease prevention and control influencing factors,explore the hierarchical structure and influence relationship between influencing factors,and provide countermeasures and suggestions for the construction of an integrated chronic disease prevention and control system.Methods From April to July 2020,the related data of chronic disease prevention and control were collected,the binary relationship of 13 influencing factors were determined through literature analysis and ISM team scoring method,and the adjacency matrix was established.Matlab software was used to calculate the reachable matrix and perform hierarchical analysis,to finally establish ISM model.Results The results of the ISM model showed that the influencing factors of chronic disease prevention and control present a"four-tiered structure",with external power influencing factors L4={2.3.9},resource allocation influencing factors L3={1,4,8},internal mechanism influencing factors L2={5,6,7,10,12},and individual synergy influencing factors L1={11,13}.Through"external power-resource allocation-internal mechanism-individual coordination",each level progresses layer by layer,and jointly affects the effectiveness of chronic disease prevention and control.Conclusion The prevention and control of chronic diseases is a complex social system,involving top-level design,institutional guarantees,and social coordination.External motives such as government macro policies and financial investment provide guarantees for the level of resource allocation;the level of medical resource allocation and the supply level of public health service items lay the foundation for improving the internal mechanism of chronic disease management;chronic disease health education activities,chronic disease prevention and control methods,and medical staff participation,resident cognition,residents participation and other activities provide the possi

关 键 词：慢性病防控 解释结构模型 MATLAB 影响因素 

分 类 号：R181.3[医药卫生—流行病学]