村(居)民委员会公共卫生委员会运行评估指标体系构建及应用效果--以广州市为例  

Construction and application of an index system for evaluating the operation of community(village)public health committees in Guangzhou city:a Delphi study

作　　者：何娣琼 孙丽丽[3] 李科[3] 刘远 邹冠炀 HE Diqiong;SUN Lili;LI Ke;LIU Yuan;ZOU Guanyang(School of Public Health and Management,Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Department of Science and Education,Futian Center for Chronic Disease control,Shenzhen,Shenzhen,518000,China;Guangzhou Municipal Center for Disease Control and Prevention,Guangzhou 510440,China;Liwan District Center for Disease Control and Prevention,Guangzhou,510000,China)

机构地区：[1]广州中医药大学公共卫生与管理学院,广州510006 [2]深圳市福田区慢性病防治院科教科,深圳518000 [3]广州市疾病预防控制中心,广州510440 [4]广州市荔湾区疾病预防控制中心,广州510000

出　　处：《中国公共卫生》2025年第2期199-205,共7页Chinese Journal of Public Health

基　　金：广州市卫生健康科技重大项目(2023A031005);广东省教育科学规划课题(2023GXJK034);广州中医药大学青年拔尖人才(团队)培育“揭榜挂帅”项目。

摘　　要：目的构建村(居)民委员会公共卫生委员会运行评估指标体系,并通过试评估测试指标体系的适用性。方法基于文献分析和小组讨论初步形成村(居)民委员会公共卫生委员会运行评估指标体系,运用德尔菲专家咨询法对26名相关领域的专家进行2轮咨询,应用层次分析法确定三级指标权重,并通过分层随机抽样选取广州市经济水平发达(A)、中等(B)、中等(C)、欠发达(D)的4个区内各10个村(居)民委员会公共卫生委员会进行问卷调查,以评估指标体系的信效度。结果2轮专家积极系数分别为100%和92.3%,专家权威系数分别为0.83和0.85,专家意见的Kendall′W系数分别为0.46和0.54(P值均<0.05),各指标的变异系数分别处于0.08~0.32和0.07~0.23,专家协调程度良好。经过2轮咨询论证,最终确立了由机制建设、组织保障、服务提供与管理、运行效果4个维度以及14个二级指标、33个三级指标组成的村(居)民委员会公共卫生委员会运行评估指标体系,其中一级指标权重为0.121~0.417,二级指标的权重为0.016~0.163,三级指标的权重为0.009~0.072。通过分析40份调查数据,发现指标体系能较好区分不同村(居)民委员会公共卫生委员会的建设水平,且指标体系应用的信效度良好(Cronbach′s Alpha系数值为0.864,公因子累计方差贡献率达87.721%)。结论本研究构建的村(居)民委员会公共卫生委员会三级运行评价指标体系通过了Kendall′W系数与变异系数检验,且试评估的信效度良好,可为有关部门完善相关政策及开展评估提供参考依据。Objective To develop an index system to assess the functioning of community(village)health committees and test its applicability through a pilot assessment.Methods A preliminary evaluation index system for community(village)public health committees was developed based on literature review and group discussions.A two-round Delphi expert consultation was conducted with 26 experts in relevant fields.The analytical hierarchy process was used to determine the weights of the indicators at different levels.Ten community/village public health committees from one of the four districts with different levels of economic development in Guangzhou city were selected by stratified random sampling for a questionnaire survey to evaluate the reliability and validity of the constructed index system.Results For the two rounds of expert consultation,the positive coefficients were 100%and 92.3%,the authority coefficients were0.83 and 0.85,and the Kendall′s W coefficients of expert′s opinions were 0.46 and 0.54(both P<0.05),respectively.The coefficients of variation of the included indicators were 0.08–0.32 and 0.07–0.23,respectively,indicating good agreement among the experts.After two rounds of consultations,an index system for evaluating the functioning of community(village)health committees was developed,consisting of four primary indicators related to mechanism establishment,organizational guarantee,service delivery and management,and operational effectiveness,as well as 14 secondary indicators and 33 tertiary indicators.The combined weights ranged from 0.121 to 0.417 for the primary indicators,0.016to 0.163 for the secondary indicators,and 0.009 to 0.072 for the tertiary indicators.Analysis of data from a sample survey of 40 community(village)health committees showed that the established index system could effectively differentiate the functional levels of different committees,and the reliability and validity of the index system were good(Cronbach′s alpha was 0.864,and the cumulative variance contribution rate of common

关 键 词：村(居)民委员会公共卫生委员会 基层公共卫生 德尔菲专家咨询 层次分析法 指标体系 

分 类 号：F42[经济管理—产业经济]