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Constructing a Resilience Assessment Index System for Tuberculosis Healthcare Services Under Public Health
Mingkuan Fan1,2, Yushu Liu1, Kui Liu1,3
1National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.
Risk Management and Healthcare Policy
|April 1, 2025
Summary
This study developed a resilience assessment index system for tuberculosis healthcare services in China. The system helps identify key areas for strengthening services and mitigating public health emergencies.
Area of Science:
- Public Health
- Health Services Research
- Epidemiology
Background:
- Resilience of tuberculosis healthcare services (TB-HSs) is critical for managing public health emergencies (PHEs).
- Existing assessment systems for TB-HS resilience are insufficient.
- A robust framework is needed to evaluate and enhance TB-HS resilience in China.
Purpose of the Study:
- To construct a comprehensive Resilience Assessment Index System (RAIS) for TB-HSs in China.
- To establish a quantifiable framework for evaluating the resilience of tuberculosis healthcare services.
- To identify key indicators for strengthening TB-HSs against public health emergencies.
Main Methods:
- A four-step process was employed: literature review, expert meetings using Donabedian's framework, a two-round Delphi survey with 26 experts, and the analytic hierarchy process (AHP) for indicator weighting.
- Expert consensus was achieved with high response rates (100% and 96.2%) and coordination (P<0.001).
- The final RAIS includes three first-grade, nine second-grade, and 39 third-grade indicators.
Main Results:
- The developed RAIS comprises 39 indicators across three tiers.
- Tuberculosis service provision/utilization emerged as the most significant first-grade indicator (49.05%).
- Key second-grade indicators included service outcomes (20.79%) and patient treatment (20.67%), with treatment discontinuation proportion (10.29%) and treatment coverage (8.90%) being critical third-grade components.
Conclusions:
- A unified hierarchical RAIS for TB-HSs in China has been successfully developed.
- The findings provide a foundation for developing targeted strategies to bolster TB-HS resilience.
- Further validation and refinement of the RAIS are recommended to enhance its utility in public health.
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