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在公共卫生紧急情况下为结核病医疗保健服务构建弹性评估指数系统:修改后的Delphi研究
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
概括
这项研究开发了中国结核病医疗保健服务的弹性评估指数系统. 该系统有助于确定加强服务和减轻公共卫生紧急情况的关键领域.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 结核病医疗保健服务 (TB-HSs) 的弹性对于管理公共卫生紧急情况 (PHEs) 至关重要.
- 现有的TB-HS抗性评估系统不足.
- 需要一个强大的框架来评估和增强中国的结核病-海斯耐药性.
研究的目的:
- 为中国的TB-HSs构建一个全面的弹性评估指数系统 (RAIS).
- 建立一个可量化的框架来评估结核病医疗保健服务的弹性.
- 确定加强针对公共卫生紧急情况的TB-HS的关键指标.
主要方法:
- 采用了四个步骤的过程:文献审查,使用Donabedian框架的专家会议,与26名专家进行两轮Delphi调查,以及用于指标权重的分析层次过程 (AHP).
- 专家达成共识,反应率高 (100%和96.2%) 和协调 (P<0.001).
- 最终的RAIS包括三个一级,九个二级和39个三级指标.
主要成果:
- 开发的RAIS包括三个层的39个指标.
- 结核病服务提供/利用率成为最重要的第一级指标 (49.05%).
- 第二级关键指标包括服务结果 (20.79%) 和患者治疗 (20.67%),治疗中断比例 (10.29%) 和治疗覆盖率 (8.90%) 是关键的第三级组件.
结论:
- 在中国成功开发了一种针对TB-HSs的统一层次RAIS.
- 这些发现为制定有针对性的策略,以加强结核病-HS的抵御能力提供了基础.
- 建议对RAIS进行进一步验证和改进,以提高其在公共卫生中的实用性.
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