基于德尔菲法构建上海市区级疾病预防控制机构建设发展指标体系

李欣宇; 邵海妍; 祖平; 陆晔; 王磊; 金晔鑫; 刘方珉; 何飞龙; 吴春峰; 陈勇

doi:10.19428/j.cnki.sjpm.2023.22639

基于德尔菲法构建上海市区级疾病预防控制机构建设发展指标体系

Developing a development index system of Shanghai district-level disease prevention and control institutions using the Delphi method

摘要

摘要:
目的为协助区级疾病预防控制（简称“疾控”）机构的建设发展，结合上海市疾控体系现代化建设要求和公共卫生工作实践，运用德尔菲专家咨询法，构建区级疾控机构建设发展情况评价指标体系。
方法根据国家和上海市对疾控机构的发展要求，结合文献检索和专家访谈提出指标框架，遴选国家、省、市（区）公共卫生领域代表性专家共39人参加咨询并构建指标体系。使用权威系数和变异系数等，对德尔菲法进行质量控制和各个指标的确定。
结果问卷回收率为100%，专家权威系数为0.86，熟悉程度为0.79，判断依据为0.92，专家权威性较高，意见集中程度较高。指标体系中的必要性指标在重要性维度上变异系数均<0.25，各级各维度肯德尔和谐系数均差异有统计学意义（均P<0.001）。经多轮函询后专家意见达成一致，形成包含6个一级指标、24个二级指标、105个三级指标（包括63个必要性指标和42个推荐性指标）的区级疾控机构建设发展情况评价指标体系。
结论基于德尔菲法形成的上海市区级疾控机构评价指标体系，具有较好的权威性、可靠性、敏感性和可操作性。该指标体系对上海市区级疾控机构的建设发展有较好的支撑作用，可用于在未来一段时间内多层次、全方位评价体系发展情况。评价结果可为今后疾控体系的现代化发展和建设目标的持续动态更新提供循证依据。

Abstract:
Objective To construct an evaluation index system for the development of district-level disease prevention and control centers according to the requirements of the modernization of Shanghai’s disease control system and public health work practices， and to comprehensively assess the construction and development of district-level disease prevention and control institutions.
Methods According to the national and municipal requirements for the development of disease prevention and control institutions， an index framework was proposed through literature search and expert interviews. 39 representative experts in the field of public health at the national， provincial， and municipal （district） levels were selected to participate in the consultation and construction of the index system. The authority coefficient， the coefficient of variation， etc. were used to carry out quality control and determination of each index on the Delphi method.
Results The questionnaire response rate was 100%， the expert authority coefficient was 0.86，the degree of familiarity was 0.79， and the judgment basis was 0.92. The coefficients of variation of the necessary indicators in the index system were all <0.25 in the dimension of importance， and there were statistical differences in the statistical test of Kendall’s W coordination coefficients at all levels and dimensions （all P<0.001）. After multiple rounds of consultation， experts reached a consensus， forming a development evaluation index system of district-level CDCs with 6 first-level indicators， 24 second-level indicators， and 105 third-level indicators （including 63 necessary indicators and 42 recommended indicators）.
Conclusion The evaluation index system of Shanghai district-level CDCs based on the Delphi method has good authority， reliability， sensitivity and operability. This indicator system can effectively support the development of Shanghai district-level CDCs， and can be used for evaluation at multiple levels and in an all-round way in the future. The evaluation results can provide an evidence-based basis for the modernization of the disease prevention and control system and the continuous and dynamic updating of the development goals in the future.

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