發(fā)布時間：2018-03-01 09:12

  本文關鍵詞： 連續(xù)保健 婦幼衛(wèi)生 綜合指數(shù) 吉林省　出處：《中國醫(yī)學科學院學報》2017年04期 　論文類型：期刊論文

【摘要】：目的從連續(xù)保健的視角出發(fā)利用不同權重法構建婦幼基本衛(wèi)生服務綜合指標,基于吉林省國家衛(wèi)生服務調(diào)查數(shù)據(jù)對綜合指標進行比較。方法依據(jù)聯(lián)合國"倒計時"和生命挽救工具,基于吉林省2008年和2013年兩次國家衛(wèi)生服務調(diào)查數(shù)據(jù)篩選指標,分別采用等權重法、分服務包等權重法、流行病學權重法和主成分權重法構建綜合指標,計算克隆巴赫系數(shù)檢驗綜合指標的內(nèi)部一致性,采用隨機區(qū)組設計的方差分析比較綜合指標得分差異,計算Spearman相關系數(shù)比較綜合指標的等級相關性,通過婦幼健康結局的相關分析檢驗綜合指標的效度。結果最終共篩選出13項干預措施指標,克隆巴赫系數(shù)大于0.7,具有較好的內(nèi)部一致性。方差分析得到4種綜合指標得分差異有統(tǒng)計學意義(F=8.14,P0.01)。等權重法、主成分權重法和分服務包等權重法兩兩間均存在較強的等級相關,Spearman相關系數(shù)均超過0.9,流行病學權重法與等權重法、主成分權重法和分服務包等權重法的Spearman相關系數(shù)分別為0.697、0.671和0.818。流行病學權重法綜合指標對5歲以下兒童死亡率和生長遲緩發(fā)生率具有一定的預測價值(R~2=0.168,P0.05;R2=0.398,P0.01);等權重法、分服務包等權重法和主成分權重法綜合指標僅對5歲以下兒童生長遲緩發(fā)生率具有預測價值(R~2=0.238,R~2=0.304,R2=0.232,P均0.01)。結論流行病學權重法構建婦幼基本衛(wèi)生服務綜合指標具有其合理性,對婦幼健康結局具有一定預測價值。
[Abstract]:Objective to construct comprehensive indexes of basic maternal and child health services from the perspective of continuous health care using different weight methods. Methods based on the countdown and life-saving tools of the United Nations, and based on the data of the National Health Service Survey of Jilin Province in 2008 and 2013, the comprehensive indicators were compared. Using the equal weight method, the equal weight method of service package, the epidemiology weight method and the principal component weight method respectively to construct the comprehensive index, calculate the Crombach coefficient to test the internal consistency of the comprehensive index. The variance analysis of random block design was used to compare the score difference of the comprehensive index, and the Spearman correlation coefficient was calculated to compare the grade correlation of the comprehensive index. The validity of the comprehensive indicators was tested by the correlation analysis of maternal and child health outcomes. The coefficient of Crombach is greater than 0.7, which has good internal consistency. The Spearman correlation coefficient of the principal component weight method and the sub-service package equal weight method was higher than 0.9, the epidemiological weight method and the equal weight method. The Spearman correlation coefficients of principal component weight method and sub-service package equal weight method were 0.671 and 0.818, respectively. The comprehensive index of epidemiological weight method had certain predictive value for mortality rate and growth retardation rate of children under 5 years old. The comprehensive indexes of equal weight method and principal component weight method only have predictive value for the incidence of growth retardation in children under 5 years of age. Conclusion it is reasonable to construct the comprehensive index of basic maternal and child health services by the method of epidemiology weight, which can be used to predict the incidence of growth retardation in children under 5 years of age. It has certain predictive value to maternal and child health outcome.
【作者單位】： 北京大學公共衛(wèi)生學院;吉林省衛(wèi)生統(tǒng)計信息中心;
【基金】：國家自然科學基金青年科學基金(71303010);國家自然科學基金優(yōu)秀青年科學基金(71422009)~~
【分類號】：R17
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本文編號：1551291