连续保健视角下不同权重法构建妇幼基本卫生服务综合指标比较:以吉林省国家卫生服务调查为例

发布时间：2018-03-01 09:12

  本文关键词： 连续保健 妇幼卫生 综合指数 吉林省　出处：《中国医学科学院学报》2017年04期 　论文类型：期刊论文

【摘要】：目的从连续保健的视角出发利用不同权重法构建妇幼基本卫生服务综合指标,基于吉林省国家卫生服务调查数据对综合指标进行比较。方法依据联合国"倒计时"和生命挽救工具,基于吉林省2008年和2013年两次国家卫生服务调查数据筛选指标,分别采用等权重法、分服务包等权重法、流行病学权重法和主成分权重法构建综合指标,计算克隆巴赫系数检验综合指标的内部一致性,采用随机区组设计的方差分析比较综合指标得分差异,计算Spearman相关系数比较综合指标的等级相关性,通过妇幼健康结局的相关分析检验综合指标的效度。结果最终共筛选出13项干预措施指标,克隆巴赫系数大于0.7,具有较好的内部一致性。方差分析得到4种综合指标得分差异有统计学意义(F=8.14,P0.01)。等权重法、主成分权重法和分服务包等权重法两两间均存在较强的等级相关,Spearman相关系数均超过0.9,流行病学权重法与等权重法、主成分权重法和分服务包等权重法的Spearman相关系数分别为0.697、0.671和0.818。流行病学权重法综合指标对5岁以下儿童死亡率和生长迟缓发生率具有一定的预测价值(R~2=0.168,P0.05;R2=0.398,P0.01);等权重法、分服务包等权重法和主成分权重法综合指标仅对5岁以下儿童生长迟缓发生率具有预测价值(R~2=0.238,R~2=0.304,R2=0.232,P均0.01)。结论流行病学权重法构建妇幼基本卫生服务综合指标具有其合理性,对妇幼健康结局具有一定预测价值。
[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.
【作者单位】： 北京大学公共卫生学院;吉林省卫生统计信息中心;
【基金】：国家自然科学基金青年科学基金(71303010);国家自然科学基金优秀青年科学基金(71422009)~~
【分类号】：R17
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本文编号：1551291