摘要
目的建立公共卫生决策数据元(指标)概念框架,确定框架的维度、子维度及其关联关系。方法应用文献分析法和概念分析法确定概念框架的结构、维度和子维度。概念框架是建立在健康影响因素模型的基础上,总体框架遵循科学性、实用性、关联性、系统性和可扩展性的5个原则。维度和子维度的确定依照概念化、目标化、独立性和数目不宜过多的4个原则。维度间的关系则根据公共卫生的特点和公共卫生理论确定。结果提出了健康结果、非医学健康因素、公共卫生系统绩效、公共卫生系统资源、社区特征和保障体系5个维度和20个子维度组成的概念模型,并说明了维度间的相互关系。健康结果维度包括健康状态、人体功能和死亡3个子维度;非医学健康因素的4个子维度是健康行为、生活和工作条件、个人资源和环境因素;公共卫生系统的绩效包括有效性、可及性、效率、安全性和反应性;公共卫生资源包括机构资源、人力资源、财政资源、设施资源和信息资源;社区特征和保障体系维度由社区特征、公共卫生政策法规和保障体系组成。结论作为对公共卫生系统的抽象,概念框架全面地反映了公共卫生系统的组成和复杂的公共卫生过程。可指导公共卫生系统指标体系、乃至公共卫生信息系统的建立。概念框架与以结构、过程、条件和结果所组成的卫生服务质量评价模型相吻合。
Objective To develop a conceptual framework for decision-making data elements （indicator） in public health through determining its dimensions, sub-dimensions and their interrelationships. Methods On the basis of literatures review, conceptual analysis and health determinant models, a conceptual framework was set up. This framework construction followed five principles： evidence-based, applicable, public health relevant, systemic and extensible. While, with the principles of conceptulization, objective-orientation, indepence, and number-restriction, the domain and subdomains were also developed. Results A conceptual framework consisting of five domains and 20 sub-domains was developed. The 5 domains were health status, non-medical health determinants, public health system performance, the resources of public health system, and characteristics of community and assurance system. The health outcome included three subdomains of health status, functional status, and death; Non-medicine health determinants domain consisted of health behavior, working and living conditions, personal resources and environmental factors; performance domain was made up of effectiveness, accessibility, efficiency, responsibility and safety; resources domain had institution resources, human resources, financial resources, equipment resources and information resources; The characteristics of community and assurance system domain was the last domain which comprises characteristics of community, public health related policy and assurance system. The complicated relationship between these domains was also described. Conclusion As the abstraction of public health system, this conceptual framework comprehensively depicts the components of public health system and complicated process of public health system. This framework conforms to the medical care quality model which is made up of structure, process, intermediate results and outco＇nes.
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2007年第5期348-352,共5页
Chinese Journal of Preventive Medicine
关键词
公共卫生
质量指标
卫生保健
信息系统
Public health
Quality indicator,health care
Information systems
