本文關(guān)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(xué)科學(xué)院學(xué)報(bào)》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(quán)重法構(gòu)建婦幼基本衛(wèi)生服務(wù)綜合指標(biāo),基于吉林省國家衛(wèi)生服務(wù)調(diào)查數(shù)據(jù)對(duì)綜合指標(biāo)進(jìn)行比較。方法依據(jù)聯(lián)合國"倒計(jì)時(shí)"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(wù)調(diào)查數(shù)據(jù)篩選指標(biāo),分別采用等權(quán)重法、分服務(wù)包等權(quán)重法、流行病學(xué)權(quán)重法和主成分權(quán)重法構(gòu)建綜合指標(biāo),計(jì)算克隆巴赫系數(shù)檢驗(yàn)綜合指標(biāo)的內(nèi)部一致性,采用隨機(jī)區(qū)組設(shè)計(jì)的方差分析比較綜合指標(biāo)得分差異,計(jì)算Spearman相關(guān)系數(shù)比較綜合指標(biāo)的等級(jí)相關(guān)性,通過婦幼健康結(jié)局的相關(guān)分析檢驗(yàn)綜合指標(biāo)的效度。結(jié)果最終共篩選出13項(xiàng)干預(yù)措施指標(biāo),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(biāo)得分差異有統(tǒng)計(jì)學(xué)意義(F=8.14,P0.01)。等權(quán)重法、主成分權(quán)重法和分服務(wù)包等權(quán)重法兩兩間均存在較強(qiáng)的等級(jí)相關(guān),Spearman相關(guān)系數(shù)均超過0.9,流行病學(xué)權(quán)重法與等權(quán)重法、主成分權(quán)重法和分服務(wù)包等權(quán)重法的Spearman相關(guān)系數(shù)分別為0.697、0.671和0.818。流行病學(xué)權(quán)重法綜合指標(biāo)對(duì)5歲以下兒童死亡率和生長遲緩發(fā)生率具有一定的預(yù)測價(jià)值(R~2=0.168,P0.05;R2=0.398,P0.01);等權(quán)重法、分服務(wù)包等權(quán)重法和主成分權(quán)重法綜合指標(biāo)僅對(duì)5歲以下兒童生長遲緩發(fā)生率具有預(yù)測價(jià)值(R~2=0.238,R~2=0.304,R2=0.232,P均0.01)。結(jié)論流行病學(xué)權(quán)重法構(gòu)建婦幼基本衛(wèi)生服務(wù)綜合指標(biāo)具有其合理性,對(duì)婦幼健康結(jié)局具有一定預(yù)測價(jià)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(xué)公共衛(wèi)生學(xué)院;吉林省衛(wèi)生統(tǒng)計(jì)信息中心;
【基金】：國家自然科學(xué)基金青年科學(xué)基金(71303010);國家自然科學(xué)基金優(yōu)秀青年科學(xué)基金(71422009)~~
【分類號(hào)】：R17
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本文編號(hào)：1551291