军队数字化医院突发公共卫生事件应对能力现状评价研究
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摘要
研究背景:
突发公共卫生事件是指突然发生的,对公众健康造成或者可能造成重大损失的传染病疫情、不明原因的群体性疾病、重大食物和职业中毒,以及其他危害公共健康的事件。近年来,我国面临突发公共卫生事件的威胁有不断上升的趋势,医院是应对突发公共卫生事件中的关键机构,医院突发公共卫生事件应对能力的提升在我国突发公共卫生事件应对体系建设中的作用十分重要。医院突发公共卫生事件应对能力评价是医院应对能力建设的基础,数字化医院是医院发展的必然趋势,但目前尚没有数字化医院突发公共卫生事件应对能力评价相关的研究报道。为了保证获取研究数据的可行性,结合本单位在军队数字化医院建设方面的多年经验,我们选择军队数字化医院做为本研究的研究对象。
目的:
一、构建数字化医院突发公共卫生事件应对能力评价指标体系;
二、编制数字化医院突发公共卫生事件应对能力调查问卷;
三、建立数字化医院突发公共卫生事件应对能力综合评价模型;
四、利用数字化医院突发公共卫生事件应对能力调查问卷和综合评价模型,调查、分析和评价军队数字化医院的应对能力
五、基于以上研究,找出军队数字化医院突发公共卫生事件应对能力现状的不足,为后续军队数字化医院应对能力的建设和提高提供初步的理论依据。
方法:
通过文献调研和专家访谈,构建数字化医院突发公共卫生事件应对能力初步评价指标体系,并通过后续两轮专家咨询法和层次分析法,确定最终评价指标体系组成和权重。依据前期构建的评价指标体系,编制数字化医院突发公共卫生事件应对能力调查问卷,对抽取的军队数字化医院应对能力现状进行调查分析。通过建立数字化医院突发公共卫生事件应对能力综合评价加权线性模型,量化数字化医院突发公共卫生事件应对能力,结合军队数字化医院应对能力现状调查的结果,对军队数字化医院突发公共卫生事件应对能力现状进行分析和评价。
结果:
1、成功构建了数字化医院突发公共卫生事件应对能力评价指标体系,该指标体系包括6个一级指标、20个二级指标和56个三级指标;
2、构建的数字化医院突发公共卫生事件应对能力评价指标体系经检测具有较好的信度和效度,可以用于后续军队数字化医院突发公共卫生事件应对能力现状调查研究;
3、构建了数字化医院突发公共卫生事件应对能力综合评价模型公式: Z=1000*0.16*[0.35*(0.40*C1+0.28*C2+0.32*C3)+...+0.30*(0.26*C7+0.32*C8+0.32*C9)]+...1000*0.15*[0.34*(0.29*C46+0.23*C47+0.21*C48+0.27*C49)+...+0.30*(0.30*C53+0.20*C54+0.22*C55+0.28*C56)]。
其中Z为数字化医院应对能力综合得分,C1、C2、C56等表示所对应三级指标的实际调查得分。
4、军队数字化医院具备较完善的突发公共卫生事件应对能力现状调查发现:被调查的军队数字化医院在应急制度、监测预警、院内外医疗处置、应急储备、人员和设备安全、教育与改进6个方面均有不足。特别是在利用数字化手段优化数字化医院以上6个方面能力上,大部分被调查医院还有很大潜力可挖。
5、军队数字化医院突发公共卫生事件应对能力评价研究发现:中心医院以上级别医院强于中心医院,教学医院强于非教学医院,SARS重灾区医院强于非SARS重灾区医院、收治过SARS患者/疑似患者医院强于未收治过相应患者医院,东部医院强于西部医院,南部和北部医院应对能力无明显差别。
结论:
1、本研究成功构建了合理可行的数字化医院突发公共卫生事件应对能力评价指标体系。
2、本研究调查的军队数字化医院在应急制度、监测预警、院内外医疗处置、应急储备、人员和设备安全、教育与改进6个方面都有不小的提升空间;特别是在结合数字化手段提升医院以上6个方面能力上,还有较大潜力。
3、中心医院以上级别医院突发公共卫生事件应对能力强于中心医院,教学医院强于非教学医院,SARS重灾区医院强于非SARS重灾区医院、收治过SARS患者/疑似患者医院强于未收治过相应患者医院,东部医院强于西部医院,南部和北部医院应对能力无明显差别。
本研究创新性:
1、首次构建了数字化医院突发公共卫生事件应对能力评价指标体系。
2、首次编制了数字化医院突发公共卫生事件应对能力评价问卷,对抽取的军队数字化医院突发公共卫生事件应对能力现状进行了调查和分析。
3、首次建立了数字化医院突发公共卫生事件应对能力综合评价模型,结合对军队数字化医院相关调查结果,对军队数字化医院应对能力进行了分析和评价。
以上研究首次对军队数字化医院应对突发公共卫生事件应对能力现状进行了调查、分析和评价,找出了军队数字化医院突发公共卫生事件应对能力现状的不足,并提出了相应的改进意见,为后续军队数字化医院应对能力的建设和提高提供初步的理论依据。
Background:
Public Health Emergencies(PHEs) may be related to outbreaks of infectious illnesses, food and waterborne illnesses as well as other threats to the public’s health and safety, which may have an impact on economic, trade, tourism and collective health of the global population. Man-made attacks can also create public health emergencies. Hospital preparedness is critical for the management of public health emergency (PHE). The evalution of hospital preparedness capacity for PHE, which is critical for hospital preparedness construction, can provide us the deficiency hospital need to overcome to raise their preparedness capacity. As the future of traditional hospital, more and more attention is being directed to digital hospital and its' role in PHE. However, the evaluation hospital preparedness capacity for public health emergency in digital hospital have not been investigated yet. Based on our ten years experiences in building of the southwest digital hospital and recent related research progress, digital hospital of PLA ,which will ensure our research data collection, were enroll in our study for further research.
Objective:
1. To establish an evaluation index system for evaluation of hospital preparedness capacity for public health emergency in digital hospital.
2. To design a questionnaire for survey of current hospital preparedness capacity for public health emergency in digital hospital.
3. To develop an evaluation model of hospital preparedness capacity for public health emergency.
4. To evalutae the current hospital preparedness capacity for public health emergency in digital hospitaol of PLA by the evalation index system, questionnaire and evaluation model we esteablised.
5. To provide suitable suggestion for improving of hospital preparedness capacity for public health emergency in digital hospitaol of PLA.
Methods:
In the present study, comprehensive literature reviews, intensive experts interviewing , Delphi method were used to establish an evaluation index system, and analytic hierarchy process(AHP) were used for weight determination of the evaluation index system.Then, a questionnaire and the evaluation model were designed and used to survey the current hospital preparedness capacity for public health emergency in 65 selected digital hospitals of PLA. Finally, baded on our survey data, we provide preliminary suggestion for improving of hospital preparedness capacity for public health emergency in digital hospitaol of PLA.
Results:
1. An evaluation index system for evaluation of hospital preparedness capacity for public health emergency were established successflully. Our indicator system framework for assessing hospitals’capacities includes 6 domains, 20 second-level indicators and 56 third-level indicators.
2. The 6 domains had good internal consistency (Cronbach alpha=0.959), external consistency (0.70) and validity which can be used for further digital hospital preparedness capacity for PHE assessing.
3. The weighted linear comprehensive evaluation model were sucessfully established for evaluation of hospital preparedness capacity for public health emergency(HPCPHE). Z=1000*0.16*[0.35*(0.40*C1+0.28*C2+0.32*C3)+...+0.30*(0.26*C7+0.32*C8+0.32*C9)]+...1000*0.15*[0.34*(0.29*C46+0.23*C47+0.21*C48+0.27*C49)+...+0.30*(0.30*C53+0.20*C54+0.22*C55+0.28*C56)].
4. Deficiencies existed in hospitals’capacties in emergency system, monitoring and warning, medical treatements, emergency stock, safty of staff members and digital system and education&improvement.
5.For assessing of hospital preparedness capacity for public health emergency集(HPCPHE), teching hospital s’HPCPHE were better than non-teaching hospital s’.hospitals which used to treat SARS patients have better HPCPHE than those did not. HPCPHE of hospital located at estern China were better than those located at western China.
Conclusion:
1. We establish a reliability comprehensive evaluation indicator system which can be used for further digital hospital preparedness capacity for PHE assessing.
2. Hospitals’capacties in emergency system, monitoring and warning, medical treatements, emergency stock, safty of staff members and digital system and education&improvement should be improved to raise the HPCPHE of digital hospitals of PLA.
3. For assessing of hospital preparedness capacity for public health emergency (HPCPHE), teching hospital s’HPCPHE were better than non-teaching hospital s’.hospitals which used to treat SARS patients have better HPCPHE than those did not. HPCPHE of hospital located at estern China were better than those located at western China.
We, for the first time, establish and design an evaluation index system, a questionnaire and an evaluation model for survey the current hospital preparedness capacity for public health emergency in digital hospitals of PLA. Our research can provide preliminary suggestion for improving of hospital preparedness capacity for public health emergency in digital hospitaol of PLA.
突发公共卫生事件是指突然发生的,对公众健康造成或者可能造成重大损失的传染病疫情、不明原因的群体性疾病、重大食物和职业中毒,以及其他危害公共健康的事件。近年来,我国面临突发公共卫生事件的威胁有不断上升的趋势,医院是应对突发公共卫生事件中的关键机构,医院突发公共卫生事件应对能力的提升在我国突发公共卫生事件应对体系建设中的作用十分重要。医院突发公共卫生事件应对能力评价是医院应对能力建设的基础,数字化医院是医院发展的必然趋势,但目前尚没有数字化医院突发公共卫生事件应对能力评价相关的研究报道。为了保证获取研究数据的可行性,结合本单位在军队数字化医院建设方面的多年经验,我们选择军队数字化医院做为本研究的研究对象。
目的:
一、构建数字化医院突发公共卫生事件应对能力评价指标体系;
二、编制数字化医院突发公共卫生事件应对能力调查问卷;
三、建立数字化医院突发公共卫生事件应对能力综合评价模型;
四、利用数字化医院突发公共卫生事件应对能力调查问卷和综合评价模型,调查、分析和评价军队数字化医院的应对能力
五、基于以上研究,找出军队数字化医院突发公共卫生事件应对能力现状的不足,为后续军队数字化医院应对能力的建设和提高提供初步的理论依据。
方法:
通过文献调研和专家访谈,构建数字化医院突发公共卫生事件应对能力初步评价指标体系,并通过后续两轮专家咨询法和层次分析法,确定最终评价指标体系组成和权重。依据前期构建的评价指标体系,编制数字化医院突发公共卫生事件应对能力调查问卷,对抽取的军队数字化医院应对能力现状进行调查分析。通过建立数字化医院突发公共卫生事件应对能力综合评价加权线性模型,量化数字化医院突发公共卫生事件应对能力,结合军队数字化医院应对能力现状调查的结果,对军队数字化医院突发公共卫生事件应对能力现状进行分析和评价。
结果:
1、成功构建了数字化医院突发公共卫生事件应对能力评价指标体系,该指标体系包括6个一级指标、20个二级指标和56个三级指标;
2、构建的数字化医院突发公共卫生事件应对能力评价指标体系经检测具有较好的信度和效度,可以用于后续军队数字化医院突发公共卫生事件应对能力现状调查研究;
3、构建了数字化医院突发公共卫生事件应对能力综合评价模型公式: Z=1000*0.16*[0.35*(0.40*C1+0.28*C2+0.32*C3)+...+0.30*(0.26*C7+0.32*C8+0.32*C9)]+...1000*0.15*[0.34*(0.29*C46+0.23*C47+0.21*C48+0.27*C49)+...+0.30*(0.30*C53+0.20*C54+0.22*C55+0.28*C56)]。
其中Z为数字化医院应对能力综合得分,C1、C2、C56等表示所对应三级指标的实际调查得分。
4、军队数字化医院具备较完善的突发公共卫生事件应对能力现状调查发现:被调查的军队数字化医院在应急制度、监测预警、院内外医疗处置、应急储备、人员和设备安全、教育与改进6个方面均有不足。特别是在利用数字化手段优化数字化医院以上6个方面能力上,大部分被调查医院还有很大潜力可挖。
5、军队数字化医院突发公共卫生事件应对能力评价研究发现:中心医院以上级别医院强于中心医院,教学医院强于非教学医院,SARS重灾区医院强于非SARS重灾区医院、收治过SARS患者/疑似患者医院强于未收治过相应患者医院,东部医院强于西部医院,南部和北部医院应对能力无明显差别。
结论:
1、本研究成功构建了合理可行的数字化医院突发公共卫生事件应对能力评价指标体系。
2、本研究调查的军队数字化医院在应急制度、监测预警、院内外医疗处置、应急储备、人员和设备安全、教育与改进6个方面都有不小的提升空间;特别是在结合数字化手段提升医院以上6个方面能力上,还有较大潜力。
3、中心医院以上级别医院突发公共卫生事件应对能力强于中心医院,教学医院强于非教学医院,SARS重灾区医院强于非SARS重灾区医院、收治过SARS患者/疑似患者医院强于未收治过相应患者医院,东部医院强于西部医院,南部和北部医院应对能力无明显差别。
本研究创新性:
1、首次构建了数字化医院突发公共卫生事件应对能力评价指标体系。
2、首次编制了数字化医院突发公共卫生事件应对能力评价问卷,对抽取的军队数字化医院突发公共卫生事件应对能力现状进行了调查和分析。
3、首次建立了数字化医院突发公共卫生事件应对能力综合评价模型,结合对军队数字化医院相关调查结果,对军队数字化医院应对能力进行了分析和评价。
以上研究首次对军队数字化医院应对突发公共卫生事件应对能力现状进行了调查、分析和评价,找出了军队数字化医院突发公共卫生事件应对能力现状的不足,并提出了相应的改进意见,为后续军队数字化医院应对能力的建设和提高提供初步的理论依据。
Background:
Public Health Emergencies(PHEs) may be related to outbreaks of infectious illnesses, food and waterborne illnesses as well as other threats to the public’s health and safety, which may have an impact on economic, trade, tourism and collective health of the global population. Man-made attacks can also create public health emergencies. Hospital preparedness is critical for the management of public health emergency (PHE). The evalution of hospital preparedness capacity for PHE, which is critical for hospital preparedness construction, can provide us the deficiency hospital need to overcome to raise their preparedness capacity. As the future of traditional hospital, more and more attention is being directed to digital hospital and its' role in PHE. However, the evaluation hospital preparedness capacity for public health emergency in digital hospital have not been investigated yet. Based on our ten years experiences in building of the southwest digital hospital and recent related research progress, digital hospital of PLA ,which will ensure our research data collection, were enroll in our study for further research.
Objective:
1. To establish an evaluation index system for evaluation of hospital preparedness capacity for public health emergency in digital hospital.
2. To design a questionnaire for survey of current hospital preparedness capacity for public health emergency in digital hospital.
3. To develop an evaluation model of hospital preparedness capacity for public health emergency.
4. To evalutae the current hospital preparedness capacity for public health emergency in digital hospitaol of PLA by the evalation index system, questionnaire and evaluation model we esteablised.
5. To provide suitable suggestion for improving of hospital preparedness capacity for public health emergency in digital hospitaol of PLA.
Methods:
In the present study, comprehensive literature reviews, intensive experts interviewing , Delphi method were used to establish an evaluation index system, and analytic hierarchy process(AHP) were used for weight determination of the evaluation index system.Then, a questionnaire and the evaluation model were designed and used to survey the current hospital preparedness capacity for public health emergency in 65 selected digital hospitals of PLA. Finally, baded on our survey data, we provide preliminary suggestion for improving of hospital preparedness capacity for public health emergency in digital hospitaol of PLA.
Results:
1. An evaluation index system for evaluation of hospital preparedness capacity for public health emergency were established successflully. Our indicator system framework for assessing hospitals’capacities includes 6 domains, 20 second-level indicators and 56 third-level indicators.
2. The 6 domains had good internal consistency (Cronbach alpha=0.959), external consistency (0.70) and validity which can be used for further digital hospital preparedness capacity for PHE assessing.
3. The weighted linear comprehensive evaluation model were sucessfully established for evaluation of hospital preparedness capacity for public health emergency(HPCPHE). Z=1000*0.16*[0.35*(0.40*C1+0.28*C2+0.32*C3)+...+0.30*(0.26*C7+0.32*C8+0.32*C9)]+...1000*0.15*[0.34*(0.29*C46+0.23*C47+0.21*C48+0.27*C49)+...+0.30*(0.30*C53+0.20*C54+0.22*C55+0.28*C56)].
4. Deficiencies existed in hospitals’capacties in emergency system, monitoring and warning, medical treatements, emergency stock, safty of staff members and digital system and education&improvement.
5.For assessing of hospital preparedness capacity for public health emergency集(HPCPHE), teching hospital s’HPCPHE were better than non-teaching hospital s’.hospitals which used to treat SARS patients have better HPCPHE than those did not. HPCPHE of hospital located at estern China were better than those located at western China.
Conclusion:
1. We establish a reliability comprehensive evaluation indicator system which can be used for further digital hospital preparedness capacity for PHE assessing.
2. Hospitals’capacties in emergency system, monitoring and warning, medical treatements, emergency stock, safty of staff members and digital system and education&improvement should be improved to raise the HPCPHE of digital hospitals of PLA.
3. For assessing of hospital preparedness capacity for public health emergency (HPCPHE), teching hospital s’HPCPHE were better than non-teaching hospital s’.hospitals which used to treat SARS patients have better HPCPHE than those did not. HPCPHE of hospital located at estern China were better than those located at western China.
We, for the first time, establish and design an evaluation index system, a questionnaire and an evaluation model for survey the current hospital preparedness capacity for public health emergency in digital hospitals of PLA. Our research can provide preliminary suggestion for improving of hospital preparedness capacity for public health emergency in digital hospitaol of PLA.
引文
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