Construction Of The Evaluation Index System Of Public Health Emergency Response Capacity In China

Objective: This study established a comprehensive,systematic,reasonable and feasible evaluation index system of public health emergency response capacity,in order to provide a reference basis for emergency management departments to carry out emergency capability evaluation work,and provide theoretical and methodological guidance for improving the emergency response capacity level of public health emergencies in China,with the aim of further improving the emergency response system of China.Methods: Literature analysis and group discussion were combined to collect and summarize the evaluation indicators of public health emergency response capacity,and establish the initial framework of the indicator system.The final framework of the evaluation index system was determined by the Delphi method through two rounds of expert consultation,the analytic hierarchy process was used to determine the importance of each indicator by checking the consistency of indicators,and calculating the weight of indicators.Finally,factor analysis was used to analyze the reliability and validity of the indicator system to verify the rationality of the indicator system structure.Results:(1)Degree of enthusiasm of experts: 13 questionnaires were distributed and 11 valid ones were received in the first round of consultation by email.The effective rate of the questionnaire was 84.6%,of which 6 experts proposed to modify the content and structure of the indicators.In the second round of consultation,a total of 11 questionnaires were issued in the same way as the previous round,and 11 valid questionnaires were received.The effectiveness of the questionnaire was 100%.The,results indicated that the experts had a high enthusiasm for the evaluation and research of the emergency response capacity for public health emergencies.(2)Expert authority and coordination: the expert judgment coefficient values in the two rounds of consultation were 1.013 and 1.036 respectively;The familiarity was0.891 and 0.945 respectively;The authority coefficient values were 0.952 and 0.991 respectively.The authority coefficients of the experts in the two rounds of consultation were greater than 0.70,indicated that the experts participating in the consultation had high authority.The Kendall coefficients of the first level indicators in the two rounds of consultation were 0.414 and 0.500;The secondary indicators were 0.200 and 0.484respectively;The third level indicators were 0.291 and 0.584 respectively.After two rounds of consultation,the Kendall coefficient values of indicators at all levels had improved,and P<0.001,indicated that experts’ opinions on indicators were highly consistent.(3)Indicator system: the evaluation indicator system of public health emergency response capacity had been established,including 6 first level indicators,32 second level indicators and 96 third level indicators,after two rounds of expert consultation.In the first round of consultation,the average importance score of the first level indicators was 5～4.564,the standard deviation was 0～0.775,the coefficient of variation was less than 25%,and the full score ratio was more than 45%.A new first level indicator was added,and the first level indicators were standardized according to expert opinions.The average importance score of secondary indicators was between 5 and 4.603,and the coefficient of variation was less than 25%.Two secondary indicators were added,and the structure of secondary indicators was adjusted according to researches and expert opinions.The average importance score of the three level indicators was between4～4.430.The coefficient of variation of five indicators was greater than or equal to 25%,and the full score ratio of two indicators was less than 25%.The 7 indicators were removed by combining literature data,indicator screening criteria and expert opinions.11 indicators were added,and three indicators were modified according to researches and expert opinions.During the second round of consultation,all indicators at all levels were refined,among which the average importance scores of indicators at levels I,II and III were 5～4.833,5～4.651 and 5～4.273 respectively;The coefficient of variation of all indicators is less than 25%,and four three-level indicators have been modified.(4)Index weight analysis: the index weights of level I were: the basic information of the emergency organization(0.064),prevention and preparation(0.153),monitoring and early warning(0.196),disposal and rescue(0.242)laboratory construction(0.186),and recovery and reconstruction(0.159).The index weights of level II and III were focused on the corresponding dimensions,and the indicators at all levels have passed the consistency test,(CR<0.1).(5)Reliability and validity analysis of indicators: the coefficient values were greater than 0.890,and the overall α the coefficients are 0.986 and 0.992 respectively,indicated that this study was reliability.The KMO values were all greater than 0.90,P<0.001 in Bartlett’s spherical test,and the number of common factors extracted was highly consistent with the preset dimensions,indicated that this study was validity.detailly,common factor 1 in the second and third level indicators explained the dimensions of disposal and rescue.common factor 2 explained the dimensions of laboratory standardization construction.Common factor 4 in secondary indicators and common factor 3 in tertiary indicators explain the monitoring and early warning dimensions.Common factor 3 in secondary indicators and common factor 4 in tertiary indicators explain the dimension of prevention and preparation.2 common factor 5 in the three indicators explained the dimensions of recovery and reconstruction.2common factor 6 of the three-level indicators explains the basic situation dimension of the emergency organization.It showed that the results of the index system were reliable and the structure was reasonable.Conclusions:(1)The "evaluation index system of public health emergency response capacity",which included 6 first-level indicators,32 second-level indicators and 96 third-level indicators,had been constructed in this study.Using scientific and rigorous research methods and processes.It had ensured the integrity of the content,the authenticity and reliability of the research data,and the scientific and reasonable research results.(2)This indicator system was based on the current system of evaluation indicators for emergency response capability of public health emergencies in China with few studies and single dimension,and a comprehensive set of indicators system which can be used for reference by multiple emergency agencies,can provide a theoretical basis and methodological guidance for the evaluation of emergency response capability among Chinese emergency agencies and emergency managers to some extent.