CAJ | 학술논문

目的：探索适合县级及以上公共卫生机构使用的区域基本公共卫生服务评价方法。方法分别采用加权综合评分法、加权综合指数法、加权逼近理想解排序法（Topsis）和加权秩和比法（RSR）对2012年浙江省11个市的基本公共卫生服务数据进行评价，采用Kendall协调系数W检验对评价结果进行一致性检验。一致性良好的前提下分别采用均值法、加权平均组合评价法和系统聚类分析对4种单一综合评价结果进行组合评价。结果各综合评价方法的单一评价结果不同，前2位排序均为杭州、宁波，一致性检验结果显示4组评价结果具有良好的一致性。均值法和加权平均组合评价法的组合评价值顺位均为杭州、宁波、绍兴、嘉兴、湖州、台州、金华、舟山、丽水、温州和衢州。系统聚类分析将11个市分为4类较为合适：优秀（杭州、宁波），良好（湖州、嘉兴、绍兴），中等（舟山、金华、台州），较差（温州、衢州、丽水），类间差异有统计学意义（P＜0.01）。结论4种综合评价方法均适用于县级及以上公共卫生机构进行本区域基本公共卫生服务评价，实际应用时宜采用多种综合评价方法。
목적：탐색괄합현급급이상공공위생궤구사용적구역기본공공위생복무평개방법。방법분별채용가권종합평분법、가권종합지수법、가권핍근이상해배서법（Topsis）화가권질화비법（RSR）대2012년절강성11개시적기본공공위생복무수거진행평개，채용Kendall협조계수W검험대평개결과진행일치성검험。일치성량호적전제하분별채용균치법、가권평균조합평개법화계통취류분석대4충단일종합평개결과진행조합평개。결과각종합평개방법적단일평개결과불동，전2위배서균위항주、저파，일치성검험결과현시4조평개결과구유량호적일치성。균치법화가권평균조합평개법적조합평개치순위균위항주、저파、소흥、가흥、호주、태주、금화、주산、려수、온주화구주。계통취류분석장11개시분위4류교위합괄：우수（항주、저파），량호（호주、가흥、소흥），중등（주산、금화、태주），교차（온주、구주、려수），류간차이유통계학의의（P＜0.01）。결론4충종합평개방법균괄용우현급급이상공공위생궤구진행본구역기본공공위생복무평개，실제응용시의채용다충종합평개방법。
Objective To develop appropriate evaluation methods of local basic public health services which are suitable to county level and above.Methods Data on basic public health services of 1 1 cities in Zhejiang province in 201 2 was evaluated by different evaluation methods including weighted synthetic scored method,weighted synthetic index method, Weighted Technique for Order Preference by Similarity to Ideal Solution (Topsis ) and Weighted Rank -Sum Ratio (RSR).The consistency of evaluation results were tested by Kendall's coefficient of concordance W test.Combination evaluation was conducted to evaluate four single synthetic evaluation results through average method,weighted average combination evaluation method and hierarchical clustering analysis.Results Different synthetic evaluation methods had different evaluation results.However,in the order,the top two were all Hangzhou and Ningbo.Kendall's W test showed good consistence of four evaluation results.Rank of 1 1 cities were Hangzhou,Ningbo,Shaoxing,Jiaxing,Huzhou, Taizhou,Jinhua,Zhoushan,Lishui,Wenzhou and Quzhou based on combination evaluation value by average method, which was the same to the rank based on weighted average combination evaluation result.Eleven cities could be classified into four categories by hierarchical clustering analysis with statistical significance (P <0.01 ):Excellent (Hangzhou, Ningbo),Good (Huzhou,Jiaxing,Shaoxing),Middle (Zhoushan,Jinhua,Taizhou)and Poor (Wenzhou,Quzhou, Lishui).Conclusion These four synthetic evaluation methods used in this study are all suitable to county level and above in basic public health services evaluation.Various synthetic evaluation methods could be used in practice with combination evaluation of various evaluation results.Average method which is convenient and accurate is preferred when consistency of various synthetic evaluation results was testified.Hierarchical clustering analysis could be used for combination evaluation when no precise rank is needed.