关键词: 基层卫生健康, 发展评价, 指标体系, 专家咨询, 层次分析法

Abstract: Objective To construct an evaluation indicator system for the development of primary health care in Guangzhou, thereby establishing a foundational framework for conducting district-level primary health care assessments. Methods Grounded in the Structure-Process-Outcome model, the health system performance assessment framework, and comprehensive evaluation theory, an initial pool of indicators was formulated through an extensive literature review, policy text analysis, and a systematic synthesis of existing indicator systems. A two-stage Delphi expert consultation, complemented by focus group discussions, was employed to screen and refine the indicators. The Analytic Hierarchy Process (AHP) was subsequently utilized to determine the relative weights of the indicators across all hierarchical levels. The methodological rigor of the research process was validated by evaluating the effective questionnaire response rate, the expert authority coefficient, Kendall's coefficient of concordance (Kendall's W), and the consistency ratio of the judgment matrices. Results The preliminary indicator pool comprised 3 primary, 26 secondary, and 79 tertiary indicators. Across the two-stage expert consultation, 47 questionnaires were distributed, yielding 46 valid responses (an effective response rate of 97.87%). The expert authority coefficients for the first and second stages were 0.90 and 0.91, respectively. In the first stage, Kendall's W values for scientific validity, importance, data availability, and expert familiarity were 0.341, 0.293, 0.375, and 0.214, respectively. In the second stage, these values improved to 0.556, 0.549, 0.559, and 0.671, respectively, with all dimensional tests demonstrating statistical significance (P<0.001). The finalized evaluation indicator system comprises 3 primary indicators (structure, process, and outcome), 22 secondary indicators, and 68 tertiary indicators. The relative weights for the structure, process, and outcome dimensions were calculated as 0.354 3, 0.325 0, and 0.320 7, respectively. The consistency ratios of the judgment matrices at all hierarchical levels were strictly <0.10, with a maximum recorded value of 0.013. Conclusion The formulated evaluation indicator system for primary health care development in Guangzhou comprehensively encompasses resource infrastructure, service delivery, and outcome performance, demonstrating a relatively equitable distribution of weights across the primary dimensions. This system provides a robust methodological framework for conducting district-level evaluations, facilitating cross-dimensional comparisons, and optimizing continuous monitoring and assessment of primary health care.

Key words: Primary health care, Development evaluation, Indicator system, Expert consultation, Analytic hierarchy process