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中华妇幼临床医学杂志(电子版)

中华妇幼临床医学杂志(电子版) ›› 2013, Vol. 09 ›› Issue (03) : 319 -322. doi: 10.3877/cma.j.issn.1673-5250.2013.03.008

所属专题： 专题评论； 文献；

论著

广州市12个区(县级市)妇幼保健服务综合绩效评价体系的构建
邱琇1, 刘裕1, 夏晓燕1, 沈松英1, 杨丽1, 冯琼1, 夏慧敏1,*,*()   
  1. 1. 510623　广州，广州市妇女儿童医疗中心
  • 收稿日期:2013-01-06 修回日期:2013-04-09 出版日期:2013-06-01
  • 通信作者: 夏慧敏

A Comprehensive Indicator System for Performance Assessment of Women and Children Health Care at County-Level of Guangzhou City

Xiu QIU1, Yu LIU1, Xiao-yan XIA1, Song-ying SHEN1, Li YANG1, Qiong FENG1, Hui-min XIA1()   

  1. 1. Women's Health Department, Guangzhou Women and Children's Medical Center, Guangzhou 510623, Guangdong Province, China
  • Received:2013-01-06 Revised:2013-04-09 Published:2013-06-01
  • Corresponding author: Hui-min XIA
  • About author:
    (Corresponding author: XIA Hui-min, Email: )
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引用本文：

邱琇, 刘裕, 夏晓燕, 沈松英, 杨丽, 冯琼, 夏慧敏. 广州市12个区(县级市)妇幼保健服务综合绩效评价体系的构建[J]. 中华妇幼临床医学杂志(电子版), 2013, 09(03): 319-322.

Xiu QIU, Yu LIU, Xiao-yan XIA, Song-ying SHEN, Li YANG, Qiong FENG, Hui-min XIA. A Comprehensive Indicator System for Performance Assessment of Women and Children Health Care at County-Level of Guangzhou City[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2013, 09(03): 319-322.

目的

探索构建广州市12个区(县级市)妇幼保健服务综合绩效评价指标体系，旨在为广州12个区(县级市)妇幼保健工作绩效管理提供思路和依据。

方法

选取《2011年广州市妇幼保健年报表》，主要包括《广州市产科质量情况年报表》、《广州市孕产妇保健和健康情况年报表》、《广州市7岁以下儿童保健和健康情况年报表》为研究对象。采用因子分析法对筛选指标进行综合分析，对各区(县级市)妇幼保健服务完成情况进行综合评价。

结果

根据绩效评价指标体系框架，从工作量、工作质量、工作过程、工作成效4个维度对广州市12个区(县级市)妇幼保健服务绩效进行评价的综合得分结果显示，排位前3位的为PY，BY和HZ区，排位靠后的为ZC，LW和HP区。

结论

本研究构建的模型客观地反映了广州市12个区(县级市)妇幼保健服务的4个维度，既体现了工作量所带来的工作难度，也显现了过程的重要性，同时统一了产出和结果，充分体现了妇幼卫生工作的主要维度。建议今后根据每年工作重心，对妇幼绩效考核指标的选取进行适当调整。

关键词: 产妇卫生保健服务, 儿童卫生保健服务, 绩效评估
Objective

To establish an indicator system for performance assessment of woman and child health care at county-level in Guangzhou.

Methods

We analyzed annual report (2011) of maternal and child health care in Gauangzhou city, including annual report (2011) of obstetric quality in Guangzhou city, annual report (2011) of maternal health care in Guangzhou city, annual report (2011) of child health care of children under 7-year-old. The indicators were summarized by factor analysis and new indexes were created. A comprehensive model was set up with the new indexes, which can be used as a tool for annual performance of woman and child health care at county-level in Guangzhou.

Results

Data from twelve county-level woman and child health care centers in Guangzhou were put into the comprehensive model. The performance was evaluated by indicators of workload, work quality, working process, and work effect. From the perspective of comprehensive scores, the top three districts were PY, BY and HZ, and the last three districts were ZC, LW and HP.

Conclusions

The model of four dimensions was a scientific and practical general performance assessment indicator system which can be applicable to woman and child health services at county-level in Guangzhou city. It also suggests that a modification should be considered based on the annual work plan.

Key words: maternal health service, child health service, performance evaluation
表2 因子负荷矩阵
Table 2 Factor loading matrix
项目 因子1 因子2 因子3 因子4 共同度
婴儿死亡率 0.53 0.53 0.49 0.05 0.80
活产儿数 －0.55 0.78 0.08 －0.02 0.92
1岁以下儿童数 －0.68 0.69 －0.06 0.05 0.94
孕产妇死亡率 0.59 0.69 －0.10 －0.04 0.84
新生儿窒息发生率 0.53 0.15 0.66 －0.25 0.80
孕产妇系统管理率 0.49 －0.05 －0.60 0.51 0.86
1岁以下儿童系统管理率 0.27 0.46 －0.23 0.68 0.80
早产发生率 0.07 －0.34 0.59 0.61 0.84
剖宫产率 －0.56 －0.10 0.42 0.58 0.84
表3 旋转后的因子载荷(正交Parsimax旋转法)
Table 3 Factor analysis of model after factor rotation
项目 因子1 因子2 因子3 因子4 特殊方差
1岁以下儿童数 0.97 －0.13 0.01 0.00 0.04
活产儿数 0.95 0.09 －0.03 －0.02 0.09
婴儿死亡率 0.09 0.88 0.18 0.03 0.18
新生儿窒息发生率 －0.20 0.84 －0.23 0.02 0.20
孕产妇死亡率 0.17 0.61 0.48 －0.45 0.17
1岁以下儿童系统管理率 0.20 0.15 0.85 0.13 0.20
孕产妇系统管理率 －0.36 －0.17 0.83 －0.14 0.13
早产发生率 －0.28 0.19 0.07 0.85 0.16
剖宫产率 0.30 －0.18 －0.05 0.84 0.17
表1 因子分析相关矩阵特征值及方差贡献率
Table 1 Factor analysis of matrix eigenvalue and variance contribution rates
主成分排序 特征值 差值 比例 累积率
1 2.31 0.10 0.26 0.26
2 2.21 0.57 0.25 0.50
3 1.63 0.15 0.18 0.68
4 1.49 0.99 0.17 0.85
5 0.50 0.11 0.06 0.90
6 0.38 0.16 0.04 0.95
7 0.23 0.02 0.03 0.97
8 0.21 0.16 0.02 0.99
9 0.05 － 0.01 1.00
表4 广州市12个区(县级市)妇幼工作因子得分、综合得分及排序
Table 4 Results of factor scores, comprehensive scores and order of maternal and children health performance of twelve districts in Guangzhou
顺序 区(县级市) 综合得分 工作量因子 工作成效因子 工作过程因子 工作质量因子
1 PY 0.70 1.35 0.41 0.65 0.17
2 BY 0.61 1.68 0.35 －0.85 0.93
3 HZ 0.36 0.29 0.93 －0.25 0.29
4 HD 0.28 0.53 0.29 －0.09 0.28
5 YX 0.21 0.06 0.46 1.59 －1.44
6 LG 0.12 －1.25 0.31 0.73 1.31
7 CH 0.07 －0.28 －1.03 1.27 0.91
8 NS －0.04 －1.54 1.83 －0.14 －0.37
9 TH －0.14 0.58 0.02 －1.13 －0.41
10 ZC －0.43 0.06 －1.89 0.67 －0.24
11 LW －0.85 －0.24 －0.67 －0.82 －2.12
12 HP －0.88 －1.25 －1.00 －1.64 0.70
因子权重(%) 　 　 30.24 28.90 21.30 19.50
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URL    
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Luo R, Jin X, Yang Q, et al. Study on establishing an indicator system for performance assessment of women and children health care institutions[J]. Chin J Hosp Admin, 2009, 25(11):737-741.
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Sun ZQ, Xu YY. Medical statistics. 2nd ed[M]. Beijing: People's Medical Publishing House, 2007, 415-425.
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