Zhongguo quanke yixue (Feb 2022)
Fuzzy Combination of TOPSIS and RSR for Comprehensively Assessing the Quality of National Essential Public Health Services
Abstract
BackgroundThe national essential public health services have been implemented since 2009 as a key initiative of the new round of China's healthcare reform. With the development of this service program, the allotted special funds and service items are increasing. Due to large number of indicators involved and wide coverage, it is imperative to explore a method that can assess the services scientifically, objectively and comprehensively.ObjectiveTo explore an appropriate method for comprehensively assessing the quality of national essential public health services, providing a basis for improving relevant policies and the quality of such services.MethodsBy use of multistage and purposive sampling, 24 community (township) health centers were selected from southern, central and northern Z Province from February to April 2019, and qualities of national essential public health services delivered by them in 2018 were comprehensively assessed using the technique for order of preference by similarity to ideal solution (TOPSIS) , rank-sum ratio (RSR) method, and fuzzy combination of TOPSIS and RSR method, respectively. With reference to the 2018 National Basic Public Health Service Project, 12 evaluation indicators were selected.ResultsAccording to the TOPSIS-based assessment, the top three community (township) health centers ranked by Ci value were A (0.917 4) , C (0.875 9) and G (0.787 9) , and the bottom three were I (0.414 2) , W (0.413 7) and N (0.407 7) . In accordance with the RSR method-based assessment, the top three community (township) health centers ranked by RSR value were A (0.890 6) , G (0.765 6) , and C (0.711 8) , and the bottom three were V (0.381 9) , W (0.362 8) , and K (0.357 6) . According to the fuzzy set theory, the top three community (township) health centers ranked by W1Ci+W2RSR values were A, C and G, and the bottom three were I, K and W in accordance with the "majority rule", which was basically consistent with the evaluation results of TOPSIS and RSR.ConclusionThe assessment results by TOPSIS, RSR, and fuzzy combination of these two and associated factors in this study are consistent with those of other studies. Either use of TOPSIS- or RSR-based quality assessment had limitations, but fuzzy combination of the two overcame these limitations, so the combination approach is worthy of promotion as an appropriate method for assessing the quality of essential public health services.
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