Development of Health Emergency Response Capability Evaluation Framework for Primary Health Institutions in metropolis: Based on Delphi Method and Analytic Hierarchy Process

Qian Li¹Hongjie Yu²Fan Cheng³Haidong Kuang⁴Xiaoqiong Zhang⁴Yuqing Shao¹Xiaoxue Ma¹Jingyu Li¹Yan Li¹Yanhong Zhu^5*Yipeng Lv^1,6*

• ¹School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ²Jiading District Center for Disease Control and Prevention, shanghai, China
• ³Department of Gastroenterology First Affiliated Hospital, Naval Medical University of the Chinese People's Liberation Army, shanghai, China
• ⁴Yichuan Community Health Service Center, shanghai, China
• ⁵Shanghai General Hospital, shanghai, China
• ⁶Key Laboratory of Urban Complex Risk Control and Resilience Governance, Shanghai Emergency Management, Shanghai Jiao Tong University, shanghai, China

Background: Primary health institutions, as the "first on-site responders", play a crucial role in responding to health emergencies. However, there are few studies on the systematic assessment of their emergency response capabilities. We aimed to develop a health emergency response capability evaluation framework for primary health institutions to assess the resuscitation capacity in metropolis.In the first stage, we collected preliminary indicators through literature and government documents concerning the primary health evaluation. Afterward, we utilized the Delphi method to consult 15 frontline health emergency response practitioners, health management officials, and research experts. After two rounds of questionnaire consultations, participants scored the importance and feasibility of all indicators. Subsequently, we employed the analytic hierarchy process (AHP) to determine the weights assigned to each indicator and construct the framework of health emergency response capability evaluation for primary health institutions.We developed a framework for evaluating the health emergency response capabilities of primary health institutions in metropolis, comprising 3 first-level indicators, 11 second-level indicators, and 37 third-level indicators. In both rounds of consultation, experts provided a unanimous positive consensus, with a 100% agreement rate. The authority coefficient was 0.92 for both rounds, and the p-value of Kendall's W was statistically significant (<0.001). Furthermore, compared to the first round, the level of coordination among experts improved in the second round.In the process of judging matrices, the consistency ratios (CRs) of indicators at all levels were less than 0.1. For first-level indicators, including "prevention and monitoring", "resource reserve and system construction", and "emergency response and summarization", the respective weight values were 0.286, 0.335, and 0.379, respectively.This study developed a framework for evaluating the health emergency response capabilities of primary health institutions in metropolis. This framework can help improve the evaluation systems for emergency response capacity in primary health institutions in China's metropolis.