全球卫生安全指数评估有效性分析

胡安琪; 王玎; 施婕; 刘超; 苏萍; 田磊磊; 迟蔚蔚

doi:10.16462/j.cnki.zhjbkz.2022.10.018

全球卫生安全指数评估有效性分析

doi: 10.16462/j.cnki.zhjbkz.2022.10.018

胡安琪^{1, 2},
王玎³,
施婕^{1, 2},
刘超⁴,
苏萍³,
田磊磊⁵,
迟蔚蔚^{1, 2, 3, ,}

1.
250012 济南, 山东大学齐鲁医学院公共卫生学院
2.
250003 济南, 国家健康医疗大数据研究院
3.
250002 济南, 山东健康医疗大数据管理中心
4.
233030 蚌埠, 蚌埠医学院公共卫生学院流行病与卫生统计学系
5.
250003 济南, 国家健康医疗大数据研究院

基金项目:

国家重点研发计划 2020YFC2003500

详细信息

通讯作者:
迟蔚蔚, E-mail: nahdyw@shandong.cn

中图分类号: R181.8
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- 文章访问数: 435
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- 被引次数: 0
出版历程
- 收稿日期: 2022-05-12
- 修回日期: 2022-06-28
- 刊出日期: 2022-10-10

Effectiveness analysis of global health security index (GHSI) assessment

HU An-qi^{1, 2},
WANG Ding³,
SHI Jie^{1, 2},
LIU Chao⁴,
SU Ping³,
TIAN Lei-lei⁵,
CHI Wei-wei^{1, 2, 3
, ,}

1.
School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
2.
National Institute of Health Data Science of China, Jinan 250003, China
3.
National Administration of Health Data, Jinan 250002, China
4.
School of Public Health, Bengbu Medical College, Bengbu 233030, China
5.
National Institute of Health Data Science of China, Jinan 250003, China

Funds:

National Key Research and Development Program of China 2020YFC2003500

More Information

Corresponding author: CHI Wei-wei, E-mail: nahdyw@shandong.cn

摘要

摘要: 目的研究全球卫生安全指数（Global Health Security Index，GHSI）与COVID-19疫情的关系，探索GHSI的价值。方法对来自公开数据库的159个国家（地区）进行横断面研究。用Spearman分析GHSI与COVID-19大流行的相关性，并绘制相关性矩阵。拟合多元线性回归模型控制各国社会经济及健康状况等因素，进一步研究GHSI与COVID-19大流行相关指标的关联。结果 159个国家（地区）2021年GHSI总分平均（41.19±13.41）分，最小值16.10分（也门），最大值75.90分（美国）。截至2021年12月31日159个国家（地区）COVID-19粗病死率0.02（0.01，0.03），最小值< 0.01（不丹），最大值0.20（也门）。每百万人口总确诊病例数50 844.42（5 807.88，101 572.70）例，最小值22.26（瓦努阿图共和国），最大值251 608.38（斯洛伐克）。每百万人口总死亡病例数590.71（105.66，1 533.20），最小值3.10（布隆迪），最大值6 075.95（秘鲁）。多元线性回归分析显示，GHSI检测报告评分与每百万人口总确诊病例呈负相关（β=-0.34，P=0.038），与每百万人口总死亡病例呈负相关（β=-0.42，P=0.025）；GHSI国际规范评分与每百万人口总确诊病例呈负相关（β=-0.49，P=0.041），GHSI卫生系统评分与每百万人口总死亡病例呈正相关（β=0.65，P=0.003），GHSI风险环境评分与粗病死率呈负相关（β=-0.91，P=0.044）。结论 GHSI在评估各国家（地区）应对COVID-19大流行的能力方面缺乏有效性，但仍存在一定价值。
- 全球卫生安全指数 /
- 新型冠状病毒肺炎 /
- 卫生安全治理
Abstract: Objective To investigate the correlation between Global Health Security Index (GHSI) and the epidemic situation of COVID-19 and to explore the value of GHSI. Methods A cross-sectional study of 159 countries from an open database was conducted. Analyze the correlation of GHSI with the COVID-19 pandemic with Spearman and plot the correlation matrix. Fitted multiple linear regression models controlled for variables such as socioeconomic and health conditions in countries, and further studied the association of GHSI with COVID-19 pandemic outcome indicators. Results The mean total GHSI score of the 159 countries in 2021 was (41.19±13.41), with a minimum of 16.10 (Yemen) and a maximum of 75.90 (The United States). As of 31 December 2021, the crude case fatality rate of COVID-19 in 159 countries was 0.02 (0.01, 0.03), with a minimum < 0.01 (Bhutan) and a maximum of 0.20 (Yemen). The total number of confirmed cases per million population was 50 844.42 (5 807.88, 101 572.70), with a minimum of 22.26 (Republic of Vanuatu) and a maximum of 251 608.38 (Slovakia). The total number of deaths per million population was 590.71 (105.66, 1 533.20), with a minimum of 3.10 (Burundi) and a maximum of 6 075.95 (Peru). Multiple linear regression analysis results showed that the Detect score of GHSI was negatively correlated with the total confirmed cases per million population (β=-0.34, P=0.038) and the total deaths per million population (β=-0.42, P0.025); the Norms score of GHSI was negatively correlated with the total confirmed cases per million population (β=-0.49, P0.041), and the Health score of GHSI was positively correlated with the total deaths per million population (β=0.65, P0.003). Risk score of GHSI was inversely correlated with case fatality rate(β=-0.91, P0.044). Conclusion The GHS Index has limited value in assessing a country's capacity to respond to the COVID-19 pandemic. Nevertheless, it has potential value in others.
- Global health security index /
- COVID-19 /
- Governance of global health security

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图 1 GHSI与COVID-19大流行的相关性

Figure 1. The correlation between the six categories of the GHS Index and the epidemic situation of COVID-19

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表 1 GHSI及6个维度释义

Table 1. Interpretation of GHSI and six categories

维度	编码	英文	释义
GHSI总分	GHSI	GHSI	全球卫生安全指数
预防	GHSI1	Prevent	预防病菌的出现或泄露
检测报告	GHSI2	Detect	快速查明并报告有可能引发全球关注的传染病
应急响应	GHSI3	Respond	快速响应并减缓传染病的扩散
卫生系统	GHSI4	Health	建立稳健的卫生系统，能够收治患者，有充足的医护人员
国际规范	GHSI5	Norms	遵守全球相关规范，承诺提高国家能力，在卫生安全方面提供资金用于补短板
风险环境	GHSI6	Risk	国家抵抗生物脆弱性威胁的能力

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表 2 159个国家(地区)GHSI、社会经济及健康水平(分)

Table 2. GHSI scores, socioeconomic and health levels in 159 countries (score)

变量(N=159)	Min	P₂₅	M	P₇₅	Max	x	s_x值
GHSI总分	16.10	30.35	38.30	51.70	75.90	41.19	13.41
GHSI1预防	0.80	16.05	29.70	44.05	79.40	31.15	17.41
GHSI2检测报告	4.20	22.20	33.30	47.65	91.50	36.11	18.75
GHSI3应急响应	17.50	29.40	36.50	46.25	70.70	38.98	12.18
GHSI4卫生系统	7.70	18.35	31.00	50.60	75.20	34.48	18.40
GHSI5国际规范	21.90	40.60	47.70	59.70	81.90	50.08	12.76
GHSI6风险环境	24.90	44.95	55.00	66.25	89.00	56.36	14.98
政府严格性指数	6.48	35.19	46.30	55.33	90.74	45.66	16.75
65岁及以上人口百分比(%)	1.14	3.54	6.22	14.37	27.05	8.83	6.35
人均GDP(美元)	661.20	4 347.10	12 236.70	27 827.40	116 935.60	19 207.53	20 130.69
预期寿命(年)	53.28	67.12	74.25	78.23	84.63	72.74	7.54

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表 3 159个国家(地区)COVID-19大流行情况

Table 3. The epidemic situation of COVID-19 in 159 countries

变量(N=159)	Min	P₂₅	M	P₇₅	Max	x	s_x值
粗病死率(%)	< 0.01	0.01	0.02	0.03	0.20	0.02	0.02
每百万人口总确诊病例数(例)	22.26	5 807.88	50 844.42	101 572.70	251 608.38	64 027.52	64 383.40
每百万人口总死亡病例数(例)	3.10	105.66	590.71	1 533.20	6 075.95	989.01	1 095.92

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表 4 COVID-19每百万人口总确诊例数标化数据多元线性回归分析

Table 4. Multiple linear regression of standardized data per million confirmed cases of COVID-19

变量(N=159)	β值	s_x值	t值	(95% CI)值	P值
GHSI1预防	0.30	0.19	1.584	-0.08~0.68	0.115
GHSI2检测报告	-0.34	0.16	-2.092	-0.66~-0.02	0.038
GHSI3应急响应	0.18	0.22	0.803	-0.26~0.62	0.423
GHSI4卫生系统	0.23	0.19	1.201	-0.15~0.60	0.232
GHSI5国际规范	-0.49	0.24	-2.061	-0.95~-0.02	0.041
GHSI6风险环境	0.52	0.33	1.564	-0.14~1.17	0.120
政府严格性指数	0.03	0.13	0.210	-0.22~0.28	0.834
65岁及以上人口百分比(%)	0.48	0.13	3.727	0.22~0.73	< 0.001
人均GDP(美元)	0.07	0.09	0.800	-0.11~0.25	0.425
预期寿命(年)	-0.06	0.78	-0.075	-1.60~1.49	0.941
RSE	0.504
adj R²值	0.493
F值	16.370
P值	< 0.001
注：COVID-19相关数据截至2021年12月31日; RSE表示残留标准误差; adj R²表示调整后R²值。

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表 5 COVID-19每百万人口总死亡例数标化数据多元线性回归分析

Table 5. Multiple linear regression of standardized data per million deaths from COVID-19

变量(N=159)	β值	s_x值	t值	(95% CI)值	P值
GHSI1预防	0.30	0.22	1.379	-0.13~0.74	0.170
GHSI2检测报告	-0.42	0.19	-2.257	-0.78~-0.05	0.025
GHSI3应急响应	0.29	0.26	1.129	-0.22~0.79	0.261
GHSI4卫生系统	0.65	0.22	2.979	0.22~1.08	0.003
GHSI5国际规范	-0.35	0.27	-1.296	-0.88~0.18	0.197
GHSI6风险环境	-0.45	0.38	-1.184	-1.20~0.30	0.238
政府严格性指数	0.15	0.14	1.006	-0.14~0.43	0.316
65岁及以上人口百分比(%)	0.52	0.15	3.523	0.23~0.80	0.001
人均GDP(美元)	-0.22	0.10	-2.175	-0.43~-0.02	0.031
预期寿命(年)	0.59	0.90	0.660	-1.18~2.36	0.510
RSE	0.578
adj R²值	0.392
F值	11.190
P值	< 0.001
注：COVID-19相关数据截至2021年12月31日; RSE表示残留标准误差; adj R²表示调整后R²值。

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表 6 COVID-19粗病死率标化数据多元线性回归分析

Table 6. Multiple linear regression of standardized data case fatality rate from COVID-19

变量(N=159)	β值	s_x值	t值	(95% CI)值	P值
GHSI1预防	-0.32	0.26	-1.214	-0.83~0.20	0.227
GHSI2检测报告	-0.36	0.22	-1.647	-0.80~0.07	0.102
GHSI3应急响应	0.03	0.30	0.096	-0.57~0.63	0.924
GHSI4卫生系统	0.46	0.26	1.786	-0.05~0.97	0.076
GHSI5国际规范	0.59	0.32	1.854	-0.04~1.23	0.066
GHSI6风险环境	-0.91	0.45	-2.033	-1.80~-0.03	0.044
政府严格性指数	-0.23	0.17	-1.322	-0.56~0.11	0.188
65岁及以上人口百分比(%)	-0.10	0.17	-0.579	-0.44~0.24	0.564
人均GDP(美元)	-0.21	0.12	-1.734	-0.45~0.03	0.085
预期寿命(年)	2.28	1.06	2.146	0.18~4.38	0.034
RSE	0.685
adj R²值	0.116
F值	3.082
P值	0.001
注：COVID-19相关数据截至2021年12月31日; RSE表示残留标准误差; adj R²表示调整后R²值。

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