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. 2025 Apr 10;25(1):1337.
doi: 10.1186/s12889-025-22549-y.

Construction of an evaluation index system for hospital resilience to emerging infectious diseases: a Delphi study from China

Kangyao Cheng #  1 , Ziwei Xu #  1 , Yanyan Zhang #  2 , Rujie Chen  1 , Li Gui  3
Affiliations

Construction of an evaluation index system for hospital resilience to emerging infectious diseases: a Delphi study from China

Kangyao Cheng et al. BMC Public Health. .

Abstract

Background: The frequent outbreak of infectious diseases has presented unparalleled challenges to hospitals globally. The pressure exerted on healthcare systems during these crises accentuates the imperative need for enhanced management and resource allocation, further emphasizing the pivotal role of hospital resilience. As the vanguard in combating infectious disease outbreaks, bolstering hospital resilience has become a strategic imperative to fortify healthcare systems against the unpredictable and volatile landscape of global health threats. Consequently, in this study, we aimed to develop an index system for the comprehensive evaluation of hospital resilience in response to emerging infectious diseases.

Methods: Drawing on the World Health Organization "Action Framework" for responding to infectious disease outbreaks, the Delphi method was implemented to identify the core evaluation index of hospital resilience in the context of emerging infectious diseases. In this method, we assembled a panel of 16 health experts specializing in medical statistics, infectious disease prevention and control, emergency medicine, hospital management, and public health administration. The panel evaluated the importance of the proposed indicators using a five-point Likert scale, supplemented by their qualitative feedback. To ascertain the weights of these indicators, the Analytic Hierarchy Process and the Precedence Chart were integrated.

Results: After two rounds of expert consultation on the evaluation index system, a consensus was reached. The system contained five first-level indicators (hospital command and coordination capacity, hospital monitoring capacity, hospital risk communication capacity, hospital medical response capacity, and hospital health management capacity) affiliated with 13 second-level indicators and 32 third-level indicators. Among the primary indicators, hospital command and coordination capacity had the highest weight, followed by hospital medical response capacity. The expert authority coefficient of consultation was 0.96. The Kendall's concordance coefficients of the total indicators were 0.223 and 0.342, respectively. The differences were statistically significant (P < 0.05).

Conclusion: The evaluation index system for hospital resilience to emerging infectious diseases, developed using the Delphi method in this study, is comprehensive and possesses high scientific reliability. The widespread application of this index system can assist hospitals in identifying and ameliorating weaknesses in their resilience capabilities, thereby enhancing their rapid response and adaptability to potential future outbreaks.

Keywords: Delphi method; Emerging infectious diseases; Evaluation research; Hospital; Resilience.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was authorized by the Committee on Ethics of Medicine of Naval Medical University in Shanghai, China (202130809) in accordance with the Declaration of Helsinki. All methods were carried out in line with the relevant guidelines and regulations. Informed consent was obtained from all participants included in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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