家庭医生团队签约服务能力评估指标体系构建  

Development of a Contracted Service Performance Evaluation System for Family Doctor Teams

作　　者：尚晓鹏[1] 杨清[1] 邱银伟[1] 赵艳荣[1] 汪炜[1] 林君芬[1] 徐校平[1] SHANG Xiaopeng;YANG Qing;QIU Yinwei;ZHAO Yanrong;WANG Wei;LIN Junfen;XU Xiaoping(Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China)

机构地区：[1]浙江省疾病预防控制中心

出　　处：《中国全科医学》2019年第16期1996-1999,2007,共5页Chinese General Practice

基　　金：2017年浙江省医药卫生科研基金项目(2017KY283)——家庭医生签约服务需求与基层医疗服务能力供给的匹配度与政策研究;2017年浙江省医药卫生科研基金项目(2017KY296)——居民电子健康档案利用与分工协作机制研究310051浙江省杭州市,浙江省疾病预防控制中心

摘　　要：背景现阶段在我国实行家庭医生签约服务,强化基层医疗卫生服务网络功能,促进基层首诊、分级诊疗是深化医药卫生体制改革的重要任务,但缺乏科学、合理、方便操作的家庭医生团队签约服务能力评估指标体系。目的构建一套家庭医生团队签约服务能力评估指标体系,为科学评价家庭医生团队签约能力、构建优质的家庭医生团队提供理论指导。方法于2017年8~9月采用德尔菲法专家咨询构建家庭医生团队签约服务能力评估指标体系,利用层次分析法确定指标的权重。结果两轮专家咨询回收率分别为100.0%(21/21)和90.5%(19/21),专家的判断系数为0.7643,熟悉程度为0.8095,权威系数为0.7869。第1轮和第2轮肯德尔和谐系数(Kendall’s W)分别为0.245(χ^2=293.206,P<0.001)和0.317(χ^2=279.631,P<0.001)。最终构建了含有7个一级指标、54个二级指标及其权重的家庭医生团队签约服务能力评估指标体系。结论本研究基于德尔菲法和层次分析法初步构建了家庭医生团队签约服务能力评估指标体系,可为客观、科学地评估家庭医生团队签约服务能力提供参考依据。Background At present,the implementation of contracted family doctor services in China is an important measure for accelerating the development of the hierarchical medical system via strengthening the functions of primary care networks and promoting first consultation in primary care,by which the reform of the pharmaceutical and healthcare system can be deepened.However,there is a lack of scientific,reasonable and easy-to-use systems for the assessment of the contracted service performance of the family doctor team.Objective To develop a contracted service performance evaluation system for family doctor teams,providing theoretical guidance for scientific evaluation of the contracted service performance of a family doctor team,and the building of a high-quality family doctor team.Methods Delphi expert consultation method was used to establish the Contracted Service Performance Evaluation System for Family Doctor Teams(CSPESFDT)in August and September,2017.Analytic hierarchy process(AHP) was applied to determine the weight of the indicators of the CSPESFDT.ResultsThe response rates of the two rounds of expert consultation were 100.0%(21/21) and 90.5%(19/21),respectively.The mean coefficient of determination,familiarity coefficient and authority coefficient were 0.764 3,0.809 5,0.786 9 for the two rounds of consultation.The Kendall’s W for the first and second consultations were 0.245(χ2=293.206,P<0.001),and 0.317(χ2=279.631,P<0.001),respectively.Finally,the CSPESFDT was developed,which consisted of 7 first-tier indicators,and 54 secondtier indicators with assigned weights.Conclusion We successfully established the CSPESFDT using Delphi and AHP methods,which is contributive to the objective and scientific assessment of the contracted service performance of the family doctor team.

关 键 词：家庭医生签约服务 DELPHI法 层次分析法 指标体系 

分 类 号：R197[医药卫生—卫生事业管理]