价值医疗模式评价指标体系构建  

Evaluation Indicator System of Value-based Healthcare Delivery

作　　者：王仓红 胡才双 卢伟健 陈博洋 陈偬立 WANG Cang-hong;HU Cai-shuang;LU Wei-jian;CHEN Bo-yang;CHEN Zong-li(Guangdong Research Institute of Xi'an Jiaotong University in Shunde,Foshan 528300,Guangdong,China;Graduate School,University of Chinese Academy of Social Sciences,Beijing 102488,China;Graduate School,Nanjing University of the Arts,Nanjing 210036,Jiangsu,China)

机构地区：[1]广东顺德西安交通大学研究院,广东佛山528300 [2]中国社会科学院研究生院,北京102488 [3]南京艺术学院研究生院,江苏南京210036

出　　处：《医学信息》2022年第1期24-29,共6页Journal of Medical Information

摘　　要：目的基于价值医疗(VBHC)模式,构建VBHC指标评价体系。方法通过VBHC及查阅相关文献,拟初步建立评价指标体系的框架和条目池。应用德尔菲专家咨询法,于2018年1月-3月,通过面对面、电话、QQ和微信的方式对30位选定的专家进行三轮咨询,由专家对各指标的重要性和可操作性进行打分,使用界值法和根据专家意见对指标进行筛选和修改,应用专家评分法和组合权重乘积法计算指标权重。结果在三轮专家咨询中,专家权威度系数分别为0.815、0.814和0.795;积极程度系数分别为86.67%、92.31%和100%;各指标重要性和可操作性的算术平均值域分别为1.30~5.0和1.19~5.0、4.19~5.0和4.29~5.0、4.21~5.0和4.19~5.0;满分频率分别为9%~91%和11%~76%、23%~100%和22%~100%、21%~100%和19%~100%;变异系数分别为0.06~0.28和0.1~0.32、0~0.15和0~0.27、0~0.14和0~0.18;协调系数分别为0.29、0.64和0.69,P值测试均小于5%。最终形成的评价指标体系共35个条目,其中一级指标3个,二级指标9个,三级指标23个;一级指标及其权重系数分别为:特定疾病的诊疗成本和疗效数据收集与共享(0.411)、医疗费用支付者(0.233)、医疗服务提供者(0.356)。结论本研究构建了基于VBHC模式评价指标体系,具有较好的科学性,可以作为评价VBHC模式在中国的落实情况的工具。Objective To construct an evaluation indicator system based on the Value-based Healthcare(VBHC)delivery.Methods VBHC and related literature were used to construct the framework and item pool of the initial evaluation index system.From January to March 2018,the Using Delphi expert consultation method,30 selected experts were consulted for three rounds by face-to-face,telephone,QQ and WeChat from January to March 2018.The importance and operability of each index were scored by experts.The boundary value method and expert opinions were used to screen and modify the index.The expert scoring method and the combination weight product method were used to calculate the weight of the index.Results In the three rounds of surveys,the authority degree coefficient of experts was 0.815,0.814,and 0.795 respective;degree of positivity was 86.67%,92.31%and 100%.The arithmetic means of the importance and operability was 1.30-5.0 and 1.19-5.0,4.19-5.0 and 4.29-5.0,4.21-5.0 and 4.19-5.0.The full-score frequency was 9%-91%and 11%-76%,23%-100%and 22%-100%,21%-100%and 19%-100%.The variable coefficient was 0.06-0.28 and 0.1-0.32,0-0.15 and 0-0.27,0-0.14 and 0-0.18.The coordination coefficient was 0.29,0.64,and 0.69,and all P values were less than 5%.The final evaluation index system consists of 35 items,that 3 first-level indicators,9 second-level indicators and 23 third-level indicators.The first-level indicators and their weight coefficients were as follows:data collection and sharing of treatment cost and curative effect for specific diseases(0.411),medical expense payers(0.233)and medical service providers(0.356).Conclusion This study constructed an evaluation index system based on the VBHC delivery,which is scientific and can be used as a tool to evaluate the implementation of the VBHC delivery in China.

关 键 词：价值医疗 医疗服务态度 医院管理 评价指标体系 

分 类 号：R197[医药卫生—卫生事业管理]