基于需方的县域医疗健康服务整合评价工具构建与适用性研究  

Research on the establishment and suitability of an assessment tool for demand-based integration of county-level health services in China

作　　者：李力[1] 郑英[1] 朱晓丽[1] 胡佳[1] LI Li;ZHENG Ying;ZHU Xiao-li;HU Jia(Center for Health Policy and Management,Institute of Medical Information,Chinese Academy of Medical Sciences,Beijing 100020,China)

机构地区：[1]中国医学科学院医学信息研究所卫生政策与管理研究中心,北京100020

出　　处：《中国卫生政策研究》2022年第1期29-36,共8页Chinese Journal of Health Policy

基　　金：中国医学科学院医学与健康科技创新工程经费资助项目(CIFMS 2016-I2M-3-018)。

摘　　要：目的:制定基于需方的县域医疗健康服务整合程度评价工具,并验证其对于评价县域医疗健康服务整合的适用性。方法:基于课题组前期研究成果,制定县域医疗健康服务整合的患者调查问卷,在河南省D县内开展现场问卷调查,采用探索性因子分析、Spearman秩相关、Cronbach’sα系数等检验信效度。结果:提取4个公因子,包含12个条目,累积贡献率为73.16%;所有条目仅对所属公因子的因子载荷大于0.4、Spearman相关系数基本均大于0.5;总体以及各公因子的Cronbach’sα系数基本均大于0.7。结论:基于需方的县域医疗健康服务整合评价工具,可分为服务协调与连续性、患者就医偏好、服务可获得性、服务可接受性与患者及家庭参与4个维度,包含8个要素与12个条目,对于评价现阶段县域医疗健康服务整合具有适用性。Objective:To establish a tool for assessing the extent of demand-based integration of county-level health services in China and verify its suitability.Methods:Based on previous research results of our group,a patient questionnaire was developed regarding the integration of county-level health services.A field survey was carried out in D County of Henan Province.The exploratory factor analysis,Spearman rank correlation,Cronbach’sαcoefficient and other tests were used to test the reliability and validity.Results:Four common factors were extracted which included twelve items,and the cumulative contribution rate was 73.16%.The factor loads of all items were greater than 0.4 only for their common factor.Spearman correlation coefficients were generally greater than 0.5.The overall Cronbach’sαcoefficient and the Cronbach’sαcoefficients of the common factors were generally greater than 0.7.Conclusions:The established assessment tool for demand-based integration of county-level health services primarily consisted of four dimensions(service coordination and continuity,patients’medical preference,availability of health services,service acceptability and patient/family participation),and included eight elements and twelve items.This assessment tool should have a certain level of suitability for evaluating the current integration of county-level health services in China.

关 键 词：卫生服务整合 评价工具 信度 效度 县域医共体 整合型医疗健康服务体系 

分 类 号：R197.1[医药卫生—卫生事业管理]