家庭医生签约服务模式效果评价指标体系构建研究  

Research on the construction of effectiveness evaluation index system for family doctor contract service model

作　　者：曾伟明 石建伟 俞文雅 陈宁 陈红 高雅 谭硕源 王朝昕 吴正一 ZENG Weiming;SHI Jianwei;YU Wenya;CHEN Ning;CHEN Hong;GAO Ya;TAN Shuoyuan;WANG Zhaoxin;WU Zhengyi(School of Public Health,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院公共卫生学院,上海200025

出　　处：《中华全科医学》2023年第5期721-725,共5页Chinese Journal of General Practice

基　　金：教育部哲学社会科学研究重大课题攻关项目(20JZD027);国家重点研发计划项目(SQ2022YFC3600172)。

摘　　要：目的目前我国各地区均已形成符合当地特色的家庭医生签约服务模式,但尚缺乏科学、可行的效果评价工具。为此,本研究构建我国家庭医生签约服务模式效果评价指标体系,旨在进一步推动家庭医生签约服务优质、高效发展。方法通过文献回顾分析并经小组讨论形成初步效果评价指标体系及专家咨询表。于2021年9月—2021年12月,采用德尔菲法,以Better Together模型为理论基础,“结果框架”为指导,经过两轮专家咨询,确定最终家庭医生签约服务模式效果评价指标体系,并通过专家咨询和层次分析法,确立各指标权重。结果专家积极性和权威程度较高,两轮专家咨询表的有效回收率分别为100%和75%,权威程度系数分别为0.898和0.877;专家意见趋于一致,两轮肯德尔系数分别为0.245(χ^(2)=393.205,P<0.001)和0.252(χ^(2)=453.417,P<0.001)。通过两轮专家咨询,最终构建以人群健康、服务质量、服务效率、成本控制、居民认可、亲密度为主要内容的家庭医生签约服务模式效果评价指标体系,其具体有5个一级指标、15个二级指标、48个三级指标,权重系数分别为0.217、0.217、0.196、0.181、0.188。结论本研究专家积极性、权威性、协调程度均较高,最终构建出的家庭医生签约服务模式效果评价指标体系结果可靠,从而为国内各地区家庭医生签约服务模式提供科学、客观的效果评价工具。Objective Currently,various regions in China have developed family doctor contract service models fitting local characteristics,however,it still lacks scientific and feasible tools for evaluating the effectiveness.Therefore,this study aims to develop the effectiveness evaluation index system for family doctor contract service models,which would promote the high-quality development of family doctor services.Methods The preliminary evaluation index system and expert consultation table were formed through literature reviews and group discussions.From September 2021 to December 2021,taking the Better Together model as the theoretical basis and the"results framework"as the guidance,the final effectiveness evaluation index system for family doctor contract service models was determined through two rounds of expert consultations using the Delphi method.The weights of each index were determined through expert consultations and analytic hierarchy process.Results The response rates of experts in the two rounds of consultation were 100%and 75%respectively,which indicated the experts were highly motivated.The authority coefficients for the two rounds of consultation were 0.898 and 0.877 respectively;The Kendall coefficients were 0.245(χ^(2)=393.205,P<0.001)and 0.252(χ^(2)=453.417,P<0.001)respectively,which indicated experts'opinions tended to be consistent.Through two rounds of expert consultation,the final effectiveness evaluation index system for family doctor contract service models was constructed,mainly focusing on population health,service quality,service efficiency,cost control,resident recognition,and intimacy.The system consisted of 5 first level indicators,15 second level indicators,and 48 third level indicators,with weight coefficients of 0.217,0.217,0.196,0.181,and 0.188,respectively.Conclusion The experts in this study are highly motivated,authoritative and coordinated,and the final effectiveness evaluation index system for family doctor contract service models are reliable,which can provide an objective and s

关 键 词：家庭医生签约服务模式 效果 德尔菲法 层次分析法 指标体系 

分 类 号：R192.3[医药卫生—卫生事业管理] R197.61[医药卫生—公共卫生与预防医学]