Research On The Evaluation Index System Of County-level Medical-prevention Integration

Background: Without national health,there will be no comprehensive well-off.To improve the health level of the population,it is inevitable to change the traditional "disease-centered" concept of health,pay attention to health promotion,and effectively integrate medical treatment and prevention.Especially since the outbreak of the COVID-19,the importance of county-level medical and preventive integration construction has become more and more prominent.To establish a scientific,standardized and effective county-level medical-prevention integration evaluation index system,to access the situation of county-level medical-prevention integration,to discover problems in key links of integration in a timely manner,to adjust the work direction in a timely manner,to rationally allocate medical and health resources,and to make better use of health services are important.It is of great importance to provide a full range of full-cycle medical services.Therefore,it is necessary to establish an evaluation index system of county-level medical-prevention integration based on the development trend of countylevel medical-prevention integration,the orientation of health policy,and the use of scientific theories and methods,so as to provide theoretical evidence for promoting,improving and enhancing county-level medical-prevention integration work.evidence basis.Objective: To understand the current situation of county-level medical-prevention integration in my country,build a theoretical framework for medical-prevention integration evaluation that meets my country’s actual development needs,and develop a county-level medical-prevention integration evaluation index system that meets my country’s actual development needs.Theoretical basis and policy recommendations.Methods: This study draws on the rainbow model theory,determined the theoretical framework and candidate index library of the county-level medical-prevention integration evaluation index system through policy analysis,literature review,interviews,etc.The indexes in the index library were screened and modified,and the evaluation index system of county-level medical-prevention integration was determined;finally,the weight of the index system was determined by the AHP.Relevant data were entered in Excel 2019,and SPSS 25.0 was used for statistical analysis.Results:（1）Theoretical framework construction: This research draws on the logical thinking of the rainbow model,combines the current trend of domestic medicalprevention integration development and the commonalities in the practical experience of various places to construct the conceptual framework of this index system.Adjustments were made during the consultation process,and an indicator system was constructed including six dimensions（primary indicators）of "system integration","organizational integration","professional integration","service integration","resource integration" and " normative integration" conceptual framework;（2）Preliminary selection of indicators: After further literature review and discussion,the indicators were initially screened,and 43 indicators were reserved for Delphi expert consultation;（3）Delphi method to determine the indicator system: A 20-person expert consultation group was formed,and to two rounds of consultation were conducted by email,and finally the evaluation index system of county-level medical-prevention integration was finalized,including: 6 first-level indicators,15 second-level indicators,and 37 third-level indicators;（4）Weight distribution of indicators: The AHP is used to calculate and determine the weight coefficients and combined weight coefficients of indicators at all levels in the indicator system by applying the AHP,of which the weight coefficients of the six firstlevel indicators are: 0.2521 for institutional integration;0.1458 for organizational integration;0.1320 for professional integration;Service fusion is 0.2051;resource fusion is 0.1527;norm fusion is 0.1124.Conclusion: The county-level medical-prevention integration evaluation index system established in this study involves 6 first-level indicators,15 second-level indicators,and37 third-level indicators,which can comprehensively reflect the actual status of countylevel medical-prevention integration.The construction process of the indicators is rigorous,the method is scientific,and the results are reliable,which has important guiding and practical significance for the healthy and sustainable development of the county-level medical-prevention integration in my country in the future.