Construction And Empirical Study Of Quality Control Evaluation Index System Of Health Management For High Risk Diabetic Population In Community

Objective:Guided by high-quality graded diagnosis and treatment,an index system for evaluating the health management level of high-risk diabetic population in the community was established to provide a scientific and effective evaluation tool for promoting the health management of high-risk diabetic population in the community.Based on the constructed evaluation index system,this paper comprehensively evaluates the health management and service ability of high risk diabetic population in community health service institutions,analyzes the existing problems in basic health institutions and puts forward corresponding suggestions for rectification.Methods:1.Evaluation index system construction and empowerment: Through literature review,policy analysis,qualitative interview,preliminary development of index items and construction of the framework;Based on the actual work of community health institutions,the rudiment of evaluation index system was established.Conduct two rounds of expert letter consultation to improve and optimize the index system;The quality control evaluation index system of community diabetes high risk population health management was established by group discussion combining with expert opinions.Based on the results of the second round of expert letter consultation,the weights of each evaluation index were assigned based on the analytic hierarchy process,so that the relative importance of each index could be more intuitively seen.2.Empirical Study on evaluation index system: A questionnaire was designed to investigate some community health service institutions in Changzhi City according to the weight results of each index combination.TOPSIS method was used for data processing.According to the closeness to the optimal solution,the health management service ability of high-risk diabetic groups in the community of each institution was ranked,and the problems were found and targeted suggestions were put forward.Results:1.Index system construction results(1)Expert letter consultation results: After two rounds of letter consultation,the effective recovery rates were 92.6% and 100%,the authority coefficients of expert opinions were 0.932 and 0.938,and the coordination degrees of expert opinions were0.13,0.16,0.26 and 0.15,0.21,0.22,respectively.The significance test P<0.05.(2)Index screening results: Nine indicators have been restated.("human resource allocation" was changed to "human resource","organizational structure" was changed to "organizational management","economic policy" was changed to "fund input","biochemical index" was changed to "physiological and biochemical index","comprehensive quality of human resource" was changed to "personnel structure","doctor-patient/medical ratio" was changed to "manpower allocation","fund situation" was changed to "fund supply","fund guarantee" was changed to "fund management","diabetes screening" changed to "high-risk diabetes screening").Five indicators were added("follow-up management" and its derived "follow-up frequency up to standard rate" and "follow-up content standard","number of general practitioners per 10,000population","number of public health doctors per 10,000 population").Five indexes were deleted("bone mineral density","length of service","doctor-patient ratio up to standard","high-density lipoprotein cholesterol","adiponectin").The index system thus constructed contains 6 first-level indexes,22 second-level indexes and 55 third-level indexes.2.Analytic Hierarchy Process to determine the weight resultsBased on the results of the second round of expert consultation,the weight of indicators at all levels was measured by AHP.Among the first-level indicators,the largest weight was patient behavior(0.3200).Among secondary indexes,the top 5 are eating habits(0.1568),fund supply(0.1275),effectiveness of organization and management(0.0800),exercise(0.0736),and screening for high-risk groups of diabetes(0.0621).3.TOPSIS comprehensive evaluation resultsThe TOPSIS method was used to comprehensively sort the survey data of five community health institutions(numbered A,B,C,D,and E,respectively).The results showed that the health management service capabilities of community diabetes high-risk groups from strong to weak were A,E,C,B,and D,respectively.Conclusion:The quality control evaluation index system of community health management for high-risk groups of diabetes mellitus established in this study includes 6 first-level indicators,22 second-level indicators and 55 third-level indicators,which has good operability in practical application.The health management service level of community health service institutions for high-risk groups of diabetes still needs to be further improved.It is suggested that the quality control evaluation of health management of high-risk groups of community diabetes should be included in the routine work to find the problems existing in the working process of community health service institutions,so as to effectively improve the quality of service.