Study On The Effect Evaluation Index System Of County-level Hospital Trusteeship In Third-level Public Hospital

Objective: This study systemically combed intension and extension of public hospital trusteeship,summarized the different practical characteristics of county hospitals trusted by tertiary public hospitals.On this basis,the study structured an evaluation model of the public hospital trusteeship,designed a set of comprehensive and scientific evaluation index system and gave weight for evaluation index.Finally,this study could be used to guide and standardize the trusteeship work of tertiary public hospitals to county hospitals.Methods: Through literature research and case analysis,this study summarized the characteristics of county hospitals trusted by tertiary public hospitals.Based on the "structure-process-result" theory,an evaluation model of tertiary public hospitals trusteeship of county hospitals was constructed.Delphi method was used to design the questionnaire,the evaluation index system was determined after three rounds of consultation with experts,the questionnaire survey method was used to collect the opinions on the importance of indicators,and the analytic hierarchy process was used to calculate the weight and the combination weight of each indicator.Results: This study summarized the main trusteeship characteristics of county hospitals trusted by tertiary public hospitals.Using "structure-process-result" theory,the evaluation index system of county hospitals trusted by tertiary public hospitals was constructed,including 3 first-level indicators,9 second-level indicators,and 29third-level indicators.The results of Delphi method showed that the reliability and validity of the questionnaire were high,and the Cronbach’s α coefficient of the overall index was 0.918.The authority coefficients of structure,process and result were 0.87,0.90 and 0.89,respectively(P<0.001).The expert coordination coefficients were 0.113,0.157 and 0.213,respectively(P<0.001).The results of questionnaire survey and analytic hierarchy process showed that the indicators all passed the consistency tests,and the CI values were all less than 0.1.Finally,the index weights and combined weights were determined.The weights of the three first-level indicators,namely structure,process and result,were 0.2972,0.1638 and 0.5390,respectively.The result weight was the highest among the first-level indicators.The average weight of second-level indicators was0.3333,among which the weights of service quality(0.5889),government support(0.5390)and personnel support(0.5390)ranked the top three.The average weight of third-level indicators was 0.3103.Among them,constant financial subsidy policy(0.7500),the number of new technologies and new projects(0.5390),the benefit distribution mechanism(0.5247)ranked the top three.Conclusion: This study constructed the effect evaluation model and index system for county hospitals trusted by tertiary public hospitals from the three dimensions of structure,process and result,which provided reference and specification for county hospitals trusted by large urban hospitals.