| Background:Green refers to healthy and harmless. With global environmental pollution, ecological disruption, and energy crisis being more and more serious, claims of "ecology, environmental, energy conservation, low carbon" is influencing the decisions of government. Healtehcare department palys an important role in economic field of China, however, their attention and action on environmental protection is in a relatively backward state. Hospital building has become the greatest energy consumer compared to other types of public architecture, and "Green Hospital" provides a noval approach of medical building reform. The development trend of courtyard, digital and family environment is more apparent in hospital as the function transforming from simplex to compound. Because of the feature of the medical treatment activity, its contribution and evaluation differ from other public service agencies. The development of "Green Hospital" in China is still in an incipient stage, the theoretical research is immature, the evaluation criteria is imperfect, the political support is till insufficient, and the regional development is unbalanced. However, construction of environment-friendly hospitals is a new challenge of Chinese healthcare industries, and is the tendancy of hospital development today.There is no unanimous definition of green hospital domestically yet, but the core conception of green hospital has been widely accepted, namely, emphasis on healthy, environmentally friendly and sustainable design of hospital building, energy conservation and pollution reduction during the operation of hospitals, green healthcare for patients, humanistic care-based harmonious doctor-patient relationship, and green administration aiming at realizing health, environment protection, safety and harmony.On aspects of green hospital building and green healthcare, the evaluation indices of green hospital has been widely studied. Patient safety and harmonious doctor-patient relationship have been innovatively considered in our study based on the role and function of hospitals. Under the atmosphere of emphasis on environment protection and sustainable, we explored the theory and practice of constructing green hospitals, and established the evaluation system for green hospital which is suitable to national condition of China, in order to provide innovative ideas and scientific instructions for the construction and management of hospitals in China.Objectives:1) Exploring the theoretical framework of Green Hospital. By reviewing the development history and inverstigationg the definition and intension of Green Hospital, we thoroughly understand the concept and connotation of Green Hospital.2) Constructing Green Hospital Evaluation Index System. The evaluation index system is defined through scientific methodiligy will be proposed, and standards will be set and further research, and promoting the hospitals becoming more energy-saving, safer and more efficient.3) Constructing Green Hospital Comprehensive Evaluation Model, and studying on level-3A hospitals in Hainan.Methods:Literature review, group discussion, Delphi’s method and field research were applied in this study. Consigering the definition and connotation, according to demostic and foreign research on green hospital, and the theoretical framework of Green Hospital, we established the evaluation index system and comprehensive evaluation model. We explored the theoretical framework of Green Hospital through literature review and group discussion. We constructed Green Hospital Evaluation Index System according to Delphi’s method in two rounds, with25experts in the first round and20experts in the second round; we constructed a complete Green Hospital Comprehensive Evaluation Model by assigning the indices and determing the method of calculating the total score. We conducted empirial study on level-3A hospitals in Hainan via questionnaire and field survey. The results of the empirical research were analyzed by comprehensive score method, weighted TOPSIS and weighted RSR method respectively; Database was established by Epidata3.01, and the data was analyzed by SPSS17.0and Excel2007.Results:Considering the evaluative object of the Green Hospital definition and connotation, we established the theoretical system of Green Hospital, the primary indices can be divided into four indices including green building, green healthcare, patient safety and green management. The green building dimension included design and architecture, indoor environment and special facilities; the green healthcare dimension included pollution control, energy and water saving, and quality of healthcare; the patient safety dimension included hospital infection, patients fall events, and security of supply; the green management inclued environmental-protecting and operation, research and teaching, and hospital patient harmonious. The index system includes4primary indices,12secondary indices, and93tertiary indices. The constraction of Green Hospital Evaluation Index System is according to evaluation index system in two rounds, with25experts in the first round and20experts in the second round, and the positive coefficient of two rounds were80%and100%respectivity. The results of famility coefficients, determine coefficients, dependability and coordination coefficients of primary and secondary indices were>0.70,≥0.75,>0.50respectivity. The coefficient of acception and operability were both>4, and variation coefficient are<0.20. These data showed that the results of the study are rational, and the final indices is feasible.According to the empirical study by comprehensive evaluation models based on synthetical judgement, the10hospitals were in inferior-middle level, with72.3being the highest score and48.6being the lowest, and only4hospotals’score were above60. The scores from high to low were:H7, H10、H2、H9、H6、H5、H8、H4、H1、H3respectivity. The sorted result is positively associated with weighted RSR and weighted TOPSIS, and the correlatioin coefficients are0.867and0.879respectivity(P<0.05).Conclusions:The green hospital index system includes4primary indices,12secondary indices, and93tertiary indices. The index system includes comprehensive contents, which is consistent with modern medicine, highlights major points and its weight coefficient is retinonal. This is one of the most systematic of green hospital evaluation until now.Comprehensive evaluation model which based on synthetical scored method was used in the first time in the field of green hospital study. The approach to calculation the tatal score was established. The model is scientifically, retional and feasibal.The score from high to low according to comprehensive evaluation model were:H7、H10、H2、H9、H6、H5、H8、H4、H1、H3, and the result show the10hospitals were in inferior-middle level of green hospital construction. The sorted result is positively associated with weighted RSR and weighted TOPSIS, which indicate the scientificity and feasibility of the model.Innovation1. We constructed an integrated green hospital evaluation system in China in terms of green building, green healthcare, patients safety and green administration, including4first-level indices,12second-level indices, and93third-level indices.2. According to the synthetically scored method, we originally established the green hospital evaluation model and formulated the weighted coefficient and score assignment of the indices in the model.3. The feasibility and effectiveness of the green hospital evaluation model has been certified by the empirical study on the level3-A hospitals in Hainan. |
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