The Comprehensive Evaluation Indicator System For Hangzhou Community Health Service Center

BackgroundThe Ministry of Health with other 9 ministries and commissions issued the Guideline for Development of the Community Health Service in 1999, which formulated the goal and fundamental requirements for the community health service in China. The guideline requires to establish the modern urban community health service system for the 21st Century, which is consistent with the Chinese preliminary socialist stage and the socialist market economy mechanism. To develop the community health service according to the Guideline has become the current key health task for health authorities at all levels. However, there is no commonly accepted criteria for scientific evaluation of the community health service either in a theoretical or practical way, due to regional variations and conceptive differences. Meanwhile, there are deficiencies in designing of the evaluation indicators, some of which are lacking sufficient practicability and some of which are not reflecting the contents of community health service. In this study we intended to develop a comprehensive evaluation system for community health service in Hangzhou based on the government policy, current local situation, and literature sources. It washoped that the evaluation system might more objectively reflect the progress, the effectiveness and efficiency, as well as the weakness of community health service centers in Hangzhou municipality.ObjectivesTo develop a comprehensive evaluation system for the community health service centers in Hangzhou Municipality based on the official guideline and local conditions, which would provide database for government in health decision making.Methods1. A series of indexes was selected with the Delphi method to obtain the evaluation indicators and their weights.2. Fifteen community health service centers in Hangzhuou were selected as pilot evaluation sites through convenient sampling method. The sampling centers were evaluated according to results from the Delphi method with the analytic hierarchy process after standardizing the data.3. Statistics: t-test, chi-square test, correlation analysis, rank sum test were used for data analysis with software SPSS 10.0.Results1. According to the Delphi, twenty-four indicators were selected forevaluation system including "policy support", "network building", "human resources", "service performance".2. The evaluation was conducted using the developed evaluation system in 15 selected community health service centers of Hangzhou.3. Results obtained with the evaluation system had significant positive correlation with that of Hangzhou Health Bureau (r=0.711, p=0.003).Conclusions1. The evaluation system developed in this study shows "Six in One" function of the community health service that can provide policy oriented effects positively.2. The results using this evaluation system showed a high consistency rate (87.5%) with those from Hangzhou Health Bureau, which indicates that this system is a practical and reliable one.SuggestionsThe evaluation for prevention activities, community rehabilitation and management of health information should be emphasized in the future improvement of the evaluation system.