Study On Indicators For Evaluating Community Health Center Performance In Shanghai

Objectives:This study aims to establish indicators for evaluating Community Health Center performance in Shanghai and to provide scientific, objective and effective tools to evaluate the performance of Community Health Center to improve the development of Community Health Service in Shanghai.Contents:With the CHC in Shanghai as the evaluation object, the contents include:(1) Basic information about the CHC in Shanghai (2) Comparasion of common health care performance frameworks of health care.(3) Conformation of frameworks and dimensions.(4) Construction of the indicators for evaluating CHS performance.(5) Modification and improvement of the indicatorsMethods:With "Structure-Process-Outcome" model as the framework, and Shanghai’s policy documents and internal data of CHS as the source of indicators, this study used literature analysis, Delphi method, key informant interview and feacibility study to set up an indicators with3level Ⅰ indicators,? level Ⅱ indicators and174levelⅢ indicators in the principle of consistency, pertinency, comprehensiveness, hierarchy, maneuverability and sensitiveness.Procedures:The researcher searchs the Chinese and English databases such as Medline, Ovid, CNKI and VIP for literature about performance of health system and analysis the strength and weakness of different framework to select a framework that meets the objective of our study. Secondly, the national and Shanghai’s policy documents and internal data of CHC were collected as reference to list the typical indicators as the candidate indicators. All the candidate indicators are classified in "Structure-Process-Outcome" model to form the first round questionaires. Thirdly, we select24experts in CHS as the Delphi panel to answer the first round questionaires. Summary of the experts’forecasts from the previous round as well as the reasons they provided for their judgments are provided after the first round. The interview meeting is hold to encourage the experts to disscuss and revise their earlier answers in light of the replies of other members of their panel. Finally, after the second round questionaire, the indicator of performance is set up. The meaning and compute mode of every indicator are explained and the weights of indicators are calculated. The application of the indicators is analyzed.Results:The study includes three parts. The main results are as follows:Setting up the indicators in "Structure-Process-Outcome" model, which including3levelⅠ indicators,7leveⅡ indicators and174levelⅢ indicators.Structure indicators includes governmental input, human resource and Funding; Process indicators includes essential medicine, public health and operating efficiency. Outcome indicators includes satisfications.Calculating indicators’weights. Level I:The weight of structure indicators is0.36, The weight of process indicators is0.50, The weight of outcome indicators is0.14. Level II: The weight of governmental input is0.12. The weight of human resource is0.12, the weight of essencial medicine is0.17. The weight of public health is0.17.The weight of operating efficiency is0.16. The weight of satisfication is0.14.Making suggestions for the application of the indicators:1. To use different standards to evalucate the CHC between the one in urban areas and the one in rural areas.2. To select different institutions to evaluate the performance in the public health and essentical medicine respectively3. To identify the standard of indicators.4. To update the indicators and the standard of indicatorsComclusions:The indicators are constructed as three dimensions:structure, process and outcome. The context includes the key item and the trend of CHS in shanghai. Some standard of indicators are higher than the national level. It will prove the development of the CHS in Shanghai. Most of the data need of the indicators is available. The process of evaluation is simple with practical applicability...