Study On The Construction Of Evaluation Index System For General Practitioner Service Team In Guangdong

ObjectiveGeneral practitioner team (GPST) is the core and soul of community healthservice(CHS) net. Performance appraisal as a vital component of performancemanagement and main distribution basis of salary benefits its improvement ofworking efficiency. In this paper，based on the status of development and performanceappraisal of GPST both in China and abroad, we attempt to establish an evaluationindicator system with highly practicability, validity and reliability to provide atheoretical basis for improving the service function of the GPST and raising theefficiency and quality of service. Moreover, through site survey, we can know thepresent situation of team’s work and test the practicability and operability of theevaluation indicator system, which serves as the basis for evaluation practice inmethodology.MethodsThis paper started with results of the job satisfaction research on the GPSTmembers and discussed in detail the underlying factors that influenced them. Then,4methods were used to construct a scale with evaluation index system for GPST in thecommunity health centers (CHCs), including document study, the Balanced ScoreCard, Key Performance Indicator and Interview Survey with experts and GPSTmembers. Afterwards,385members of GPST became objects of this anonymousquestionnaire survey. The scale was revised and got the objective weights ofindicators by exploratory factor analysis.The test of items significance, correlationtesting and inter-item consistency were used to test the structure and reliability of thescale. At last,21GPST coming from2CHCs managed by social entities(G-CHCs) and hospitals(H-CHCs) in Guangzhou and Shenzhen are chosen as the researchobjects. Adopting empirical research method, we test the practicability and operabilityof the evaluation indicator system and attempt to find the problems thoroughperformance evaluation score, so as to encourage and guide the team members toachieve basic medical and public health service goals.Results⑴The research indicated that the job satisfaction of GPST members from CHCsmanaged by hospitals and social entities were both of medium level, namely ofaverage satisfaction. Hygiene factors, including pay, procedure and promotion werethe extent of being recognized.⑵The evaluation index system included4first class indicator,15second classindicators and34third class indicators. First class indicators were composed of fourparts. They were F1”satisfaction, public health and learning supports”,F2”resources”, F3”medicalservice and work supports” and F4”convenience” withcorresponding weighting values of0.291、0.266、0.245and0.199respectively.⑶All index achieved significant level.The factor analysis of the second classindicators showed good validity: totally four common factors were extracted withbigger than1initial eigenvalues and the accumulative variance reached73.120%.Cronbach’s alpha coefficient of the second and third class indicators was0.894and0.975respectively, which meaned that the reliability of the indicators was very good.⑷The results of field surveys showed that the scores of job satisfaction(t=5.109,P=0.000) and medical care satisfaction (t=-2.882,P=0.004) of H-CHCsgroup were higher than that of G-CHCs group. Public awareness of GPST, by contrast,G-CHCs group stayed ahead of H-CHCs group (t=-8.037，P=0.000). Job satisfactionshowed no significant difference between different teams while satisfaction of thepatients and Public awareness varied from team to team. The performance evaluationresults results conformed to the "cask principle " and showed that the performanceappraisal for GPST exerted its orientation function to the members and CHCs: Theranking of each GPST in G-CHCs was determined by the score of F3”medicalservice and work supports” while the ranking of each GPST in H-CHCs was determined by the score of F1”satisfaction, public health and learning supports”.Conclusions(1)The improvement of hygiene factors such as policies,pay and promotionensures the smooth and efficient running of GPST.(2)This evaluation index system has considerable reference value in theevaluation of performance for GPST in Guangdong, as well as perfecting thefunctions of GPST and improving the efficiency and quality of the service.(3)G-CHCs and H-CHCs should better use of data from the evaluation indexsystem to assess performance and to improve with both monetary incentive andnon-monetary incentive, effective communication and feedback mechanisms andindividualized programs to meet the needs of each GPST.