Study On The Effectiveness Evaluation Index System Of Beijing Basic Health Supervision Institutions

Research purposeAlong with the constant deepening of the medical and health system reform,the Beijing health supervision system has been adjusted and promoted,and the health supervision function is changing.At present,the effectiveness evaluation system of the basic health supervision institution has not yet been established.Based on the analysis of situation and reform of Beijing basic health supervision institution system,the paper fully considers the functional particularity as well as the new reform situation and task of Beijing basic health supervision institutions,in order to select and admit evaluation indexes,propose the scientific and feasible effectiveness evaluation index system,provide the basis for Beijing health supervision effectiveness evaluation under the new situation,and provide reference for strengthening Beijing basic health supervision institution construction.The establishment of the effectiveness evaluation index system of basic health supervision institutions by means of scientific methods can provide reference for the operation mode after the basic health supervision institution function's change.Through the application and result analysis of the index system,the basic health supervision institution truly implements the change concept and adapts to new needs of social development and legalization after strengthening the capacity construction.Research contentIn this paper,the construction of the effectiveness evaluation index system of Beijing basic health supervision institutions is studied,including the selection,design and evaluation of the effectiveness evaluation indexes of Beijing basic health supervision institutions.The research object is the effectiveness evaluation index of Beijing basic health supervision institutions.The research scope is 17 district – level health supervision institutions,excluding the Beijing Municipal Health and Family Planning Supervision Institution.Also,the collection,selection and screening of the evaluation index are developed from the functional development,functional implementation,organizational resources,health supervisors' competency,guidance and application and external environment.The Delphi method is used to determine the evaluation index and its weight.After constructing the evaluation index system,the fuzzy comprehensive evaluation model of Beijing basic health supervision institutions is established according to the first level and second level index systems.The questionnaire is designed and the survey object is selected.The weight allocation scheme and the principal factor deterministic synthetic algorithm are used to judge it.The effectiveness of district-level health supervision institutions is investigated,the weighted cumulative score method is used to calculate the score,and the effectiveness of the index system is compared by using the score difference to test the practicality of the index system.Research methodThe paper uses the literature survey method and the personal interview method to review more than 100 literatures related to the health supervision effectiveness evaluation,health supervision development process,basic health supervision institutions and so on,collects relevant professional information,and summarizes primary indexes of the basic health supervision institution effectiveness evaluation;the paper uses Delphi expert consultation method to make two rounds of consultation for 17 basic front-line supervisors,health supervision and management decision-makers,as well as experts from health supervision business departments,health administrative departments and health management teaching institutions in Beijing city urban district,suburb districts and outer suburb districts.In the first round of consultation,the evaluation index expert consultation questionnaires are sent to experts for 5-level scoring with views and suggestions.In the next round of consultation,results of the last round are fed back to the experts,and the analytic hierarchy process and consistency test are used to calculate the weight of indexes at all levels for ultimate establishment of evaluation index system;the paper then uses fuzzy comprehensive evaluation method to determine the evaluation object set,construct the evaluation factor set and select the remark level domain and establish the fuzzy comprehensive evaluation model.And then,we use the comprehensive scoring to carry on the level evaluation,and calculate the grading index and the overall evaluation score,so that the Beijing basic health supervision institution effectiveness is evaluated;it uses the weighted accumulative comprehensive scoring method to calculate the score,and the practicability of the index system is verified by comparing the institution effectiveness of the districts based on score difference.Research resultBased on the above research process,following research results are obtained:(1)The initial effectiveness evaluation system includes six first-level indexes,22 second-level indexes,73 third-level indexes,in which the first-level indexes include functional development,organizational resources,health supervisors' competency,functional implementation,guidance and application and external environment.Due to more grading indexes,they are not listed separately.(2)The weight of each level is determined,among which the weight of first-level indexes is: 20.55?20.55?18.31?11.53? 14.53?14.53,the weight value of second-level indexes is: 3.68?3.07? 2.03?2.73?2.73?2.43?6.88?5.46?4.33?7.05?3.79?3.79?2.04?11.11? 5.56?6.67?3.33?6.67?6.97?4.14?1.82?3.74.From the weight distribution of indexes at all levels,it can be seen that Beijing basic health supervision institutions,as the supervision backbone,focuses on functional development and implementation(especially law enforcement according to the law),which is consistent with the current Beijing health supervision assessment focus.In third – level indexes,the public supervision has the highest weight,indicating that the Beijing basic health supervision institutions attach great importance to the public's satisfaction.In the second round,11 indexes are added,such as the licensing pass rate,the smoking control draw monitoring,the complaint and report case handling quality,the number of food safety enterprise standard record and so on,so that the index system closely follows the supervision policy changes with the more comprehensive content and more reasonable structure compared to the previous health supervision effectiveness evaluation index system.(3)The fuzzy comprehensive evaluation method is used to allocate the weight of the effectiveness evaluation index system of Beijing basic health supervision institutions,and evaluate the effectiveness of Beijing basic health supervision institutions,with the better total score of 3.047.Each level index score is: XA=2.85 XB =3.30 XC=2.70 XD =3.42 XE =3.20 XF =2.95.The first – level indexes(guidance and application,functional development,health supervisors' competency,organizational resources,function implementation and external environment)have better scores(E2).The fuzzy comprehensive evaluation method to evaluate the effectiveness of small-scale health supervision institutions intuitively avoids undetermined problems from other methods.(4)Through results obtained by the weighted cumulative comprehensive scoring method,we can see that in four district-level supervision institutions of the city,S has the highest score(75.04),and Y has the lowest score(58.61)(S > M > H >Y),so the effectiveness in four district-level supervision institutions is above the average level.ConclusionAccording to above research results,following conclusions and suggestions are obtained:(1)The evaluation index system of Beijing basic health supervision institutions is comprehensive enough to fully reflect the research entirety,with the relatively independent expert consultation,the reasonable evaluation index screening method and the scientific weight determination method,so the ultimate index system covers the current health supervision system work points and elements with a comprehensive and clear structure distribution,which is coordinative and authoritative.(2)Compared with the previous evaluation index system of health supervision effectiveness,11 indexes added in this index system(such as,the double-random system implementation,the smoking control draw monitoring)are the first to fully combine the new situation features of Beijing basic health supervision institutions,so the system is strongly targeted.(3)Through construction of the fuzzy comprehensive evaluation model of the index system,the overall effectiveness evaluation of Beijing basic health supervision institutions in is realized,and the internal work effectiveness index can be compared according to the evaluation results at all levels.(4)According to the weighted cumulative comprehensive evaluation,4 Beijing district-level health supervision institutions' work effectiveness is evaluated.Compared with the comprehensive score difference,horizontal effectiveness comparison can be achieved for district-level health supervision institutions.So,higher institutions and local government departments can also understand lower institutions' status quo and shortcomings in health supervision work in order to further explore the use effect of the index system.(5)Health supervision and evaluation indexes appear a certain dynamic with the policy reform,so all factors should be considered as far as possible in the index design,which may not yet fully reflect the assessment requirements,so it is needed to further expand the scope of empirical research with the reliability and validity analysis of the evaluation system,in order to make the index system more perfect.