Research On Performance Evaluation Of Mental Health Service In Guangxi Township Health Centers

Objective To learn from the theory and method of performance evaluation at home and abroad,through the literature research,Delphi method and other methods,to construct a scientific and feasible performance evaluation index system for mental health service in township hospitals in line with the actual situation in Guangxi,and to test its reliability and validity.Taking Guangxi Township Health Center as the evaluation unit,using factor analysis method to construct a comprehensive evaluation model of mental health service in township hospitals,comprehensively evaluating the performance of mental health service in Guangxi township hospitals and analyzing the main factors affecting performance,so as to propose improvement of Guangxi township hospitals Policy recommendations for mental health service performance.Methods:1.Through the literature research and Del Phi method,etc.,construct the performance evaluation index system of mental health service in township hospitals.2.A stratified cluster random sampling method was used to extract 45 township health centers in Guangxi,and the status quo assessment of mentalhealth services in township hospitals was carried out.3.Based on the field survey data,the reliability and validity of the indicator system are tested.The internal consistency reliability of the indicator system is evaluated using the Cronbach alpha coefficient.Structural validity analysis was performed using factor analysis.4.Using factor analysis method to establish a comprehensive evaluation model of mental health service performance in township hospitals,comprehensive evaluation of mental health service performance in Guangxi township hospitals.Results1.Using the Delphi expert consultation method,conduct two rounds of expert consultation,screen indicators,and determine the indicator system.The positive coefficients of the two rounds of consulting experts were 87.5% and100.0%,respectively;the expert authority coefficients were 0.82±0.06 and0.84±0.01,respectively;the coordination coefficients were 0.221 and 0.267,respectively(P<0.001).Finally,a performance evaluation index system for mental health services of township hospitals including 3 first-level indicators,11second-level indicators,and 49 third-level indicators was established.2.The assessment of the status quo of mental health service performance in Guangxi township hospitals shows:(1)The mental health service funding of township hospitals is insufficient,and the source is relatively simple.(2)The overall number of health technicians is insufficient and the quality is not high.(3)There is a lack of mental health manpower in township hospitals,mainly part-time workers,and the quality is not high.(4)With the support of the “strong grassroots” policy,the infrastructure of township hospitals has been significantly improved.(5)The quality of operation of township hospitals and the efficiencyof basic medical services need to be improved.(6)A serious mental disorder prevention and control network has been basically established in rural areas,but the comprehensive management coordination mechanism for multi-sectoral collaboration needs to be improved.(7)The management service capacity of patients with severe mental disorders in township hospitals still needs to be improved.(8)Medical staff in township hospitals have large workload,low job satisfaction and salary satisfaction,and lack of professional achievement.(9)The awareness rate of mental health knowledge of medical staff in township hospitals is low.(10)The mental health of rural residents is not high,and the awareness rate of mental health knowledge is low.3.The reliability test of the indicator system shows that the overall Cronbach’s α coefficient is 0.782,and the three-dimensional Cronbach’s αcoefficient is between 0.642 and 0.720.The structural validity analysis showed that the principal component was extracted by factor analysis,and the first five principal components were finally extracted,and the cumulative contribution was 75.61%.The five principal component factors reflect the inputs,processes,and effects of mental health services,and the results of factor analysis are similar to those of the constructed indicators.4.The comprehensive evaluation model of mental health service performance of township hospitals established by factor analysis method consists of basic medical service factors,input and output factors,knowledge and attitude factors,mental health policy support factors and operational support factors: F comprehensive = 0.3814 F basic medical services +0.2200 F input and output +0.1466 F knowledge attitude + 0.1375 F policy support + 0.1145 F operational guarantee.Township hospitals have higher input-output factors and mental health policy support factors,and lower scores for basic medical servicefactors.According to the model,the comprehensive performance scores of 45 township hospitals were calculated,and the scores were ranked from small to large,and divided into three levels: “poor”,“medium” and “good”.The results showed that there were 11 township hospitals(24.4%)rated as “poor”,21(46.7%)in “middle” township hospitals,and 13 “good” township hospitals(accounting for 28.9).%).Conclusions1.This study used the Delphi method to build a performance evaluation index system for mental health services in township hospitals.After two rounds of expert consultation,a consensus was reached,and the expert authority coefficient was high and scientifically credible.2.The performance evaluation index system of mental health service in township hospitals constructed in this study has good internal consistency reliability and good structural validity,which can be used to evaluate the performance of mental health services in township hospitals.3.The comprehensive evaluation model of mental health service performance of township hospitals established by factor analysis method is basically consistent with the conclusion of the current survey results,indicating that the comprehensive model constructed has good rationality.Policy recommendations:1.Strengthen government leadership and establish and improve a comprehensive mental health management coordination mechanism for government leadership,departmental cooperation,and social participation.2.Establish and improve a multi-channel mental health work input mechanism based on government input.3.Strengthen the construction of mental health service managementpersonnel in township hospitals.4.Further improve the management service capacity of patients with severe mental disorders in township hospitals,and establish and improve a community rehabilitation service system for mental disorders.5.Strengthen mental health education and improve mental health of rural residents.