| Background Medical consortium(hereinafter referred to as "medical consortium")is an important carrier of deepening the reform of medical and health system in China,as well as an institutional innovation for promoting hierarchical diagnosis and treatment and improving the medical and health service system.At present,various forms of medical consortium have been established in China,which plays an important role in promoting the sinking of high-quality medical resources and improving the capacity of primary medical service.For a better standard of couplet of medical development,fully arouse the enthusiasm of medical institutions to carry out the construction of medical body and initiative,in July 2018,the national health committee and the state bureau of traditional Chinese medicine formulated and issued "about print and distribute medical consortium scheme for comprehensive performance evaluation(trial)notice(hereinafter referred to as the"notice "),to carry out medical couplet of comprehensive performance evaluation put forward some guidance,around the "notice" pointed out that in combination with the practical situation of the local medical,detailed assessment index system respectively,and strengthen the construction of couplet of cities to promote the medical examination.Purpose As an effective form of medical couplet,county medical community is conducive to remolding the three-level medical service network in rural areas and promoting the downward movement of medical and health work.Based on the national comprehensive performance assessment index of medical consortium and the actual situation of the development of Anhui county medical community,this study explores to construct a scientific and feasible index system suitable for the comprehensive performance assessment of Anhui county medical community.Method The expert consultation method is used to screen the indicators,and the index system is formed by calculating the average comprehensive score,standard deviation and coefficient of variation of the indicators.The analytic hierarchy process(AHP)was used to calculate the weight coefficient of the index.Result(1)A total of 19 people from hospitals,universities and research institutions were selected as consulting experts,8 people(42.11%)and 5 people(26.32%)studied health policy and hospital management respectively.There were 6(31.6%)and 10(52.6%)with master's degree and doctoral degree respectively.Five people(26.3%)and 12 people(63.2%)have the title of deputy high and normal high respectively.18 persons(94.7%)who have been engaged in this major for more than 10 years.(2)One round of expert consultation,19 questionnaires were issued,and 19 effective questionnaires were recovered.The expert's positive coefficient was 100%,the authority coefficient of the 19 experts was ? 0.7,and the overall authority coefficient of the experts was 0.827.The overall index,the Kendall harmonious coefficient of the secondary and tertiary indicators,the P value is less than0.05,from the importance,feasibility and sensitivity of indicators Kendall test,in addition to the maneuverability of the secondary index and sensitivity of the P value is greater than 0.05,the rest of the importance,feasibility and sensitivity of significance test P values are less than 0.05,it shows that there is a good consistency between the expert's judgments(3)The expert consultation to determine the importance,feasibility and sensitivity of the weight was0.411,0.336 and 0.253,respectively,by calculating the average scores of proposed indicators,standard deviation,coefficient of variation and quartile,and combined with expert amendments of index finally construct consists of three level index,nine secondary index and 45 three-level index comprehensive evaluation system of performance appraisal.(4)In the second round of expert consultation,19 questionnaires were issued,18 were recovered,17 were effective,and the recovery rate was 89.47%.Using the analytic hierarchy process(AHP)toconstruct judgment matrix,and consistency of the matrix,the CR value is less than 0.1,namely each matrix has good consistency,three indicators of weight value of A1 respectively to organize the implementation of(0.4800),A2 medical resources through up and down(0.2337),A3 efficiency(0.2863),the combination weight = the weight of the same level * the weight of the same level of the upper level.Conclusion(1)The method used in this research is mature and reliable,and the research process follows the principles of scientificity,rationality and feasibility,so it has good credibility.(2)The three-level indicator system,which combines the relevant requirements of the state and Anhui province,ensures the operability of the indicator application and can provide reference for the performance assessment of the county medical community in Anhui province. |
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