Construction And Application Of Evaluation Index System Of Medical Staffs Labor Service Value

Research purposesBy clarifying the operational definition of the value of medical staff labor,exploring the characteristics of medical staff labor cost,constructing an evaluation index system of medical staff labor value based on disease type,and reasonably reflecting the labor value of medical staff.Research method1.Literature analysisThrough library search and internet search,we read a wide range of domestic and international literature and materials on the subject to find the indicators used to reflect the value of medical staffs labor in the pricing of medical services at home and abroad and establish a pool of indicators.2.Delphi methodExperts in relevant fields were widely selected and two rounds of expert solicitation were conducted.An evaluation result with high consistency and reliability was finally obtained,and the index weights were obtained by scoring the importance of experts.3.Evaluation Methodology of Indicator SystemThe reliability test of the index system was conducted using the reliability analysis module.Pearson bivariate correlation module was used for correlation analysis;factor analysis module was used for exploratory factors of the index system;validation factor analysis was performed using AMOS 24.0 for comprehensive assessment of validity.4.Empirical study of indicator systemThe index system scores and overall expert value scores were obtained for comparison by expert scoring of the medical staff labor value expert evaluation form,and by scoring the overall labor value of the patient categories using a percentage system and the Likert five-point scale.Research result1.Operational definition and Delphi expert consultationThis study proposes an operational definition of the value of medical staff labor as the personal cost and residual value of medical staff as the value created by the living labor of medical staff.And five primary indicators and 42 secondary indicators were initially selected based on the literature.A total of 17 experts from the fields of health management,health economics,and clinical medicine were selected to enter the consultation.In the two rounds of consultation,the positive coefficients of experts were 68.00%and 82.35%;the authority degree of experts was 0.75;and the coefficient of agreement of experts’opinions was statistically significant(P<0.05).Finally,5 primary indicators and 16 secondary indicators were selected.2.Evaluation of the index systemThe results of the reliability analysis of the medical staff labor value evaluation index system in four disease categories suggested that the reliability indexes were all greater than 0.7.The factor analysis extracted four factors with characteristic roots greater than 1,and the contribution rate of each factor ranged from 6.955%to 51.285%,with a cumulative variance contribution rate of 79.657%.The results of the indicator first-order model reached an acceptable range after four corrections,and could better reflect the theoretical concept.3.Empirical analysis of the indicator systemAccording to the expert index system scores,acute simple appendicitis via laparoscopic appendectomy and radical rectal cancer resection using laparoscopy for rectal malignancy were considered to have slightly higher labor value than the other two.There was a high rate of agreement among experts on the overall value scores for the four studied conditions.One-sample t-test results were not statistically different.Analysis conclusionIn this study,the index system of medical staff labor value evaluation was prepared using the Delphi solicitation method.The design of the index system is consistent with the initial theoretical concept,and can reflect the true connotation of medical staff labor value in a more comprehensive,specific and accurate way.Due to time and financial constraints,the number of survey subjects and research subjects was small,and the grading criteria and price adjustment ideas were not tested in practice.In the future,we will expand the number of subjects and survey participants,and determine the scientificity of the grading standard and price adjustment concept through large sample measurement.