| Objective:This study takes the district or county as the research object,mainly uses the literature research method to clarify the basic connotation of the ability of combining medical care and elderly care services in home communities,constructs the evaluation index system framework of combining medical care and elderly care service capacity in home communities in combination with Delphi method,determines the specific evaluation indicators,and determines the weight and validity of the constructed capacity evaluation index system through expert consultation,so as to provide decision-making support for further evaluating and improving the capacity of combining medical care and elderly care services in home communities and promoting the construction of combining medical care and elderly care service systems in home communities during the 14th Five-Year Plan period.Contents:First,clarify the basic connotation of the ability of combining medical care and elderly care services in home-based communities;The second is to build an index system framework for the evaluation of the ability of combining medical care and elderly care services in home-based communities;The third is to determine the specific evaluation indicators of the ability of combining medical care and elderly care services in home-based communities;The fourth is to determine the weight of the evaluation index of the ability of combining medical care and elderly care services in the home community;The fifth is to test the validity of the evaluation index of the ability of combining medical care and elderly care services in the home community.Methods:This study mainly uses the literature research method to clarify the basic connotation of the ability of combining medical care and elderly care services in the home community,combines the Delphi method to construct the evaluation index system framework of the combining medical care and elderly care service capacity of the home community,determines the specific evaluation indicators,and determines the weight and validity of the constructed capacity evaluation index system through expert consultation.Results:1.Clarify the basic connotation of the ability of combining medical care and elderly care services in home communities:with the district or county as the unit,the entities related to the provision of combining medical care and elderly care services in the home community within the jurisdiction provide effective medical care and elderly care services for the elderly in the home community through integrating resources,standardizing management order,optimizing service processes and other means.Specifically,the combining medical care and elderly care service capacity of the home community includes three main aspects:medical and health service capacity,elderly care service capacity and medical and nursing service guarantee ability,and the integrated medical and nursing care service guarantee capacity includes leadership governance,talent ability,financial ability,facility and equipment capacity,and information ability.2.Construct an evaluation index system for the ability of combining medical care and elderly care services in home-based communities:including three first-level indicators of input,process and outcome;Organization management,human resource investment,capital investment,institutional construction,informatization,medical and nursing services,basic public health services and elderly care services,accessibility,quality and satisfaction 11 secondary indicators and 36 third-level indicators.3.The weights of evaluation indicators of combining medical care and elderly care service capacity in home-based communities were determined:among the three first-level indicators,the weights were process,input and outcome indicators in descending order;Among the 11 secondary indicators,the top five indicators with the highest combined weight are medical and nursing services,elderly care services,quality,accessibility,and basic public health services.Among the 36 tertiary indicators,the top five indicators with the highest combined weight were service accessibility,blood pressure control rate in the management population,blood glucose control rate in the managed population,drug accessibility,and care services4.The validity test of the evaluation index of the ability of home community medical and nursing care service was carried out:the content validity:the I-CVI value of 98%of the indicators was 0.78 and above,and the Kappa value of 98%of the indicators was above 0.74,indicating that the content validity of the evaluation index was good overall;the S-CVI value was 1,indicating that the average content validity was better.Conclusion:This study builds the framework of the index system based on the system theory,healthy aging concept and ability evaluation theory,evaluates the whole process of the ability of combining medical care and elderly care services in the home community from the three aspects of input,process and results,follows the principles of comprehensiveness,representativeness and feasibility in the selection of specific indicators,adopts the Delphi method with strong reliability and professionalism for index screening and weight determination,and uses expert consultation to test the validity of indicators.Through the combined use of qualitative and quantitative research methods,a reasonable and practical evaluation index system of combining medical care and elderly care services in home communities was finally obtained.Recommendations:Pay attention to the dynamic adjustment of the evaluation index system of combining medical care and elderly care services in home communities;Focus on improving the capacity and accessibility of medical and nursing services in home-based communities;Pay attention to strengthening the evaluation and supervision of the ability of combining medical care and elderly care services in home communities. |
