Construction Of A Management Index System For Telemedicine Care Services In Medical And Nursing Institution

Objective: To understand the advantages and disadvantages of telemedical & nursing service for the elderly in the application of integrated medical and elderly care facility,and construct a telemedical & nursing service management index system for integrated medical and nursing institutions,aiming to improve the integrated medical and nursing service system and provide scientific basis for service standardization and homogenization.Methods: Guided by the standardization theory,the complex adaptive systems theory,and the "structure-process-outcome" model,the dimensions and item pool of the indicator system were initially formed through the literature research method,the first draft of the indicator system was formed by the expert meeting method,and the telemedical & nursing service management index system for integrated medical and nursing institutions was finally determined by the two rounds of Delphi method.The weight of indicators at all levels was determined by the analytic hierarchy process,and the stability and effectiveness of the indicator system were tested by the reliability and validity analysis.Frequency,percentage,expert positivity coefficient,expert authority coefficient,mean,full score rate,coefficient of variation,Kendal’s coefficient of synergy were used for statistical analysis.Cronbach’s α Reliability and validity tests were conducted using coefficient analysis,exploratory factor analysis,and Pearson correlation analysis.Results:1.Preliminary establishment of an item pool for the indicator system through literature research method,including 5 primary indicators,15 secondary indicators,and 49 tertiary indicators.2.The 9 experts in the expert meeting method have good industry and disciplinary representation,with an authority coefficient greater than 0.80,forming a preliminary draft of the indicator system,including 5 first level indicators,15 second level indicators,and 38 third level indicators.3.The 15 correspondence experts in the Delphi method are well represented in the industry and disciplines.The recovery rate of the two rounds of questionnaires is 100%,the expert authority coefficient is over 0.80,all indicators meet the mean value is over 3.75 and the coefficient of variation is less than 0.25,and the Kendal synergy coefficient of the five first level indicators,15 second level indicators and 38 third level indicators is 0.327,0.311 and 0.286(P<0.01),respectively.The indicator system is finally established.4.The weights of indicators at all levels have been determined,with the first level indicators ranking from high to low: service management(1.197),basic conditions(1.115),service content and requirements(1.033),management scope(1.000),and service supervision(0.934).5.Reliability and validity test Cronbach’s α The coefficient is 0.927,the KMO value is 0.782,the Bartlett test sig value is less than 0.01,the correlation coefficients between the five dimensions and the population are between 0.643 and 0.943,and the correlation coefficients between the 38 items and the population are between 0.090 and 0.849(P<0.05).Conclusion: We have constructed a telemedical & nursing service management index system for integrated medical and nursing institutions,which includes 5 first level indicators,15 second level indicators,and 38 third level indicators,including management scope,basic conditions,service management,service content and requirements,service supervision.After reliability and validity testing,it has a certain degree of stability and effectiveness,and is suitable for medical and nursing institutions that provide remote medical services and remote medical care services.