Study On The Evaluation Index System For High-quality Development Of Tertiary Public TCM Hospital Based On The Characteristics Of Traditional Chinese Medicine

[Background]The Fifth Plenary Session of the 19th CPC Central Committee pointed out that China has entered a stage of High-Quality Development,and the theme of economic and social development during the "14th Five-Year Plan" period is to promote High-Quality Development,strive to meet the growing demand of the people for medical and health services,and continuously enhance the people’s sense of gain,happiness and security.The "Opinions of the General Office of the State Council on Promoting the High-quality Development of Public Hospitals" clarifies the HighQuality Development goals of public hospitals,adheres to the people’s health as the center,aims to establish and improve the modern hospital management system,strengthens system innovation,technological innovation,model innovation and management innovation,accelerates the expansion of high-quality medical resources and balanced regional layout,and achieves three changes in the development mode of public hospitals to better provide High-Quality and efficient medical and health services.In order to meet the needs of High-Quality Development,the corresponding evaluation index system of public TCM hospitals should also change with the needs of social development.[Objective]To provide a set of scientific tools for scientific and objective evaluation of the High-Quality Development of Tertiary Public TCM hospitals,this study is based on the theory of "Structure-Process-Outcome" and the theory of Change,and according to the connotation of High-Quality Development of Tertiary Public TCM hospitals,guided by problems and needs,combined with policy requirements,socio-economic development and hospital operation and management needs,focusing on the key factors affecting the development of Tertiary Public TCM hospitals,starting from five aspects:Input Structure,Activity Process,Result Output,Quality and Efficiency Improvement,and Social Impact.Construct an evaluation index system for the High-Quality Development of Tertiary Public TCM hospitals based on the characteristics of Chinese medicine.[Methods]Through literature research,the current status of hospital evaluation research is sorted out,and the main theories,measurement methods and evaluation status in the field are summarized and sorted out,so as to explore the main theories and evaluation models suitable for this research,and lay a theoretical foundation for building the framework of evaluation index system.Through the comparative study of the performance appraisal of the national examination and the evaluation index system of High-Quality Development,the advantages and shortcomings of the current evaluation system of Tertiary Public TCM hospitals are found.Through the consultation of 63 TCM clinicians and hospital managers of Tertiary Public TCM hospitals on the"Questionnaire on Issues and Countermeasures Related to the Development of TCM Hospitals" and "Questionnaire on the Evaluation and Development of TCM Hospitals",the current status quo,existing problems and related suggestions of the evaluation and development of TCM hospitals and TCM hospitals were explored,so as to determine the core elements of the evaluation index system and provide a basis for the construction of evaluation indicators.The framework and content of evaluation indicators were discussed through expert interviews,and the evaluation index system was preliminarily established;Carry out three rounds of Delphi expert consultation,discuss the scientificity and rationality of indicators by issuing consultation questionnaires to 20 experts,revise and improve the index system through discussion between the research group and the expert group according to expert opinions and suggestions for deletion,modification and addition,and weight the indicators at all levels through the analytic hierarchy method to establish the final evaluation index system;Discuss and formulate evaluation index descriptions with sample hospitals,conduct empirical research through the index data collected by four sample hospitals,standardize the index data and comprehensively evaluate the index weights.[Results]The study established the evaluation index system including 5 first-level indicators,14 second-level indicators and 75 third-level indicators.Using the analytic hierarchy method,the weights of indicators at all levels and the combined weights of third-level indicators were obtained,and the key factors affecting the High-Quality Development of Tertiary Public TCM hospitals were input structure,quality and efficiency,result output,activity process,and social impact.Through the comprehensive evaluation of the index data of four sample hospitals,the scientificity and rationality of the evaluation index system were verified.[Conclusion]In this study,the theory of SPO,the theory of Change and the theory of High-Quality Development are organically combined to construct the framework,and form a five-dimensional evaluation system model.It has set up 14 indicators in financial medical insurance,talent team,discipline construction,information construction,talent training,scientific research,quality and safety,revenue and expenditure structure,comprehensive services,traditional Chinese medicine characteristic services,high-quality development,medical efficiency,operational efficiency and satisfaction,which not only highlights the functional positioning of Tertiary Public TCM hospitals,but also implements the new development concept,which can comprehensively evaluate the High-Quality Development of Tertiary Public TCM hospitals.Through the comprehensive scoring of the indicators of the four sample hospitals,the feasibility,scientificity,rationality and applicability of the evaluation index system are verified,which can be used for the High-Quality Development evaluation of Tertiary Public TCM hospitals,which is of certain significance for hospitals to play the characteristics of TCM and improve their comprehensive service capabilities.The evaluation index system also needs to be continuously optimized in practice,and the evaluation index system should be regularly sorted,modified and adjusted so that it can evaluate all aspects of hospital development with higher quality.