Evaluation Of Internal-corporate Governance Structure Of A Three-level Public Hospital Based On Multilevel Fuzzy Comprehensive Evaluation Method

Objective:In order to deepen the reform of public medical system and meet the objective needs of the evaluation of public health care system pilot,this paper selects internal-corporate governance structure of the three-level public hospital as the research object,and intends to establish a set of feasible,well-operable and widely-applicable multilevel fuzzy comprehensive evaluation and calculation method to objectively and comprehensively analyze and evaluate the situation of the internal governance structure of the three-level public hospital.It will provide the basis for the evaluation and assessment of public hospital reform.Methods:In view of the problems of data missing and data statistics in the reform pilot process,the paper is based on fuzzy mathematics,applies the fuzzy set theory and the principle of maximum membership,and comprehensively considers all kinds of influencing factors of evaluated object synthetically.Using literature analysis,Delphi method and analytic hierarchy process(AHP)and multilevel fuzzy comprehensive evaluation method(MLFCE),the paper focuses on the construction of evaluation index system,the setting of weight of evaluation index,the making of index level and the design of evaluation calculation method to realize the construction of multilevel fuzzy comprehensive evaluation and calculation.And A public hospital was selected to conduct empirical test.1.Construction of an evaluation index system for the internal governance structure of the third-level public hospital.According to the principles of scientific,comprehensive,and feasible index systemestablishment,the paper choose “stucture-process-results” as the basic framework for the construction of alternative index system,selects 20 experts and scholars who have various fields of medical hygiene,relevant theoretical research foundation and practical work experience,respectively,sets the threshold of average and full score,and uses the Expert consultation method to screen the alternative index system.2.Construction of an evaluation index system for the internal governance structure of the third-level public hospital.On the basis of constructing a hierarchical model,a number of judgement matrices are formed by expert pairs of the importance of each index,which serves as a source of data for setting index weights,and calculates the weights and sorting of each judgment matrix.3.Formulation of the grade criteria for the evaluation of the internal governance structure of the third-level public hospital.In order to facilitate the digital presentation of the evaluation results,the dissertation uses the governance model of the board of directors as the research object,formulates criteria for its evaluation grade standards,and distinguishes qualitative and quantitative indicators from the ”gradual” and “not-to-type” expression forms.After repeated consultations by experts and group discussions,they are separately set.4.Design of evaluation methods for internal governance structure of three-level public hospital.Using the fuzzy set theory and the principle of maximum membership,this paper deal with expert opinions that are not easily quantifiable,combine the hierarchical relationship among the influencing factors in the evaluation index system,and adopt a progressive layer-by-layer aggregation approach to use the calculation results of low-level evaluation indicators as input of high-level operation,design multilevel fuzzy comprehensive evaluation calculation method.5.The application of the evaluation method of the internal governance structure of the three-level public hospital.A study letter was designed based on the corporate governance structure evaluation index system,evaluation grade standards,and evaluation index scores.Twenty experts in related fields were invited to score the operation status of the internal governance structure of A public hospital in Beijing and use the paper to construct multilevel fuzzy comprehensive evaluation method deals with the data.Results:1.Construction of an evaluation index system for the internal governance structure of the third-level public hospital.Through the way expert consultation,the Expert reliability(effective recovery rate is100%,95%,the expert authority coefficient is 0.80),the concentration degree of coordination(0.391,0.447)as the basis for detailed construction that have 3 first-level indicators,10 second-level indicators,and 42 third-level indicators.It lays a foundation for the evaluation of corporate governance structure in public hospitals.2.Construction of an evaluation index system for the internal governance structure of the third-level public hospital.The weights and combined weights of 3 first-level index,10 second-level index and 42third-level index are obtained by the calculation and consistency test of the weight of the matrix,and the difference of the important degree in the evaluation index system was realized.Among them,the weights of the first-level indicators are:governance structure(0.2970),operation process(0.5396),and operation result(0.1634).3.Formulation of the grade criteria for the evaluation of the internal governance structure of the third-level public hospital.The evaluation grade criteria of 37 ”progressive” and 5 ”not”expressions were obtained,and the distinction,practicality and dynamics of the evaluation grade standards were discussed.4.Design of evaluation methods for internal governance structure of three-level public hospital.Establishing the evaluation factor sets,the factor weight sets,and the grade standard sets,and setting the index membership matrix to obtain a multilevel fuzzy comprehensive evaluation calculation flow,and discuss the comprehensiveness and objectivity of evaluation calculation methods.5.The application of the evaluation method of the internal governance structure of the three-level public hospital.The score of the comprehensive evaluation of the internal corporate governance of A public hospital in Beijing was 0.9022.The evaluation result was good,and the problems are exposed,the reasons are clarified and corresponding improvement measures are proposed.Conclusions:The multilevel fuzzy comprehensive evaluation calculation method,which is designed in theory analysis and practice,shows good feasibility and maneuverability,can reflect the practical operation of public hospital reform pilot work comprehensively,and has the potential of popularization with extensive adaptability.It has important reference and guiding significance to the evaluation of the public medical system reform experiment.