Establishment And Empirical Research On Post Competency Index System Of Rural Family Contract Doctor

[Purpose]At present,the number of rural family contract doctors is small and the professional level is insufficient,which restricts the development of rural medical and health level.Therefore,based on Mc Clellan’s Competency Dictionary,this study will build an evaluation index system applicable to the post competency of rural family contract doctors,and carry out an empirical research to verify it.Thus,it provides objective basis for the cultivation and assessment of rural family contract doctors.[Methods]Literature research and Delphi method were used to construct the competency index system of rural family contract doctors.With the method of objective sampling,15 experts who are familiar with the related research of rural family contract doctor were selected from medical colleges,primary medical institutions and health administrative agencies.The analytic hierarchy process(AHP)was used to calculate the combination weight of the indicator.The post competency of rural family contract doctors in Ye county and Danjiangkou was measured by semi-structured interview and observation.Questionnaire survey was used to investigate the cognition and feeling of rural residents towards rural family contract doctors,so as to verify the competence of rural family contract doctors from the side.Use descriptive statistics to analyze the basic situation of rural family contract doctors,villages,patients and residents.The frequency distribution was used to distinguish the excellent group and the average group of the rural family contract doctors.Chi-square test and Logistic regression were used to analyze the factors that might affect the competency of rural family contract doctors.Pearson correlation analysis was used to analyze the relationship between the post competency score of rural family contract doctors and residents’ score of rural family contract doctors.[Results](1)By comparing the explicit competence and implicit competence of family doctors,and combining the actual work needs of rural family contract doctors,the final choice of this study was to build a theoretical model based on the Mc Clelland’s Competency Dictionary,and initially drafted the post competency index system of rural family contract doctor with 6 primary indicators and 17 secondary Indicators,65 third-level indicators.The first-level indicators are "Achievement and Action","Assistance and Service","Impact and Influence","Management","Cognition" and "Personal Effectiveness".(2)The index system was modified by Delphi method,the expert authority coefficient was 0.824,and the coordination coefficient of the three-level indicators was 0.38,0.198,and 0.14(P<0.05).Finally,the post competency index system of rural family contract doctor was established with 6 primary indicators,16 secondary indicators,and 59 third-level indicators.The top five secondary indicators of the AHP combined weight ranking are "Achievement Orientation","Initiative","Relationship Building","Interpersonal Understanding" and "Knowledge and Application".(3)The empirical research shown that the rural family contract doctors in Ye county and Danjiangkou has some problems such as responsibilities unclear,lacked general thinking,lacked initiative to improve themselves and serve residents,organizational belonging needs to be strengthened,insufficient authority and influence on residents,insufficient awareness of village-rural integration,inadequate collaboration capabilities of county and village,and inadequate handling of family doctor team relationships.The possible reasons are the low starting point of rural family doctors,the high threshold for learning and training,and the lack of incentives and policy guarantees.[Conclusions](1)The competency index system of rural family contract doctors constructed in this study has good reliability and scientificity.(2)The results of the evaluation of the rural family contract doctors by the index system in this study are consistent with the evaluation results of the rural family contract doctors by the residents,which indicates that the index system has practical feasibility and can provide a reference for the cultivation and assessment of rural family contract doctors.(3)In view of the current problems of the rural family contract doctors,the countermeasures and suggestions are put forward to optimize the training and training system,establish a scientific assessment and incentive mechanism,strengthen the relevant policy publicity and guidance,change the role of rural family contract doctor,and continuously strengthen the village-rural integration construction.