Construction Of Chronic Disease Management Quality Evaluation Index System

Background The high morbidity,disability and mortality of chronic diseases,as well as the heavy economic burden of health caused by them,have aroused great attention of the state.China’s Medium and Long-Term Plan for the Prevention and Treatment of Chronic Diseases(2017-2025)(hereinafter referred to as the Plan)points out that "on the basis of 2015,the premature mortality rate of patients aged 30 to 70 years old with chronic diseases should be reduced by 20%".It can be seen that chronic disease management is urgent.The plan also pointed out that chronic disease management should be promoted step by step,and a corresponding effect evaluation mechanism should be established.At present,most of the chronic disease quality assessment research carried out by medical institutions focuses on single diseases,and overemphasizes the role of process indicators in quality assessment while neglecting the importance of patient health outcome indicators in quality assessment.Based on full consideration of the characteristics of various chronic diseases and their impact on patients’ health,this study selected the Nursing Outcomes Classificaton(NOC)as the theoretical framework,with patients’ health Outcomes as the main indicator dimension.Through literature review,expert meetings,expert consultation method to establish evaluation index system of chronic disease management quality,and combined with analytic hierarchy process(ahp)to calculate the index weight,in order to fundamentally promote and guide the medical institutions at all levels with an emphasis on health outcomes for patients with the ultimate goal of chronic disease management,health care workers and improve the effectiveness and efficiency in the management of chronic diseases.Objective To construct a systematic and comprehensive evaluation index system for the quality of chronic disease management suitable to China’s national conditions,to supervise and guide the smooth development of chronic disease management,and to provide a scientific and reliable practical basis for the continuous improvement of the quality of chronic disease management,so as to improve the health status of patients with chronic disease and reduce premature mortality.Methods1.Through systematic retrieval of domestic and foreign literatures related to the quality evaluation of chronic diseases,the evaluation indexes were extracted.2.Through the expert meeting,the classification,name,index connotation,calculation method and data collection method of chronic disease management quality evaluation index system were preliminarily designed,and the preliminary draft of chronic disease management quality evaluation index system was developed.3.Through three rounds of expert consultation,group discussion was conducted for expert opinions and suggestions,and combined with SPSS analysis of relevant data,the quality evaluation index system of chronic disease management was determined.Finally,on this basis,the AHP is used to calculate the weight of each index.Results1.The three rounds of expert consultation had high enthusiasm of experts(the questionnaire recovery rate was 100%),high authority of experts(CR was 0.9),and the Kendall coordination coefficient W was 0.083,0.113,0.114(P < 0.001).2.The quality evaluation index system of chronic disease management consists of 5first-level indicators,10 second-level indicators and 16 third-level indicators.In order of weight,the first-level indicators were as follows: physical health field(0.0937),functional health field(0.124),mental health field(0.2308),health knowledge and behavior field(0.164),and other health field(0.614).In the secondary index,the combination of medical resources consumption has the largest weight,followed by sleep quality and life quality.The incidence of low sleep quality was the most important factor for the tertiary indicators,followed by the readmission rate of the same chronic disease within one year and the level of quality of life.Conclusion The quality evaluation index system of chronic disease management based on literature review,expert meeting,expert consultation and analytic hierarchy process has realized the unified evaluation of chronic disease management level in different medical institutions.The construction method is scientific and reliable,and the content is practical.