Study On Performance Evaluation Index System Of Tight County Medical Community In Anhui Province

Objective:(1)This study is based on relevant policy documents and literature research on the compact county medical community,combined with the construction requirements and path of "two guarantees,three orders,and six connections" in Anhui Province,to explore the construction of a performance evaluation index system for the compact county medical community in Anhui Province.(2)By constructing a performance evaluation index system,important reference basis is provided for relevant administrative departments to supervise and assess the medical community and conduct self-evaluation in the pilot areas of the medical community.At the same time,key factors for the development of the medical community can be explored,and countermeasures and suggestions can be provided for better building a close county medical community.Method:(1)The literature research method was used to sort and summarize the relevant theories and research status of the compact medical community’s development and evaluation,explore the meaning of the compact medical community’s performance evaluation,collect related policy documents of the compact county medical community,and pull appropriate evaluation indicators from the policy documents and related literature of the compact county medical community.The structure-process-outcome approach was used to make the performance assessment index system for the compact county medical community in Anhui Province.(2)Using the Delphi method,two rounds of letter questionnaires were sent to 22 experts in hospital management,health policy,health economics,and other research or work fields.Assessment indicators were then checked.Evaluation indicators with an important mean larger than 4,a coefficient of variation less than 0.25,and a standard deviation less than 1 were kept,and the performance assessment indicator system of Anhui Province’s tight county health community was eventually decided.(3)The weight values of indicators at all levels were calculated using the analytic hierarchy process(AHP)to enhance the design of the compact county medical community in Anhui Province’s performance assessment index system.Results:(1)The compact county medical community in Anhui Province built a performance assessment index system that contained three first-level indicators(structure,process,and outcome),thirteen second-level indicators,and 54 third-level indicators.(2)The positive coefficients of the experts in the second round were 95.9%and 100%,respectively;the expert authority coefficients were 0.85 and 0.86;and the expert coordination coefficients were 0.368 and 0.411(P 0.05),which were significant.(3)The weights of first-level indicators are 0.3278,0.3049,and 0.3671,respectively,while the weights of second-level indicators vary from 0.0356-0.1250.The weight of the "satisfaction" index is the greatest at 0.1250,followed by "health manpower" and "medical insurance payment".The weights were 0.1107 and 0.1046,while the third-level indicator weights varied from 0.0050 to 0.0659.The weight of "patient satisfaction" was the highest at 0.0659,followed by the weights of "government financial contribution to the medical community" and "implementation of the whole prepaid system" at 0.0616 and 0.0423,respectively.Conclusions: Based on the theoretical model of structure process result,this study builds an evaluation index system based on Delphi method method and analytic hierarchy process,which can ensure the scientificity,applicability and policy orientation of the performance evaluation index system of Anhui compact county medical community.Using analytic hierarchy process to determine the index weight can show the key factors of the development of Anhui compact county medical community,and provide reference for the next step of policy formulation.Unlike previous related studies,the indicator system constructed in this study incorporates characteristic indicators such as medical prevention integration and rural integration that reflect the construction of a close county-level medical community in Anhui Province.It emphasizes a result oriented approach and focuses on improving patient satisfaction,which can better achieve the goal of "health co construction and sharing" in the national health strategy.