Construction And Empirical Study Of Integrated Health Service Evaluation Index System

Objective Integrated health services are the best strategy to cope with population aging,correct the fragmentation of health service provision and meet the health needs of residents worldwide at present.The integration of health services in China is not progressing fast and integration is not strong due to the lack of construction guidelines,norms and related standards,and the evaluation of integrated health services has become an important tool to promote the benign and good development of health service reform.This paper addresses the evaluation needs of integrated health services,clearly defines the concept of localized integrated health services,constructs an integrated health service evaluation index system applicable to China,and verifies the index system in an empirical study to provide an applicable judgment basis for promoting the development of integrated health services.Methods(1)This paper used the literature review method to collected relevant domestic and foreign literature and domestic policy documents on integrated health services,constructed an index framework and a library of indicators,classified the indicators and determined their hierarchy according to logical relationships,and initially formulated an evaluation index system for integrated health services;(2)Through the Delphi expert consultation method,this paper conducted two rounds of expert consultation,statistically analyzed the positive coefficients,authority coefficients,and coordination(2)Using the Delphi expert consultation method,two rounds of expert consultation were conducted to analyze the positive coefficients,authority coefficients,and coordination coefficients of experts,and experts’ suggestions on the index system were solicited,and the final integrated health service evaluation index system was determined based on the experts’ scores and suggestions;(3)Using the hierarchical analysis method to construct the index hierarchy,conduct a two-by-two comparison and consistency test,and calculate the index weights;(4)An empirical study was conducted with six medical communities in a city in central Anhui Province to verify the applicability of the integrated health service evaluation index system.(4)To verify the applicability of the integrated health service evaluation index system,an empirical study was conducted in a city in central Anhui Province.Results(1)This paper defined integrated health services as a health service delivery model based on institutional coordination,organizational synergy,professional collaboration and service interface,which follows the core principles of human-centeredness and patient-oriented health needs,emphasizes multi-level and various types of health institutions working together,moderate patient participation,unified leadership,clear division of labor,synergy,prevention and treatment,and resource sharing within the system.It aimed to provide patients with a kind of life-cycle,integrated,continuous and personalized health service from prevention,medical treatment,rehabilitation to health promotion;(2)The literature and policies related to integrated health services were comprehensively sorted out to form the evaluation index system of integrated health services.A total of 18 experts were invited to participate in the consultation,and the positive coefficients of experts in the two rounds were94.44%% and 82.35%,respectively,and the authority coefficient of experts was 0.8642.the p-values of the coordination coefficients of the two rounds of expert consultation were less than 0.05.finally,an integrated health service evaluation index system with system integration,organizational integration,professional integration,and service provision integration as the main framework was constructed,including 4 primary indicators,16 secondary indicators,and 43 tertiary indicators;(3)The weights of the integrated health service evaluation index system were determined.In the process of assigning weights by hierarchical analysis,the consistency ratio of the judgment matrix was less than 0.1000.the weight coefficients of the primary indicators were: system integration(0.3151)> service provision integration(0.2894)> organizational integration(0.2029)> professional integration(0.1927).(4)Through practical application,it was found that the integrated health service evaluation index system developed in this paper is scientific,representative,oriented and operable.Conclusion The evaluation index system of integrated health services constructed in this paper is consistent with the actual development of integrated health services in China,and can reflect the development of integrated health services in a more reasonable way,with certain scientificity and applicability,and can provide policy makers with decision-making reference for promoting the development of integrated health services.