| Research background and purpose:Maternal and Child Health(MCH)pertains to the provision of healthcare services for women and children.China’s MCH institutions are the core of the MCH service system and public welfare institutions that provide medical and public health services for women and children.The development of MCH institutions in western China is unbalanced,and it is urgent to establish a learning MCH information management system based on digital data and innovative technology.Drawing from the current status and direction of the MCH facilities’ development capability in Sichuan Province,this study constructs a development capacity evaluation system that conforms to the characteristics of MCH institutions in Sichuan Province,and provides reference suggestions and scientific basis for the development direction of MCH institutions and the establishment of the dynamic monitoring system of MCH.Materials and Methods:The data of this study are from the information network direct reporting system of the National Women and Children’s Center and the Sichuan Health Statistics Network direct reporting system.The research objects are 202 women and children’s health care institutions in Sichuan Province.SPSS 26.0 was used to analyze the current development capacity of MCH institutions at all levels in Sichuan Province in 2021.The annual growth rate was used to vertically analyze the changing trends of eight important indicators from2015 to 2021,including fixed assets,number of 10000 yuan of equipment,business room area,annual outpatient(emergency)visits,actual number of beds,number of discharged patients,business income,and number of health technical personnel.The index pool of the development capacity evaluation system of MCH institutions in Sichuan Province is formed by combining the literature analysis method,and the reliability analysis of the expert inquiry results is carried out through the Delphi method to establish the evaluation system framework.The analytic hierarchy process(AHP)is employed for constructing a model in a hierarchical structure,and MATLAB is used to assign the weights of indicators at all levels to build an evaluation system for the development capacity of MCH institutions in Sichuan Province.Randomly select MCH institutions in Sichuan Province to verify the evaluation system,and test the stability of the evaluation results through sensitivity analysis.Research Results:1.The current situation and changing trend of the development capacity of MCH institutions in Sichuan Province in 2021:(1)Basic information: In 2021,there were 202 MCH institutions in Sichuan Province,and institutions at all levels were directly subordinate to the health administration department,80.69% of which were fully funded institutions.(2)Resources: In 2021,the total assets,fixed assets,and liabilities of institutions at all levels will decline with the decline of the level of institutions.The number of 10000 yuan of equipment and the area of building business houses at all levels will basically maintain a year-on-year growth trend.(3)Service provision: In 2021,the average annual number of outpatient and emergency patients in institutions at all levels was 1096200,180700,and 56100.There are significant differences in actual bed settings,with the ratio of actual beds to planned beds in institutions across the province being72.89%.Affected by the epidemic situation,the number of outpatient and emergency patients,the number of actual beds and the number of discharged patients in institutions at all levels will decrease to varying degrees in 2021.(4)Operation: In 2021,the average total expenditure of municipal(prefecture)and county(city,district)level institutions was99.54 million yuan and 21.93 million yuan,with 46.53% of the institutional revenue and expenditure balance and 47.03% of institutional losses.(5)Science and education: The yearly expansion rate of healthcare technical staff across various levels of institutions is7.36%,5.79%,and 9.46%,sequentially.Provincial and municipal(state)level institutions are mainly staffed by personnel with bachelor’s degree or above,while county(city,district)level institutions are mainly staffed by personnel with college degree or below.The proportion of scientific research capacity and teaching management decreased significantly as the level of institutions decreased.(6)Safety evaluation: the medical quality and safety of institutions at all levels are good,and the annual average of relevant indicators meet the national requirements.2.Reliability analysis of expert opinions: the effective recovery rate of the two rounds of questionnaires is higher than 90%,and the expert authority coefficient is 0.90? 0.7,average coefficient of variation ? 0.2,after two rounds of correspondence,the collaboration coefficients of experts at all levels were 0.68,0.54 and 0.51 respectively,indicating that the coordination of experts’ opinions was high,with statistical significance(P<0.05).A total of 20 indicators were deleted,4 were modified,and 2 were added.The evaluation system framework for the development capacity of MCH institutions in Sichuan Province consists of 5 first-level indicators,18 second-level indicators and 133third-level indicators.3.Construction of the evaluation system for the development capacity of MCH institutions in Sichuan Province: The consistent ratio(CR)of the indicator weight judgment matrix at all levels < 0.10,all of which have passed the consistency test.Among them,the weighting coefficients of the first-level indicators’ ability to fulfill social responsibilities,institutional medical service capacity,institutional operation capacity,institutional sustainable development capacity and participants’ perception capacity are0.233,0.411,0.127,0.127 and 0.07 respectively;The weight coefficient of the combination of secondary indicators ranks the top three in this level: the health level of women and children in the jurisdiction(0.126),medical safety(0.103),medical quality(0.103),service ability(0.103)and management level in the jurisdiction(0.069);The weight coefficient of the combination of three indicators ranks the top three in this level:network security protection level(0.051),maternal mortality rate(0.05),infant mortality rate(0.05)and resident standardized training rate(0.035).4.Verification of evaluation system: The sensitivity coefficients for the ability to fulfill social responsibilities,the operational ability of the institution,the medical service ability of the institution,the sustainable development ability of the institution,and the perceived ability of participants are 0.10-0.39,0.10-0.65,0.10-0.34,0.10-0.20,and 0.10-0.90,respectively.Within a specific range of weight changes,indicator weight changes have a significant impact on the final result,but the overall applicability of the evaluation system is good.Conclusion:4.This study analyzed the current situation and changing trend of the development capacity of MCH institutions in Sichuan Province through commonly used statistical methods,providing a reference basis for the construction of the evaluation system of the development capacity of MCH institutions in Sichuan Province.Strengthen industry management,improve service efficiency,promote the performance of public health functions,and carry out MCH group work in an all-round way.5.Further,a set of development capability evaluation system applicable to MCH institutions in Sichuan Province has been constructed through Delphi method and analytic hierarchy process,providing an effective tool for monitoring and evaluating the construction of MCH institutions in the context of MCH development,and laying a foundation for promoting high-quality development of MCH institutions.6.To ensure the stability of the results obtained from the evaluation system,an indicator system is employed for empirical analysis.However,it is still necessary to listen to the opinions of other stakeholders,constantly revise and improve the evaluation system,enhance the landing and operability,and strive to comprehensively improve the overall service level of MCH as soon as possible. |
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