| Objective: This study integrated quantitative and qualitative research methods to establish and verify a set of geriatric friendliness evaluation index system applicable to three types of medical institutions(basic hospitals,specialized hospitals,general hospitals),so as to provide a reliable tool for the construction and evaluation of geriatric friendly medical institutions.Methods:1.By combing relevant policy documents issued in China and searching common databases at home and abroad,we extracted the contents of evaluation indicators of geriatric friendly medical institutions based on the best evidence,and preliminarily formulated the items of evaluation indicators.2.Verify,delete and supplement the evaluation indicators of geriatric friendly medical institutions through the expert meeting method,and form the first draft of the indicator system.3.Use Delphi method to revise and improve the initially established indicator system repeatedly until expert opinions reach a consensus and form an evaluation indicator system of geriatric friendly medical institutions.4.The analytic hierarchy process was applied to determine the weights of each index in the evaluation index system of geriatric friendly medical institutions,and the consistency test was carried out to improve the construction of the evaluation index system.5.Questionnaire was developed for germ-friendly medical institutions,stratified sampling method was adopted to conduct questionnaire survey on medical institutions,and Cronbach’s αcoefficient,split half reliability,content validity and structural validity were used to test the reliability and validity of the index system.Results:1.Based on literature research and expert meetings,this study preliminarily established the basic hospital version(4 first-level indicators,13 second-level indicators,61 third-level indicators),the specialized hospital version(4 first-level indicators,14 second-level indicators,67 third-level indicators),and the general hospital version(4 first-level indicators,15second-level indicators,71 three-level indicators)evaluation index system of age-friendly medical institutions,as the basis for further research.2.A total of 18 experts in different fields participated in the two rounds of Delphi expert consultation,and the questionnaire recovery rate of both rounds was 100%,which fully explained that the experts had a high enthusiasm to participate in this study;Expert familiarity was 0.878,judgment coefficient was 0.939,and authority coefficient was 0.909.The variation coefficient of each index in the two rounds of consultation ranged from 0.00 to 0.34 and 0.00 to0.23.The Kendall harmony coefficient in the two rounds was 0.135(P<0.05)and 0.232(P<0.05),suggesting that the coordination of experts was good.3.The evaluation index system of geriatric friendly medical institutions was finally formed,including the basic hospital version(4 first-level indicators,14 second-level indicators and 56 third-level indicators),the specialized hospital version(4 first-level indicators,12second-level indicators and 60 third-level indicators)and the general hospital version(4first-level indicators,12 second-level indicators and 58 third-level indicators).Analytic hierarchy process(AHP)was used to determine the weights of all levels of indicators.The weights of first-level indicators ranged from 0.109 to 0.572,the weights of second-level indicators ranged from 0.088 to 0.750,and the weights of third-level indicators ranged from0.015 to 0.800.4.The questionnaire survey of medical institutions showed that the overall Cronbach’s αcoefficient of the three versions of this study was greater than 0.9,and the Cronbach’s αcoefficient corresponding to the four first-level indicators was greater than 0.8 in the three versions.The overall broken half reliability of the three versions is greater than 0.9,and the broken half reliability of each level index of the three versions is greater than 0.6,indicating that the reliability of the index system is good and the results are reliable.The correlation coefficients between the first level index and the total score,the second level index and the first level index,and the third level index and the second level index of the three versions showed significant correlation except for some items(P<0.01),indicating that the structural validity was acceptable.Conclusion: The evaluation index system of germ-friendly medical institutions constructed in this study includes 4 first-level indicators(friendly culture,friendly management,friendly service and friendly environment),14 second-level indicators and 56 third-level indicators in the basic hospital edition,12 second-level indicators and 60 third-level indicators in the specialist hospital edition,and 12 second-level indicators and 58 third-level indicators in the general hospital edition.The index system is relatively complete,scientific,reasonable in structure,has good reliability and validity,has certain representativeness and operability,and can provide theoretical basis and guidance for the construction and evaluation of geriatric friendly medical institutions. |
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