| ObjectiveIn this study, Delphi method was used to set up a scientific, objective and sensitive evaluation index system of designated medical institutions of the new rural cooperative medical system (NRCMS).The purpose of this study was to have effective and scientific supervision of the designated medical institutions, as well as to estimate the health service of institutions scientifically and objectively. Thereby, regulate medical behavior of the designated medical institutions, and to prevent the medical cost of the institutions being out of control. The aim is to provide protection for using the medical resources reasonably, protecting the basic rights and interests of the farmers who joined in the NRCMS, advancing the satisfaction of the farmers joined in the NRCMS, and promoting the health and sustainable development of the NRCMS would be accomplished.MethodsIn this study, literature review method, system evaluation, brainstorming, expert consultation and Delphi were used to construct evaluation index system of designated medical institutions of the NRCMS. And fuzzy comprehensive evaluation method was used to calculate the index weight coefficient. The credibility of expert advice was reflected by calculating the coefficient of expert authority, positive coefficient and coordination factor.ResultsWith all these research activities, this study achieved the following results:1. Delphi survey results:(1) the active degree:34 questionnaires were sent, the first round of the questionnaire response rate was 82.35%, the second round of the questionnaire response rate was 89.29%, and expert active degree was higher; (2) the authoritative degree:expert judgment basis was 0.92 and expert familiarity degree was 0.81, which were higher. Average of expert authority degree was 0.87 and expert authority degree was higher; (3) expert coordination degree:expert coordination coefficient of the first round was 0.16-0.29 and experts coordination coefficient of the second round was 0.24-0.41, which expert coordination was better.2. The main structure was constructed from input index, process index and outcome index, including 3 first-level index,9 second-level index, and 39 third-level index. Input index included 2 second-level index which were government support and staffing etc; process index included 3 second-level index which were supervision, medical services and regulations etc; outcome index included 4 second-level index which were efficiency, benefit, satisfaction, health service etc.3. The index weights of three levels were defined, which the weight of the first-level index respectively were 0.3332,0.3300,0.3368; and the weight of the second-level index respectively were 0.1719,0.1613,0.1114,0.1090,0.1096,0.0832, 0.0881,0.0847,0.0809.ConclusionIn this study, Delphi method was used to construct an evaluation index system of designated medical institutions of the NRCMS, which used input index, process index, and outcome index for the main structure. The theoretical basis of the index system was scientific and rational; the choice of index was comprehensive and operational; the methods chosen were scientific. |
