Study On Performance Assessment Of Community Health Service Providers In Key Posts

Research PurposesThis study stays focused on developing framework and indicator system for general practitioners, community nurses and public health workers based on responsibilities of different posts, aiming to provide reference for the country publishes policy to conduct practice of community health service (CHS) providers’ performance assessment in various regions.ContentsThe theory and practice of CHS providers’ performance assessment are systematically analyzed; the indicator system for general practitioners, community nurses and public health workers has been built; the pilot test is carried out through screening reasonable indicators, aiming to inspect suitability and operability of indicators and improve the performance assessment indicator system for CHS providers in key posts.Research MethodsThe practice and experience of CHS providers’ performance assessment were summarized and analyzed by means of literature review; the indicators and weight were defined by experts’consultation method; the indicator system was improved and perfected using the pilot test. Results and Analysis1. The key posts and their responsibilities were defined; the evaluation framework was developed based on three dimensions, namely, the service quantity, the service quality and satisfaction. On the basis of literature review, the general practitioners (doctors worked on general medical posts) were responsible for Out-patient service, control of chronic disease, health education, etc. The public health workers (prevention physicians) were responsible for residents’health file management, vaccination, control of chronic disease, health supervision and cooperation, etc. The community nurses (the professional technical personnel engaged in the community nursing care) were responsible for medical care, health education, preventive care, etc. Meanwhile, combined with the research and practice in China, the result-oriented framework was developed, and the CHS providers in key posts were evaluated from dimensions of the service quantity, the service quality and satisfaction,2. The performance assessment indicator system of CHS providers had built in key posts through experts" consultation and seminar, It included three main dimensions of the service quantity, the service quality and satisfaction, totally62indicators. For general practitioners, under the dimension of service quantity, there were15indicators namely person-times of general outpatient (emergency),etc; Under the dimension of service quality, there were8indicators namely rate of qualified medical instrument, etc. For community nurses, under the dimension of service quantity, there were7indicators namely person-times of outpatient care, etc; under the dimension of service quality, there were4indicators namely rate of qualified nursing record writing, etc; For public health workers, under the dimension of service quantity, there were15indicators namely person-times of new health records, etc; under the dimension of service quality, there were7indicators namely rate of qualified health files, etc. Under the dimension of satisfaction, the indicators of number of times of complaints and disputes and resident (patient) satisfaction were all introduced in different posts.3. In order to improve the indicator system, appropriate indicators were selected from the indicator system to implement the pilot test in2CHS institutes of Jiulongpo district, Chongqing. After the performance scores were calculated by the even multiplication method, the results showed that the indicator system built by this study is reasonable and discrimination, presenting in a certain degree the principle of "more pay for more work" and "higher salary for better performance". The Cronbach’s alpha coefficient was0.944, which showed good reliability. Meanwhile, the indicator system can reflect the essential medical care and public health service provided by CHS providers, and the indicator system’s structure was reasonable, which showed good content validity.Conclusions1. The performance assessment framework built by this study is reasonable, comprehensive and systematic. It can reflect the essential medical service and public health service provided by CHS providers in key posts.2. A variety of methods are applied, such as literature review and experts’consultation, and ensures scientificity of process and results.3. The performance assessment indicator system built by this study is Appropriate and operational. It can reflect the characteristics of the CHS providers in different posts and the intersection of responsibilities. Meanwhile, the indicator system is discrimination and the comparison of CHS providers of different posts can be realized.Suggestions1. The performance assessment tool for CHS workers should be specific to the functional orientation of CHS, and the procedures to build the indicator system should be standardized.2. The job analysis on Posts Characteristics in CHS institutes should be strengthened, and the job responsibilities of CHS workers in different posts should be cleared.3. The construction of the community health information should be promoted, and supportive conditions for the development and implementation of performance assessment for individual should be provided.4. The theory study on performance assessment of CHS providers should be deepened, and the performance assessment indicator system should be improved.