Comprehensive Evaluation Model Of Healthcare Service Quality Of Level-3A Hospitals In Hainan

Background:Evaluation of health care was booming in the1800s. With the continuous development of society and economy, healthcare and healthy has been an important topic of our daily life, and public requirement of healthcare industry was increasing. There has been an urgent problem in medical industry that how to realize impartial and logical evaluation of healthcare service quality. The healthcare service peculiarity lead to the complexity of its definition and assessment. We could define healthcare service quality as the extent to which health services provided to patient populations improve desired health outcomes and satisfied by professional technology. The global recognized connotations of healthcare service quality include technology, relationship and environment, and which was proposed by Donabedian. Year of hospitals management activity has been launched in2005in China of which topic was "strive for patients centered services and continuous quality improvement", and ISO9000, JCI has been used to hospital comprehensive evaluation. Hainan is the only special economic zone at provincial level. Exploring the comprehensive evaluation model in Hainan level-3A hospitals is typical and meaningful as medical industry in Hainan has entered the fast development period and has caught up with the national average in the previous five years.Objectives:By reviewing the development state of Hainan medical industry in five years, and referring to the standards and documents of healthcare service quality location and abroad, We constructed healthcare service quality evaluation index system and model based on Hainan provincial healthcare quality evaluation indices.Methods1. Literature analysis. Literature analysis is collection, identification and organization of literatures and reach to scientific understanding based on literature studying. Literature analysis could systematic summarized and review the research achievements, and provide guidance to construct study protocol and summarize indices. We mainly analyzed the standards and indices of healthcare service quality location and abroad.2. Delphi’s method. Delphi’s method is a way that collected expertise anonymity and make a common conclusion of professor advise by several modifications. We constructed healthcare service quality evaluation index system according to Delphi’s method in two rounds.3. Field research. We acquired information of hospital environment, public facilities and ward in field research by empirical investigation questionnaire.Results:1. We established the evaluation index system of healthcare service quality of level-3A hospitals in Hainan, the system includes3primary indices,9secondary indices and59tertiary indices. In two round Delphi’s method study,19experts in the first round and17experts in the second round, and the results of familiar coefficients, determine coefficients and dependability coefficients of primary level indices were>0.8, and coordination coefficients of primary-, secondary-and tertiary-level indices were>0.5. This showed that the results are rational and the indices are scientific.2. Comprehensive evaluation model was built based on synthetically judgment, and we divide the score into three degrees, namely,60-70for pass,70～80for good,80～for excellent. The scores of6empirical hospitals from high to low were:H2、H1、H5、H6、H3、H4, and the average was65.69±6.70,in pass level. The sorted result of model was positively associated with weighted TOPSISI, and the correlation was0.829, P<0.05.Conclusions:1. We constructed the evaluation indices system which includes3primary indices,9secondary indices and59tertiary indices based on medical technology-relationship-environment theory and two round Delphi’s study. The index system accorded with the healthcare development status in Hainan, and could be extended to non-technical quality, which indicated the scientific of the exploring.2. According to select indices, assign weight coefficient, schedule score plan and manage the score calculation, we established the comprehensive evaluation model based on synthetically judgment which was rational and feasibility.3. Comprehensive evaluation model of healthcare service quality was used to the empirical study in6level-3A hospitals in Hainan, the sorted result of model is positively associated with weighted TOPSIS, which indicate the scientific of the model. The score of evaluation model showed that the healthcare service quality in Hainan is in the pass level, and has great develop potential in the future.