Research On The Establishment Of Performance Evaluation Index System Of Primary Medical And Health Institutions In GuiZhou Province Based On Delphi Method

Objective: To maintain the public medical welfare and improve the standardized and scientific management of primary medical and health services,a set of practical and scientific performance evaluation index system was applicable in primary medical and health institutions of Guizhou province.The system was constructed by qualitative and quantitative methods according to the overall target and basic principle.Methods: In this study,literature analysis,causation analysis and the expectation questionnaire were used to establish the performance evaluation system of the primary health care institutions;the Delphi and group methods were used to evaluate and build the index system.The expert survey weighting method was used to determine the weight of the first level.Normalization and multiplier methods were used to calculate the importance of level two and three.Judgment(Ca),familiar with degree(Cs)and Kendall Concorde coefficient(W)were used to check the authority of experts and coordination degree.To evaluate the performance review of primary health institutions,and explore the feasibility and validity of the performance evaluation in Guizhou province,9 institutions were sampled randomized.Results:(1)The performance evaluation system was consist of 4 first-level indicators,13 secondary indicators,47 three-level index;Then secondary of support condition indexes includes manpower,financial resources construction and infrastructure configuration and so on;Service includes 2 functional indicators,public health service and medical service.The comprehensive management indicators include health management,organizational management,financial management,business management,personnel management and information management;Social benefit indicators include service benefit and satisfaction;Since there were many third-level indicators,details were not shown here.(2)The weight of each index of each levels were determined,among which the weight of the three primary indexes were 0.1593,0.4793,0.2393,and 0.1221 respectively;The weights of the 13 secondary indicators are 0.0541,0.0509,0.0533,0.2413,0.2377,0.0385,0.0403,0.0385,0.0409,0.0421,0.0385,0.0605 and 0.0615 respectively.(3)The degree of expert authority was 0.858,the Kendall concordance coefficient was 0.96(2=907.29,P < 0.001),Cronbach's q factor was 0.875,and the content validity index(s-cvi /Ave)was 0.955.(4)Correlation coefficient transient =0.867(p=0.002)in Spearman correlation statistical analysis.Conclusion: Based on the "structure-process-result" framework,this study established a evaluation index system of the basic structure in Guizhou province from the perspective of government performance evaluation.In which supporting conditions,services,comprehensive management and social benefit were included.There were 4 primary indexes,13 secondary indexes,47 level indicators.All of the contents while evaluating the performance in basic health care institutions were included in this system.The performance of primary medical and health institutions can bereflected comprehensively and effectively.There system was proved with realistic significance on promoting the sustainable development of basic medical and health institutions.This study provided valuable experience in further improvement of the medical and health institutions in Guizhou province.