| [Purpose] The primary medical and health institutions are the cornerstone of China’s medical and health system.The healthy development of primary medical and health institutions is conducive to the stability and continuous improvement of the whole medical and health system.Performance evaluation is one of the methods of scientific,effective and economic evaluation and supervision.Based on the research of performance appraisal of primary medical institutions around the world,combined with the current situation and development goals of primary medical and health care in Wuhan City,this study uses the expert consultation method to build the performance evaluation index system of primary medical and health institutions applicable to the region,and uses the index system developed in the empirical study to improve the performance of primary medical and health institutions in Wuhan city.Conduct evaluation,explore the existing problems and their causes,and propose continuous improvement strategies.[Methods] Combined with the purpose of the research,this paper uses the literature method to consult the relevant literature such as journals,newspapers,dissertations and Internet materials online,uses the content analysis method to objectively and systematically describe and analyze the main contents of the collected various literature materials,sums up and summarizes the current situation and trend of the relevant research at home and abroad,and systematically sorts out the existing performance evaluation framework of primary medical and health institutions So that we can draw lessons from the experience,views and achievements.On the basis of literature research,Delphi method is used to construct the performance evaluation index system of primary medical and health institutions in Wuhan.On the spot data collection mainly uses the questionnaire survey method to investigate the grass-roots medical and health institutions,grass-roots medical staff and patients.Using descriptive analysis,weighted average method,system evaluation and other data analysis methods,the collected data were statistically described,the index system was given weight,and the performance of primary medical and health institutions was evaluated.[Results] The performance evaluation index system of basic medical and health institutions in Wuhan was established.The system includes 4 first level indicators,16 second level indicators and 18 third level indicators.The authority coefficient of experts participating in expert consultation is greater than 0.7.After weight calculation,the percentile scores of the four first-class indicators public health service,medical and health service,comprehensive management and social evaluation are respectively 30,35,20 and 15.The total score of the city’s community health service center is between 16 and 82,and that of the township(street)health center is between 26 and 78.There are significant differences in the public health service provision between the 7 central urban areas and the community health service center of Donghu high tech Development Zone,mainly reflected in the elderly health management and chronic disease management related indicators.According to the classification of hosts,the community health service center held by colleges and universities has the highest score,and its advantages are mainly reflected in the provision of public health services.The differences in scores of six remote town(street)health centers are mainly reflected in medical and health services and comprehensive management.9931 medical staff were investigated,including 5525 community health service centers and 4406 township(street)health centers.The grass-roots medical staff in the city are satisfied with their job satisfaction,job stability and the opportunity to play their ability in work.At the same time,the satisfaction of the medical staff in the community health service center in working conditions is poor,and the satisfaction of the grass-roots medical staff in the township(street)health center in the leadership is poor.3489 patients were investigated in primary medical and health institutions,including 2226 in community health service centers and 1263 in township(street)health centers.The total score of evaluation is 5 points.The overall satisfaction and medical experience scores of the patients in the community health service center of Wuhan are 4.70 and 4.65 respectively.The overall satisfaction and medical experience scores of the patients in the township(street)health center of Wuhan are 4.70 and 4.63 respectively.[Conclusions] Through practical application,it is found that the performance index evaluation system of primary medical and health institutions in Wuhan has the characteristics of sensitivity,guidance and sustainability.The evaluation found that the basic level of medical and health work in Wuhan is well founded and constantly improved,and most of the evaluation indicators are higher than the national level.However,the problem of medical prevention is prominent,the medical service capacity of primary medical and health institutions is declining,the medical and health talents are unstable,the medical insurance system restricts the development of primary medical and health institutions,medical disputes increase the economic loss and work pressure of primary medical and health personnel,the financial burden is heavy,and there is no effective assessment mechanism.It is suggested that we should give full play to the policy linkage effect,promote the integration and common development of medical treatment and prevention,expand the grass-roots health talent team as soon as possible,further promote the reform of personnel management system,formulate reasonable control standards for the total amount of medical insurance,give full play to the use efficiency of medical insurance funds,reform the basic drug system,establish and improve the liability insurance system,and increase the anti risk ability of grass-roots medical and health workers.So as to gradually improve the performance level of basic medical and health institutions in Wuhan.[Innovation and deficiency]Under the background of the reform of primary medical and health institutions,the results of literature research and policy analysis are organically combined to form a set of performance evaluation index system that conforms to the overall requirements of the country,adapts to the local economic development and serves the planning objectives of regional primary medical and health institutions,and applies it to the actual evaluation link,which is the work of relevant theoretical research and policy transformation Benefit exploration.However,due to the large number of objects involved and the wide range of evaluation,but the research time is limited,some research materials have not been excavated in depth,such as the dynamic evaluation of the performance of primary health care in Wuhan,the analysis of the problems involved in each index and the causes,etc.,which need further study. |
PDF Full Text Request