Research on the Development of an Evaluation Indicator System for Health Service Capacity of Village Clinics in Western Areas of China
|School||Huazhong University of Science and Technology|
|Course||Social Medicine and Health Management|
|Keywords||Village health Service capabilities Evaluate Indicator System|
Purpose of this study was to study the integrated use of qualitative and quantitative research methods, establish a set of village clinics in the western region the actual situation of health services capabilities, with high reliability, validity and discrimination and easy practical application and promotion of village health Rooms health service capacity evaluation index system for the management of health administrative departments and institutions to strengthen village health and health services in a scientific, standardized management to provide reference and basis. Research methods using literature intelligence analysis, personal interviews, focus group interviews, site surveys, Delphi expert consultation method used to establish the index system, and uses fuzzy comprehensive evaluation method to calculate index weight coefficient; using factor analysis, cluster analysis and variance analysis and other methods of mathematical statistics index system efficiency, reliability and discrimination test; using composite index and weighted Topsis France two kinds of evaluation methods for comprehensive evaluation. Research (1) evaluation of access to basic health services and research theories, methods and research results at home and abroad to establish research framework and structures; (2) use of expert advice and literature review and other methods to determine the village health services and basic services; (3) through on-site survey to find out the western region village health service capacity situation, identify gaps and propose policy recommendations; (4) through the use of expert interviews, expert consultation and on-site surveys and other methods to screen and establish evaluation index system, calculating index weight; (5) the use of comprehensive index method and weighted Topsis France two kinds of evaluation methods, in the western part of the village health room area comprehensive evaluation, and the use of collaborative Kendall coefficient test method for convergence of inspection, verification and evaluation of the stability indicator system operability; (6) using factor analysis, cluster analysis and variance analysis, mathematical statistics evaluation index system efficiency, reliability and discrimination; (7) to establish a standardized evaluation system, the formation of operational The evaluation manual. Results (1) through expert advice, focusing on informed person interviews and other methods, from the service conditions, public health services, basic medical services and non-medical services to build capacity in four areas village health service capacity evaluation index system, while each one classes are divided into three levels according to different indicators. (2) an evaluation of conditions of service, including equipment, facilities, human resources and financial resources as well as two three two indicators index next nine three indicators; public health services, including maternal and child health, health education, disease control and assisted by four two indicators and two indicators under 22 three indicators; basic health services, including diagnosis and treatment of common diseases, emergency aid and standardize services three two indicators and common disease clinics knowledge proportion passing the examination, the common Emergency knowledge examination pass percentage rate of prescription writing norms and essential drugs prescription drugs accounted for a percentage of four three indicators; non-medical services capabilities including reactive and satisfaction two two indicators and reactivity community residents and community residents and village would Satisfaction two three indicators. (3) through expert advice and Fuzzy comprehensive evaluation method to determine the weight of each level index. An index weight values ??were 0.243333,0.400833,0.261667,0.094167; two index weights were 0.100417,0.095000,0.047917,0.054615,0.145769 , 0.077308,0.081667,0.046667,0.116667,0.060833,0.084167,0.046667,0.047500. (4) evaluation indicators for each two factor analysis, confirmatory evaluation index system construct validity. Conditions of service of two indicators of factor analysis showed that three common factors were extracted, the contribution rate of 76.355%. Factor 1 by staff training, staff numbers and qualifications of personnel, conditions of service can be seen as the \equipment and facilities \The same method for the other two indicators of level indicators subordinate factor analysis, factor analysis results showed the results of evaluation with a similar default indicators that index system design in general has good construct validity, internal structure basically stable. (5) calculating Cronbach α coefficient reflects the inherent reliability indicators. Two indicators Cronbach α standard value of 0.82, three standard indicators Cronbach's α value of 0.92, α values ??were greater than 0.7, the reliability index is higher. (6) Cluster analysis showed that eight evaluation region is divided into good, bad, three more reasonable analysis of variance also showed that among the three groups, and each of the differences between the two groups is statistically significant (P <0.05), index system has better discrimination. (7) the results of comprehensive evaluation results show a variety of evaluation methods compare convergence (synergy factor W = 0.5982, approximate chi-square value x ~ 2 = 16.7500, p <0.05), describes the evaluation of the screening Indicators can be used for the western region village health health service capacity evaluation. Conclusions (1) village health essential health services and content should implement the principle of prevention, rural areas to carry out common disease preliminary diagnosis and public health services to meet the health care needs of rural residents. (2) evaluation index system with a more rational structure, contents intact. (3) using the Delphi expert consultation on the screening evaluation, the results are more reliable. (4) Based on the expert judgment using fuzzy evaluation method to calculate index weights to ensure that the results of scientific accuracy and reasonableness. (5) index system has good reliability, validity and discrimination, with the basic conditions used in practice. (6) the results of different evaluation methods have good consistency, indicating evaluation index system has good stability and maneuverability, also shows evaluation system can be used for village health health service capacity evaluation.