上海市某社区基于家庭医生制服务的家庭健康评估指标体系研究

Establishment of family health assessment index system in Shanghai urban communities

目的 探讨构建上海市城市社区中科学、可行的家庭健康评估指标体系,为在家庭医生制服务下开展针对性的社区分类分层健康管理提供依据.方法 在文献回顾和专题讨论的基础上,初步制定指标体系框架并编制专家咨询问卷.遴选上海市21名从事全科医疗、专科医疗、卫生行政管理及公共卫生管理的专家,进行两轮改进的德尔菲专家咨询,对结果进行统计分析及意见汇总,确立评估指标体系.结果 构建的评估指标体系含一级指标5项,二级指标16项,三级指标59项.一级指标包括家庭基本资料、家庭结构、家庭功能、家庭资源、成员健康状况,其权重系数分别为0.199 6、0.197 5、0.201 7、0.185 0、0.216 2.两轮咨询中专家积极系数均为100%;专家权威程度分别为0.867和0.880;指标重要性的协调系数分别为0.294和0.415（P〈0.05）;可操作性的协调系数分别为0.320和0.402（P〈0.05）.结论 采用德尔菲专家咨询法构建的家庭健康评估三级指标体系,可为家庭医生在同类社区中开展家庭健康评估工作提供工具参考.

Objective To establish a standardized and feasible family health assessment index system based on the family practice system in Shanghai urban communities.Methods On the basis of literature review and special topic discussion, a preliminary index system framework was developed and an expert consultation questionnaire was compiled.Twenty one experts of general practice, medical specialties, health administration and public health management were invited and two rounds of improved Delphi expert consultation were conducted.The results of statistical analysis were summarized and the evaluation index system was established.Results The evaluation index system included 5 first-level indicators, 17 second-level indicators and 63 third-level indicators.The weight coefficients of first-level indicators in basic information, family structure, family function, family resources and health status of the family members were 0.199 6, 0.197 5, 0.201 7, 0.185 0, 0.216 2, respectively.In the two rounds of consultation, the positive coefficient of experts was both 100%, the degree of expert authority was 0.867 and 0.880, and the coordination coefficient was 0.294 and 0.415, respectively （P〈0.05）.The operational coordination coefficients were 0.320 and 0.402 （P〈0.05）, respectively.Conclusion The family health assessment index system constructed by the Delphi expert consultation method can provide reference for family doctors to carry out family health assessment in urban communities.