基于层次分析法与Delphi咨询法的社区卫生服务中心多部门标化工作量测算办法

Measuring Multi-departmental Standardized Workload of Community Health Service Center with Analytic Hierarchy Process and Delphi Method

目的进行社区卫生服务中心标化工作量部门间平衡测算,为社区卫生服务中心标化工作量的部门间平衡提供借鉴。方法选取2015年9月—2016年7月上海市静安区与邻近4家社区卫生服务中心的管理者代表17例,参与两轮Delphi咨询,采集其对社区卫生服务中心诊疗类、护理类、公共卫生类、辅助检查类服务操作难度(相对人力消耗与耗时)、技术难度、风险程度的看法,并借助层次分析法对各项服务的标化工作量进行测算。结果有效回收率为100%,专家积极性较高。对各项服务操作难度的判断依据为0.81,熟悉程度为0.84,权威程度为0.82;对各项服务技术难度判断依据为0.84,熟悉程度为0.87,权威程度为0.85;对各项服务风险程度判断依据为0.77,熟悉程度为0.74,权威程度为0.76。第一轮操作难度评分的Kendall协调系数为0.915(P<0.001),技术难度评分的Kendall协调系数为0.990(P<0.001),风险程度评分的Kendall协调系数为0.966(P<0.001),各测量维度贡献比例的Kendall协调系数为0.028(P>0.05)。第二轮操作难度评分的Kendall协调系数为0.975(P<0.001),技术难度评分的Kendall协调系数为0.981(P<0.001),风险程度评分的Kendall协调系数为0.987(P<0.001),各测量维度贡献比例的Kendall协调系数为0.564(P<0.001)。第二轮咨询结果显示,操作难度、技术难度、风险程度对标化工作量的贡献比例分别为0.3、0.4、0.3。结论本次咨询结果具有一定的可信性,部门间标化工作量测算结果也具有一定的合理性。

Objective To carry out the balance calculation of the standardized workload among different departments of community health service center,so as to provide reference for the multi-departmental standardized workload of community health service center.Methods From September 2015 to July 2016,managers from four community health service centers in Jing'an District,Shanghai,which are near to researcher's institute,were invited to participate in two rounds of Delphi consultation to collect their opinions on the degree of operational difficulty(relative human consumption and time-consuming),technical difficulty,risk perception in diagnosis and treatment service,nursing service,public health service,and auxiliary examination service.And With analytic hierarchy process,it calculated the standardized workload of different services.Results The effective recovery rate is 100%,and the expert's enthusiasm is high.Basis of judgment of the difficulty of service operation is 0.81,the extent of familiarity is 0.84,degree of authority is 0.82;judgment basis for the services of technical difficulty is 0.84,familiar with the degree of 0.87,degree of authority is 0.85;judgment basis for the service level of risk is 0.77,extent of familiarity is 0.74,0.76 degree of authority.Kendall's W of the first round operation difficulty score was 0.915(P<0.001),the Kendall's W of technical difficulty score was 0.990(P<0.001),the Kendall's W of risk degree score was 0.966(P<0.001),the Kendall's W of contribution ratio of each measurement dimension is 0.028(P>0.05).Kendall's W of the second round operation difficulty score was 0.975(P<0.001),the Kendall's W of technical difficulty score was 0.981(P<0.001),the Kendall's W of risk degree score was 0.987(P<0.001),the Kendall's W of contribution ratio of each measurement dimension is 0.564(P>0.05).Conclusion The consultation results have certain credibility,and the calculation results of the standardized workload among departments also have certain rationality.