基于粗糙集约简理论社区卫生服务评价指标体系优化研究

To Optimize the Evaluation Index System of Community Health Service based on the Rough Set Reduction Theory

目的构建简约化社区卫生综合服务能力评价指标体系,并对其信度、效度和区分度进行检验。方法基于粗糙集理论对深圳市社区卫生评价指标体系进行优化,根据知识信息量理论计算各指标重要度并确定指标权重。应用克朗巴赫系数和分半信度进行评价指标体系信度检验,采用内容效度、聚敛效度和标准关联效度进行评价指标效度检验,通过计算Kappa系数对指标区分度和评价结果一致性进行检验。结果将深圳市社区卫生服务评价指标由184个优化到89个,包括管理体制、标准化建设、公共卫生服务和基本医疗服务4个维度。简约化指标体系的克朗巴赫系数为0.83,指标体系分半信度为0.78。Pearson相关分析显示,评价指标体系具有可靠的内容效度、聚敛效度和标准关联效度。简约化指标体系评价结果与原始指标体系评价结果的Kappa系数达到0.76。结论研究构建的简约化评价指标体系具有可靠的信度、效度和区分度,能够应用于社区卫生综合服务能力评价实践,并提高评价工作效率。

Objective To construct a simple evaluation index system of community health comprehensive service ability,and to test its reliability,validity and discrimination. Methods The rough set reduction theory was taken to optimize the community health service(CHS)evaluation index system in Shenzhen.According to the knowledge information quantity theory,the importance of each indicator was calculated and the weight was determined.Reliability of the evaluation index system was tested by Cronbach's alpha and split-half reliability.Validity of the evaluation index system was tested by content validity,convergent validity and criterion-related validity.Discrimination of indicators and consistency of evaluation reaults were tested by caculating the Kappa coefficient. Results In this study,after optimizing the evaluation index system of CHS in Shenzhen,the number of the index was reducted from 184 to 89.Four dimensions were included as following:management system,standardization construction,public health service and basic medical service.Cronbach's alpha and split-half reliability were 0.83 and 0.85,respectively.Pearson correlation analysis showed that the evaluation index system have reliable content validity,convergent validity and criterion-related validity.Kappa coefficient of the simplified index system and the original index system was 0.76. Conclusion The simplified evaluation index system that constructed in this study have reliable reliability,validity and discrimination,which can be applied to the practice for improving the efficiency of evaluation.