基于德尔菲法的深化医改群众“获得感”评估机制构建研究

Study on the construction of evaluation mechanism of deepening medical health reform for the masses’ “sense of gain” based on Delphi

[目的]构建一套基于群众"获得感"的新型医药卫生体制改革绩效评估系统,完善和创新现有的医改工作绩效评估模式,并提出有建设性的政策建议。[方法]应用德尔菲法,通过专家咨询建立医药卫生体制改革群众"获得感"评价指标体系。[结果]评价指标体系包括5个一级指标和12个二级指标。判断矩阵CR值都在0.1以下,均通过了一致性检验。公共卫生服务体系群众获得感强度相对数、医疗保障体系群众获得感强度相对数、医疗服务体系群众获得感强度相对数、医药供给体系群众获得感强度相对数、医改导向体系群众获得感强度相对数的最终权重分别为0.20、0.26、0.31、0.15、0.08。[结论]本研究构建的以"获得感"为基准的医改新评估机制及指标体系,克服了以满意度为评估的不足,可为医改绩效评估工作提供更加客观的参考和指向。

Objective To construct a set of performance evaluation system of new type of medical and health system reform based on the masses’ "sense of gain", improve and innovate the existing medical reform performance evaluation model, and put forward constructive policy recommendations. Methods Applied Delphi method and established evaluation index system of medical and health system reform for the masses’ "sense of gain" through expert consultation. Results The evaluation index system includes 5 first-level indicators and 12 second-level indicators. The CR values of judgment matrix were all below 0.1, and all had passed consistency test. The final weights of relative number of people’s "sense of gain" in public health service system, medical security system, medical service system, medical supply system and medical reform-oriented system were 0.2, 0.26, 0.31, 0.15 and 0.08 respectively. Conclusions The medical reform new evaluation mechanism and index system based on this study constructed "sense of gain" has overcome the shortage of the evaluation according to satisfaction, and can provide further objective reference and guidance for performance evaluation work of medical reform.