基于IMOI模型构建家庭医生签约服务团队评估指标的系统综述

Constructing Assessment Indicators Regarding Effectiveness of a Family Doctor Team Using the IMOI Framework:a Systematic Review

背景家庭医生签约服务团队是当前基层医疗服务的主要提供者,提升团队服务质量是提高社区卫生服务效果的重要手段。有关团队服务有效性的评估研究日益受到重视。目的以投入-中介-产出-再投入(input-mediator-output-input,IMOI)模型为框架,对国内外评估家庭医生签约服务团队有效性的指标进行分类归纳,了解各结构中指标的核心维度。方法计算机系统检索PubMed、中国知网、万方数据知识服务平台及维普中文期刊全文数据库中关于国内外家庭医生签约服务团队评估指标构建的文献,检索时限为2000年1月至2020年10月。采用指标映射法将指标按照IMOI模型结构分类并对其进行比较分析。结果纳入14篇研究,其中国外4篇、国内10篇。按照IMOI模型分析,投入(I)主要与组织环境、团队建设、团队中个人素质等相关,中介(M)关注团队突生状态和团队过程,结果(O)则以服务结果、个人反馈为主,再投入(I’)指标缺乏。结论国内外家庭医生签约服务团队评估指标构建相关研究的理论模型和研究方法质量仍需提高。依照IMOI模型构建指标可以很好地评估团队有效性,但需要进一步补充指标内容。

Background Improving the effectiveness of a family doctor team,the main provider of primary healthcare,is an important means to enhance the effectiveness of community health services.The evaluation of team effectiveness has gained increasing attention.Objective To classify and summarize the assessment indicators and analyze the core dimensions of each indicator set regarding the effectiveness of a family doctor team using the input-mediator-output-input(IMOI)framework.Methods Studies about the development of indictors for assessing the effectiveness of a family doctor team were systematically retrieved from databases of PubMed,CNKI,Wanfang Data and VIP from January 2000 to October 2020.Indicator mapping was used to classify and compare the indictors according to the structure of IMOI framework.Results Fourteen studies were included,4 of which were published abroad,and 10 in China.The indicators were classified using the IMOI framework:organizational environment,team building,and team member quality were classified as input(I),team emergent state and team process were classified as mediator(M);service achievement and personal feedback were classified as output(O),but no indicators were classified as input(I').Conclusion The qualities of theoretical models and research methods used for developing assessment indicators regarding the effectiveness of a family doctor team need to be improved.The assessment system developed based on the IMOI framework may be a good tool for evaluating team effectiveness,but the indicators need to be supplemented further.