城市纵向医联体分级诊疗效果评价体系构建研究

Research on the Construction of Evaluation Index System of Implementation Status of Hierarchical Medical System in City Vertical Medical Consortium Based on the AHP

目的 以政策为导向,构建评价由三级医院-基层医疗机构组成的城市纵向医联体分级诊疗效果指标体系,为量化分级诊疗效果评价的提供依据。方法 采用德尔菲法对11名专家进行2轮函询,筛选指标,构建体系。利用层次分析法对所构建体系进行组合权重计算以及一致性检验。结果 两轮问卷有效回收率≥90%,专家配合度高,权威系数0.89,专家协调系数两轮分别为0.21,0.20。最终形成的指标体系,包括4项一级指标(基层首诊、双向转诊、急慢分治、上下联动),11项二级指标和33项三级指标,指标权重判断矩阵通过一致性检验。结论 城市纵向医联体分级诊疗效果指标体系所选指标较为客观,可获得性高,可作为实际评价的参考工具。

Objective This research, which is to evaluate the effects on hierarchical medical system of city vertical medical alliance consisting of grassroots medical institutions and tertiary hospital, is policy-oriented.The purpose is to provide a basis for quantifying the effect.Methods The Delphi method was used to conduct two rounds of inquiry to 11 experts in order to screen indicators and then build a system.Using AHP to calculate the combined weight and check the consistency of the constructed system.Results The effective recovery rate of the two rounds of questionnaires was ≥90%,which means the cooperation rate of experts was high.The authority coefficient was 0.89 and the expert coordination coefficient was 0.21 and 0.20.The final evaluation system included 4 fist-level indicators(primary consultation, two-way referrals, acute and chronic disease and up-down linkage),11 second-level indicators and 33 third-level indicators.The metric weight judgment matrix passed the consistency test.Conclusion The index system of this study is for evaluating the effect of hierarchical medical system of vertical medical alliance and can be used as a reference tool to truly reflect the current situation in the implementation of hierarchical diagnosis and treatment.