基层全科医生岗位胜任力评价指标体系的构建研究

Construction of Evaluation Index System for Post Competency of Primary Care General Practitioners

背景分级诊疗制度是深化医药卫生体制改革、建立中国特色基本医疗卫生制度的重要内容。基层医疗卫生机构是分级诊疗服务体系的必要组成部分,承担居民健康“守门人”的职责。全科医生作为基层医疗卫生机构的核心人才要素,其岗位胜任力直接影响医疗机构的服务能力。目的构建基层全科医生岗位胜任力评价指标体系,为基层医疗卫生机构开展全科医生岗位胜任力评价提供依据。方法于2022年9—12月,通过德尔菲专家咨询法对13位行业专家进行咨询;运用层次分析法与熵值法确认指标权重。结果本研究通过两轮德尔菲专家咨询对指标体系进行优化筛排,最终构建了由5个一级指标、27个二级指标组成的基层全科医生岗位胜任力评价指标体系。通过层次分析法结合熵值法明确各级指标权重,其中基本公共卫生服务能力指标权重最高,为核心指标。指标体系通过小样本信效度检测,均处于可接受水平。结论初步构建了基层全科医生岗位胜任力评价指标体系,有助于基层医疗卫生机构选贤任能,为评价基层全科医生岗位胜任力评价提供参考依据。

Background Hierarchical diagnosis and treatment system is crucial for deepening the medical and health system reform and establishing the basic medical and health system with Chinese characteristics.Primary care institutions play an essential role in hierarchical diagnosis and treatment system by assuming the role of"gatekeepers"of residents health.The post competency of general practitioners,who are the core of primary care institutions,significantly influences the service capacity of these institutions.Objective To construct an indicator system for the evaluation of post competency of general practitioners in primary care institutions.Methods From September to December 2022,13 medical professionals were consulted through two-round Delphi expert consultation method;the hierarchical analysis and entropy method was used to calculate the weights of the indicators.Results The indicator system was optimized and sifted through two rounds of Delphi expert consultation,the evaluation system of primary general practitioners was finally constructed,consisting of 5 primary indicators and 27 secondary indicators.The weights of the indicators at all levels were clarified through the hierarchical analysis combined with the entropy method,in which the basic public health service capacity indicator had the highest weight and was the core indicator.The indicator system was tested for reliability and validity by small samples,and all of them were at an acceptable level.Conclusion An indicator system for evaluation the post competency of general practitioners in primary care institutions was constructed,contributing to the selection and appointment of general practitioners,which will provide an objective reference for the evaluation of post competence of general practitioners in primary care institutions.