基于Donabedian模型的三级公立医院日间医疗质量评价体系研究

Research on the evaluation system of daytime medical quality in tertiary public hospitals based on Donabedian model

目的:构建三级公立医院日间医疗质量评价指标体系,为客观评价日间医疗质量提供科学依据。方法:采用文献检索和半结构化访谈法确定初始指标,设计专家函询问卷,采用德尔菲法和层次分析法构建基于Donabedian模型的三级公立医院日间医疗质量评价指标体系并确定各指标权重。结果:两轮专家函询的问卷有效回收率分别为90.91%和100%,专家权威系数为0.892,专家协调系数为0.137~0.246(P<0.05),各级指标判断矩阵均通过一致性检验(CR<0.1),最终构建的日间医疗质量评价指标体系包含3个一级指标、11个二级指标和38个三级指标。结论:本研究构建的三级公立医院日间医疗质量评价体系具有较高的科学性和可靠性,能够客观、全面地评价日间医疗质量,促进日间医疗质量规范化管理和持续改进。

Objective:To construct an evaluation system of daytime medical quality in Grade III public hospitals and provide a reference for the objective assessment of daytime medical quality.Methods:Determine the initial indicators through literature search and semi-structured interview,design expert correspondence questionnaires,construct the evaluation system of daytime medical quality in Grade III public hospitals based on the Donabedian model and determine the index weight with the Delphi method and the analytic hierarchy process.Results:The effective response rates for the two rounds of expert questionnaires were 90.91%and 100%,the expert authority coefficient was 0.892,the expert coordination coefficients ranged from 0.137 to 0.246(P<0.05),the judgment matrix of all indexes passed the consistency test(CR<0.1).The final evaluation indicator system of daytime medical quality consists of 3 primary indicators,11 secondary indicators,and 38 tertiary indicators.Conclusion:The ambulatory medical quality evaluation system of Grade III hospitals constructed in this study is highly scientific and reliable,can objectively and comprehensively evaluate the quality of ambulatory medical care,and promotes the standardized management and continuous improvement of ambulatory medical quality.