重庆市综合医院全科医疗质量评价指标体系构建研究

Establishment of Assessment System for Medical Quality of General Practice in Chongqing General Hospitals

背景全科医疗为健康中国战略实施的关键环节,然而其医疗质量评价尚未形成规范的标准体系,建立健全的全科医疗质量评价体系是亟待解决的新要求。目的建立一套适用于重庆市各综合医院的全科医疗质量评价指标体系,为综合医院全科医学科室建设和全科医疗质量控制中心的测评工作提供参考。方法于2022年2—4月采用文献分析法拟订评价指标,依据Delphi法通过对重庆市20所综合医院(包括临床住培基地)的25位全科专家函询,结合全科医疗质量控制中心专家建议完成评价指标体系的构建。结果25位函询专家中男性占比64.0%,中高级及以上职称占76.0%;经过两轮专家函询,有效回收函件分别为21份和20份,专家积极系数为84.00%和95.24%,对应权威程度高于0.85;在专家函询和全科医疗质量控制中心建议下最终形成由5个一级指标、10个二级指标及28个三级指标构建的综合医院全科医疗质量评价指标体系。结论基于Delphi法建立的评价指标体系,对标准化综合医院全科医疗服务质量,推进重庆市全科医疗建设和加强全科医疗质量控制中心监管具有重要意义。

Background General practice(GP)plays a key role in carrying out the"Healthy China initiative",but the standardized medical quality evaluation involved remains incompletely established.The establishment of an appropriate quality evaluation indicator system for GP has to be settled urgently.Objective To evaluate the medical quality of GP in general hospitals of Chongqing,the medical quality evaluation indicator system for GP is established,and the indicator system would also provide reference for the construction of GP and the research work of Centers for General Medical Quality Control in Chongqing.Methods The evaluation indexes were formulated in February-April 2022 using the literature analysis method.Based on Delphi method,the indicator system was revised according to the correspondence consultation from 25 general practice experts of 20 general hospitals(including clinical residential training bases)in Chongqing.The final draft was combined with the suggestions of experts from the Center for Medical Quality Control of GP.Results Among the selected experts,men accounted for 64.0%,and 76.0%had middle or senior titles.Two rounds of experts'consultation responses were 21 and 20 copies respectively,and the experts'authoritative coefficient were 84.00%and 95.24%.Corresponding degree of authority above 0.85.After two rounds of experts'consultation and the suggestions of the quality control center,the medical quality evaluation indicator system of general practice for general hospital was finally established including 5 first-class indexes,10 second-class indexes and 28 third-class indexes.Conclusion The evaluation indicator system based on Delphi method is of great significance for standardizing the quality of general practice service in general hospitals,promoting the construction of general practice service in Chongqing and strengthening the supervision of medical quality control center.