未来社区健康场景服务质量评价指标体系构建研究

Research on the Service Quality Evaluation System Construction of Future Community Health Scenario

背景在国家推动“以治病为中心”向“以健康为中心”理念转变的背景下,浙江省率先打造面向全人群和全生命周期的未来社区健康场景,为基层卫生健康综合改革提供了“浙江样板”,构建一套科学有效的未来社区健康场景服务质量评价指标体系具有重要的理论意义和实践价值。目的构建浙江省未来社区健康场景服务质量评价指标体系,为提升社区健康服务能力和质量,推动人群健康目标实现提供参考。方法基于SERVQUAL理论模型,通过政策分析、文献研究和实地调研建立初始指标池;2023年10—12月,采用两轮德尔菲专家咨询法确定指标体系,并运用层次分析法确定各指标的权重和组合权重。结果两轮专家咨询均有17位专家参与,其中高级职称共12名(70.6%);工作年限≥10年15名(88.2%);未来社区的管理人员和医务人员共5名(29.4%)。两轮咨询专家积极性均为1.0,权威系数分别为0.862和0.842,协调程度逐轮提高,最终构建的指标体系包含5个一级指标、13个二级指标、36个三级指标。一级指标中,有形性、可靠性、保证性、响应性、移情性的权重分别为0.168、0.180、0.240、0.178、0.232;二级指标中,场地设施、数字化设备、服务提供、健康监测、服务效率、服务可及性、危机预防和应急救援能力、专业技能、活动组织、智能平台维护、服务态度和情感支持、服务效果、个性化服务的权重分别为0.399、0.601、0.672、0.328、0.487、0.171、0.342、0.410、0.416、0.174、0.284、0.323、0.393。结论本研究构建的浙江省未来社区健康场景服务质量评价指标体系科学可靠,具有较强的系统性、创新性、可操作性和应用价值,是开展未来社区健康场景评价的有效工具,希望能够为政府制定改进策略和相关政策提供参考。

Background Under the background of the promotions concept change from"disease-centered"to"health-centered",Zhejiang province takes the lead in building a future community health scenario for the whole population and the whole life cycle,providing a"Zhejiang model"for the comprehensive reform of grassroots health care.It is of great theoretical significance and practical value to construct a set of scientific and effective service quality evaluation index system for future community health scene.Objective The purpose of this study is to construct a service quality evaluation index system for future community health scenes in Zhejiang province,aiming to provide a reference for improving the capabilities and quality of community health services and advancing the achievement of public health objectives.Methods Employing the SERVQUAL theory model,an initial indicators pool was developed through policy analysis,literature review,and field research.From October to December 2023,a two-round Delphi expert consultation method was used to refine the indicators,and the Analytic Hierarchy Process(AHP)was applied to determine the weights and composite weights of each indicator.Results A total of 17 experts participated in both rounds of consultation,among which 12(70.6%)hold senior titles;15(88.2%)have 10 or more years of work experience;and there are 5(29.4%)managers and medical staff from future community.The positivity level of the experts in both rounds was consistently rated at 1.0,with authority coefficients of 0.862 and 0.842,respectively,and the degree of expert consensus increased round by round.The final constructed indicator system includes 5 primary indicators,13 secondary indicators,and 36 tertiary indicators,and the weights for the primary indicators-tangibles,reliability,assurance,responsiveness,and empathy were 0.168,0.180,0.240,0.174 and 0.238,respectively.For the secondary indicators,the weights for venue facilities,digital equipment,Service Provision,Health Monitoring,Service Efficiency,Service Accessibility,Crisis Prevention and Emergency Rescue Capability,Professional Skills,Activity Organization,Smart Platform Maintenance,Service Attitude and Emotional Support,Service Effectiveness and Personalized Services were 0.399,0.601,0.672,0.328,0.487,0.171,0.342,0.410,0.416,0.174,0.284,0.323 and 0.393 respectively.Conclusion The indicator system constructed in this study,which is an effective tool for conducting evaluation of future community health scenario,is scientifically reliable and exhibits a degree of systematization,innovation,operability and practical value.It is hoped to provide a reference to fomulate relevant policies and targeted improvement strategies.