Development of the Evaluation Index System of the Supply Service Quality of the Community-home Care Center with Medical Care

doi:10.12114/j.issn.1007-9572.2018.00.248

Abstract

Abstract: Background　In order to cope with the aging，the government has given strong support to the medical care，so the number of community-home service institutions has increased. However，due to“old before rich”national conditions and the late start of pension undertakings in China，there are many problems，such as the non-standard medical service and the imperfection of the service quality system.Objective　To develop the Evaluation Index System of the Supply Service Quality of the Community-home Care Center with Medical Care.Methods　From June to August，2017，twenty community service centers and fifteen community day-care centers in Beijing，Tianjin and Hebei were chosen by purposive sampling，and the initial version of the service quality evaluation index system was established.From November 2017 to January 2018，three rounds of questionnaire consultations were delivered in person or by E-mail to 23 experts to make a judgment on the appropriateness，importance，familiarity and basis for determination.At the end of the questionnaire consultation，the expert positive coefficient，authority coefficient，coordination degree and index importance value，full score ratio and variation coefficient were calculated.Results　The three rounds of positive coefficients were 88.5%，100.0% and 100.0%，respectively；the authority coefficients were 0.905，0.909 and 0.922 respectively; the coefficients of variation were 0.06 to 0.24，0 to 0.17 and 0 to 0.22；and Kendall's W coefficient were 0.249，0.252 and 0.316.According to the index screeningcriteria and experts' opinions，twelve indicators were deleted，and sixteen indicators were increased in the first round and five indicators were deleted，only one indicator was revised and added in the second round.The indexs were not revised ，deleted or added in the third round.Finally，the service quality evaluation index system of the combination of medical care and pension in the home care center with 3 first-level indicators，15 second-level indicators，64 third-level indicators were established after three-round Delphi consultation.Conclusion　The expert opinion concentration degree of the system is high，and the result reliability is strong，which can provide a basis for the evaluation，construction and improvement of the Evaluation Index System of the Supply Service Quality of the Community-home Care Center with Medical Care.

Key words: Community health services, Medical care；The community-home care center；Service quality；Evaluation index system

摘要：

背景　为应对老龄化，我国对医养事业给予大力扶持，致使医养结合社区居家养老服务机构数量剧增。但因我国“未富先老”的国情及养老事业起步较晚，医养结合养老模式存在医疗服务不规范和服务质量评价体系不健全等诸多问题。目的　构建医养结合社区居家养老中心供给服务质量评价指标体系。方法　于2017年6—8月，采用目的抽样法抽取北京市、天津市、河北省20个社区养老服务驿站（中心）和15个社区日间照料中心进行实地调研和访谈，形成医养结合社区居家养老中心供给服务质量评价指标体系（初版）；于2017年11月—2018年1月选取23名专家，通过亲自发放或电子邮件发放3轮函询问卷，由专家对指标的合适性、重要性、熟悉程度及判断依据做出判断；函询结束后，整理专家咨询结果，计算专家积极系数、权威系数、协调程度和指标重要性赋值、满分比、变异系数。结果　3轮函询专家积极系数分别为88.5%、100.0%、100.0%，专家权威系数分别为0.905、0.909、0.922，变异系数分别为0.06~0.24、0~0.17、0~0.22，Kendall's W系数分别为0.249、0.252和0.316。依据指标筛选标准，综合专家意见后，第1轮删除12个指标、增加16个指标，第2轮删除5个指标、修改1个指标、增加1个三级指标，第3轮无删除、修改、增加指标，最终形成了3个一级指标、15个二级指标、64个三级指标的医养结合社区居家养老中心供给服务质量评价指标体系。结论　构建的医养结合社区居家养老中心供给服务质量评价指标体系的专家意见集中度较高，结果可靠性较强，可为医养结合社区居家养老中心服务质量的评价、建设和改进提供依据。

关键词: 社区卫生服务, 医养结合, 社区居家养老中心, 服务质量, 评价指标体系

ZHU Liang,YANG Xiaojiao,ZHANG Qian, et al. Development of the Evaluation Index System of the Supply Service Quality of the Community-home Care Center with Medical Care　[J]. Chinese General Practice, 2019, 22(2): 199-205. DOI: 10.12114/j.issn.1007-9572.2018.00.248.
朱亮,杨小娇,张倩等. 医养结合社区居家养老中心供给服务质量评价指标体系的构建研究[J]. 中国全科医学, 2019, 22(2): 199-205. DOI: 10.12114/j.issn.1007-9572.2018.00.248.

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