Abstract: Background　During the “Twelfth Five-Year Plan” period，Beijing proposed a new model of community home care for the elderly. Therefore, faced with the surge in the elderly population，the increase in medical burden and the shortage of nursing home，it is urgent to establish a comprehensive health assessment for community in-home elderly and quantitative technology which is suitable for China's national conditions and culture in the transition from medical science to bio-psycho-social medicine. Objective　To develop a comprehensive health assessment for community in-home elderly in Beijing based on modified Delphi method，and to provide reference for new model of community home care for the elderly.Methods　Twenty experts worked on clinic medicine，psychology，nutrition，nursing，education and management of health，and statistics were invited from December 2017 to March 2018.According to the modified Delphi method，the evaluation index system for community in-home elderly （version 1） was designed on the basis of comprehensive geriatric assessment.In two-rounds of consultation，the expert consultation tables were delivered by E-mail and face-to-face conversation.The significance of the indexes，the extent of familiarity and the basis for judgment were graded by the experts.The active coefficient，the degree of expert authority，the significance of each index，the coefficient of variation and the degree of expert coordination of the all indexes were calculated according to the results of the consultation.Results　Twenty consultation forms were issued in each round，and 20 copies were recovered，with a recovery rate of 100%.The extent of familiarity for the first round was 0.73 and the second round was 0.74，and the basis for judgment were both 0.89.The degree of expert authority were 0.81 and 0.82，respectively.In the first round，average points of the significance were 3.80 to 4.80，the coefficient of variation 0.09 to 0.37 and the degree of expert coordination 0.341 （χ2=132.778，P<0.05）；in the second round，average points of the significance were 4.05 to 4.80，the coefficient of variation 0.09 to 0.23 and the degree of expert coordination 0.410 （χ2=132.329，P<0.05）．According to expert consultation，six indexes were deleted and two indexes were added in the first round of consultation，and no index was revised in the second round.Finally，the comprehensive health assessment covered 5 items and 12 indexes.Conclusion　The result of the comprehensive health assessment for community in-home elderly in Beijing based on modified Delphi method is satisfied，which could provide reference for in-home elderly assessment.

Key words: Community health services, Geriatric assessment, Delphi technique

摘要： 背景　北京在“十二五”期间提出了社区居家养老新模式，所以在我国老年人口激增、医疗负担加重、养老机构严重不足的大环境下，在医学模式从生物医学向生物-心理-社会医学模式转型的大背景下，急需建立适合中国国情和文化背景的社区居家老年综合健康评估体系与量化技术。目的　基于改良德尔菲法构建北京社区居家老年综合健康评估指标体系，为新型服务模式社区居家养老的探索提供借鉴和参考。方法　选取临床医学、精神心理学、营养学、护理学、卫生教育与管理学、统计学等专业的20位专家，采用改良德尔菲法，以老年综合评估为基础，形成北京社区居家老年综合健康评估指标体系（第1版）。于2017年12月—2018年3月通过电子邮件或当面呈递的方式向专家发放两轮咨询表，专家对社区居家老年综合健康初步评估体系指标的重要性、对指标的熟悉程度和判断依据进行评分。函询结束后，整理专家咨询结果，计算专家积极程度、权威程度，各指标的重要性评分、变异系数以及对所有指标的协调程度。结果　两轮各发放咨询表20份，回收20份，回收率均为100.0%。两轮专家咨询的熟悉程度分别为0.73、0.74，判断依据均为0.89，权威程度分别为0.81、0.82。第一轮各指标重要性均数为3.80~4.80，变异系数为0.09~0.37，协调系数为0.341（χ2=132.778，P<0.05）；第二轮各指标重要性均数为4.05~4.80，变异系数为0.09~0.23，协调系数为0.410（χ2=132.329，P<0.05）。根据指标删除标准及专家建议，第一轮专家咨询后，删除6个指标，增加2个指标；第二轮专家咨询后，无删除、修改、增加指标，最终形成5个一级指标和12个二级指标的北京社区居家老年综合健康评估指标体系。结论　通过改良德尔菲法构建的北京社区居家老年综合健康评估指标体系较为理想，可为居家老年评估提供参考。

关键词: 社区卫生服务, 老年人身心健康评价, 德尔菲技术