In the context of an aging society, the incidence of chronic degenerative bone and joint diseases has been increasing year by year, and the serious lack of capacity of primary bone health services has become a key constraint to the efficiency of disease prevention and treatment, and there is an urgent need to identify its weak points for accurate optimization and effective enhancement.

This study aims to construct an evaluation index system of bone health service capacity of primary healthcare institutions to cope with the increasing burden of chronic musculoskeletal diseases and the insufficient capacity of primary bone health services in an aging society.

From September 2024 to January 2025, Chinese journal databases such as CNKI, Wanfang Data Knowledge Service Platform, Wipu Chinese Science and Technology Journal Database, China Biomedical Literature Database, and English databases such as Web of Science, PubMed, Embase, etc. were used to search for information on the evaluation of the capacity of the primary osteopathic health care service related literature on the indicator system. We checked and sorted out the relevant policies and regulations and guidance outlines on the official websites of the Chinese Government Website, the National Health and Health Commission, and the State Administration of Traditional Chinese Medicine, etc., so as to get a preliminary understanding of the current research status of the evaluation of the capacity of bone health services, and to summarise and analyse the latitudinal framework that affects the evaluation results. Literature research method was used to sort out related literature and policies, semi-structured interviews and brainstorming method were used to construct a preliminary pool of index system entries. Delphi method was used to carry out two rounds of expert consultation to screen and optimize the indexes, and Hierarchical Analysis Method was used to determine the weights of the indexes.

The study invited 24 experts from 21 regions and different professional fields in China. The positive coefficient of the experts reached 100.0%, and the authority degree was 0.906. The coordination coefficient of the experts' opinions in the two rounds suggested that the results of the study were credible. The finally constructed indicator system contains 3 first-level indicators, 15 second-level indicators and 40 third-level indicators. The first-level indicators are resource allocation, basic medical and public health services, and management and security, with weights of 0.198, 0.490, and 0.312, respectively, and the latitude of "basic medical and public health services" has the highest weight (0.490), which suggests that the enhancement of medical and public health services should be taken as the key task of capacity building of grassroots bone health services. The highest weight (0.490) was given to "basic medical and public health services", suggesting that the improvement of medical and public health service capacity should be regarded as the key task of primary bone health capacity building. In addition, the weights of indicators in the dimensions of talent cultivation, service efficiency, and medical collaboration are also relatively high, which is significant to the improvement of service capacity.

The evaluation index system of bone health service capacity of primary healthcare organizations formed in this study has high authority and scientificity, which provides reference and basis for further assessing the current status of bone health medical service capacity of primary healthcare organizations in China, and helps to promote the enhancement of bone health service capacity of primary healthcare organizations, and provides a scientific basis for the development of medical decision-making.

老龄化社会背景下，慢性退行性骨与关节疾病的发病率逐年攀升，基层骨健康服务能力严重不足已成为制约疾病防治效率的关键问题，亟需找出其薄弱点以便于精准优化与有效提升。

本研究旨在构建基层医疗卫生机构骨健康服务能力评价指标体系，以应对老龄化社会中慢性肌肉骨骼疾病负担加重及基层骨健康服务能力不足的问题。

2024年9月—2025年1月，利用中国知网、万方数据知识服务平台、维普中文科技期刊数据库、中国生物医学文献数据库等中文期刊数据库以及Web of Science、PubMed、Embase等英文数据库，检索有关基层骨健康医疗服务能力评价指标体系的相关文献。查阅、梳理中国政府网、国家卫生健康委员会、国家中医药管理局等官方网站相关政策法规和指导纲要，初步了解骨健康服务能力评估的研究现状，归纳分析影响评价结果的维度框架。运用文献研究法梳理相关文献与政策，经半结构化访谈和头脑风暴法初步构建指标体系条目池；采用德尔菲法开展两轮专家咨询筛选优化指标，运用层次分析法确定指标权重。

研究邀请了来自全国21个地区、不同专业领域的24位专家，专家积极系数达100.0%，权威程度为0.906，两轮专家意见协调系数提示研究结果可信。最终构建的指标体系含3个一级指标、15个二级指标和40个三级指标。一级指标分别为资源配置、基本医疗和公共卫生服务、管理与保障，权重分别为0.198、0.490、0.312。"基本医疗和公共卫生服务"维度的权重值最高（0.490），提示应将医疗和公共卫生服务能力提升作为基层骨健康服务能力建设的关键任务。此外，人才培养、服务效率、医疗协作等维度的指标权重也相对较高，对提升服务能力意义重大。

本研究形成的基层医疗卫生机构骨健康服务能力评价指标体系具有较高的权威性和科学性，为进一步评估我国基层骨健康医疗服务能力现状及卫生决策提供了参考和依据。