城市社区卫生服务医疗保险考核指标体系的构建研究

目的：建立一套科学量化、简单易行,与上海市社区卫生服务综合改革相匹配的的社区卫生服务医疗保险考核指标体系。方法：采用文献查阅法和半结构性专家访谈法设计考核指标体系;采用两轮Delphi专家咨询法对拟定的指标体系进行筛选;SPSS统计学软件进行数据的分析和处理。结果：初步构建了城市社区卫生服务医疗保险业务考核评价指标体系,包括5个一级指标和27个二级指标;并对各个指标的可操作性进行了研究。结论：本研究提出的考核指标体系,能够较全面反映社区卫生服务医疗保险考核的要求和标准,可从多维度对其医疗保险业务质量进行较公正、客观的监督与考核评价。

Establishment of Assessment Index System for Medical Insurance of Community Health Service

Objective： To establish a kind of scientific statistical and simple assessment index system for medical insurance of community health service,which is accompanied with the comprehensive reform of Shanghai community health service.Methods： The methods of literature and half-structure expert interview were adopted.Delphi Method was used to obtain the index system.The data was analyzed with SPSS.Results： The index system for the medical insurance of community health service included 5 first-level indexes and 27 second-level indexes.The operability of the indexes was tested also.Conclusions： The index system can reflect the requirement and standard of medical insurance of community health service.And it can also give a justice and objective monitoring and assessment.