关于建立北京市农村社区卫生服务效果、效益评价指标体系的研究

目的建立一套适宜北京市的农村社区卫生服务效果、效益评价指标体系。方法改进的特尔菲(Delphi)法。结果经两轮专家函询共确定评价指标109项,其中一级指标5项,二级指标34项,三级指标99项。两轮专家权威程度较高,分别为0.7509和0.7319。协调系数分别为0．176和0.195。结合专家权威系数,从重要性和可操作性两方面综合专家评分结果,确定指标最终组合权重,其中投入、服务内容、服务满意度、服务费用和效果效益五项一级指标的权重分别是0．2118、0.1813、0．2145、0.1889和0.2035。结论本指标体系的建立考虑了北京市农村社区卫生服务发展水平,是全方位的评价指标体系,适用于农村地区社区卫生服务中心或社区卫生服务站的评价。

Study to Create a Set of Evaluating Index System on the Effect and Benefit of Rural Community Health Services in Beijing

OBJECTIVE To create a set of reasonable evaluating index system on the effect and benefit of rural community health services in Beijing.METHOD improved Delphi method.RESULTS After twice specialist consultation,there were 109 indexes remained in the fi-nal evaluation indicator system on the effect and benefit of rural ocmmunity health services,among them 5 first grade indexes,34 sec-ond grade indexes,and 99 third grade indexes.The degrees of the specialist authority were higher in the twice consultation,and the av-erage values were 0.750 9,0.731 9.The coordination coefficients of the specialist opinions were 0.176 in the first consultation and 0.195 in the second.Combining with the specialist authority degrees,we ascertained the final ocmpound weight of each index by inte-grating specialist graded results,on essentiality and maneuverability.The weights of the first grade indexes,namely input,service con-tent,and the satisfaction degree of service ,service expenses and effect efficiency were 0.211 8,0.181 3,0.214 5,0.188 9,and 0.203 5 respectively.CONCLUSIONS The evaluating index system was omni directional.It embodies the feature of "six in one"service system of CHS.It was according to the development level of commnuity health service of the rural areas in Beijing to make the indicator system.This system was used for evaluating the rural community health service stations or centers.