量化分级管理在住宿业卫生行政许可中的应用研究

目的探索量化分级管理在住宿业卫生行政许可中的应用。方法应用Delphi法,进行指标的筛选,权重赋值,确定关键项和非关键项以及各指标评分细则。结果住宿业卫生行政许可指标共57项,其中一级指标5项,二级指标16项,三级指标21项,关键项共15项,非关键项13项;并确定了各指标的权重和评分细则。结论住宿业行政许可量化是可行的,可推广到各类公共场所卫生行政许可量化。     

新型农村合作医疗常规性指标的分析与评价

新型农村合作医疗试点以来，各地实施部门和研究部门从不同方向进行了评价。笔者选择山东省运行满一年的20个试点县，在初选34项指标的基础上，从指标的可操作性、敏感性、独立性、相关性和代表性等方面考虑，采用专家咨询法、离散趋势法和指标聚类分析法联合筛选出13项指标，现予以分析和评价。     

特色医疗技术综合评价指标体系构建

本文作者运用系统论和专家咨询法，对特色医疗技术综合评价体系的构建进行研究，采用Delphi法进行了两轮专家咨询，运用SPSS13．0统计软件进行数据分析，确定了该指标体系包括4个一级指标、10个二级指标、18个三级指标，及各级指标的权重。选取了2家三级甲等医院的13项医疗技术对该评价体系进行实例验证，经过数据统计分析和信度评价，证明了本研究构建的评价体系具有较强的科学性和实用性。     

宿迁市三级医院综合效益评价研究

目的：本研究旨在构建三级医院综合效益评价指标体系并进行实证研究，评价宿迁市三级医院综合效益。方法：首先用平衡计分卡理论和德尔菲法完成指标的纳入和筛选，其次用德尔菲法和层次分析法计算指标的权重，最后用加权秩和比法和模糊评价法对宿迁市6家三级医院综合效益进行评价。结果：本研究构建了用于评价三级医院综合效益的指标体系，包含5项一级指标、13项二级指标和46项三级指标。实证研究中两方法对宿迁市6家三级医院综合效益评价排序结果呈显著相关。结论：本研究构建的三级医院综合效益评价指标体系具有较好的科学性和可行性，实证研究进一步验证了指标体系的可靠性，该指标体系对公立和民营三级综合医院均适用。     

环境镉污染健康风险评价指标体系的构建

目的 建立环境镉污染健康风险评价指标体系,为风险评估奠定基础,为风险管理提供理论依据.方法 采用德尔菲法和专家会议法相结合确定指标体系.结果 构建了包括3项一级指标、6项二级指标和20项三级指标的指标体系,并确定其权重值.结论 环境镉污染健康风险评价指标体系构建科学合理,指标体系的完善有待于进一步实证研究.     

构建城市公立医院公益指数研究——以温州市为例

公益性是城市公立医院的基本定位,但如何科学考量其公益性是近年来学术界和医疗卫生部门关注的热点和难点问题。基于文献研究,创新性提出了城市公立医院公益性的"四个特性"说;以BSC作为理论分析框架,搭建了一个包含4个一级指标、13个二级指标、50个三级指标的初始指标集;以温州市为例,运用Delphi method确定了由20项指标组成的指标体系;采用AHP群决策法为指标赋权;结合温州城市公立医院实际,测算出指标的基准目标值。     

江苏省卫生资源区域配置现状及公平性研究

目的 探索江苏省医疗卫生资源配置区域分布特征及公平性情况,以优化卫生资源配置.方法 选取医疗服务设施、卫生人力资源两方面的5项指标,采用熵权TOPSIS法和泰尔指数对江苏省卫生资源配置水平及公平性进行分析.结果 基于熵权TOPSIS法,江苏省13个城市中,南京卫生资源配置综合评价值Ci最高,为0.654,镇江最低,为0...     

基于平衡计分卡的公立医院绩效评价指标体系

目的构建一个科学、实用的公立综合医院平衡计分卡绩效评价指标体系,以便对医院的绩效做出综合、客观、公正的评价。方法以平衡计分卡的基本理论为指导,采用专家咨询法(Delphi法)和层次分析法,建立指标体系并确定各级指标权重,并采用加权综合指数法对3所医院的情况进行综合评价。结果构建了一套科学、实用的公立综合医院平衡计分卡绩效评价指标体系,该体系包括患者维度、流程维度、创新和学习维度、财务维度4个一级指标,13个二级指标,48个三级指标。结论平衡计分卡从多个维度评价医院的发展情况,有利于医院发现自己的不足之处,并在今后的管理中总结经验弥补不足。     

上海市长宁区社区健康教育绩效评价指标体系的初步构建

目的探索一套能较好反映社区健康教育工作的评价指标体系。方法选取35名涉及公共卫生、健康教育、全科医疗及卫生管理领域的专家,实施两轮德尔菲法咨询,确定健康教育评价指标体系。结果两次咨询问卷有效回收率均为100%;专家的权威程度系数为0.95;最终专家协调系数为0.40(P0.05)。3项一级指标、6项二级指标、13项三级指标纳入长宁区社区健康教育绩效评价指标体系,并确定了各指标权重。结论专家的积极程度和权威程度均较高,两轮咨询后专家意见趋于一致,协调性较好,结果可靠,但构建的指标体系还需在今后的应用中验证其合理性与有效性。     

我国健康人社会功能衰老测量量表构建研究

目的 探讨并构建我国健康人社会功能性衰老评估指标体系,制作人体社会功能性衰老量表。方法 采用文献搜集、改良Delphi法和层次分析法（analytic hierarchy process,AHP）筛选并确立社会功能性衰老评估指标体系及权重系数;通过信度、相关性和探索性因子分析等评价量表的信度、效度并提取指标。结果 确定社会维度衰老指标体系,其中二级指标3项（即个人能力、社会参与、组织交往）,三级指标13项（生活自理能力、人际关系等）;量表信度克朗巴哈α系数为0.873,重测信度系数r为0.848（P<0.001）,内容效度指数（content validity index,CVI）为0.836;结构效度经因子分析共提取3个公因子,能解释总变异量的53.69%,各原始指标公共度介于0.573~0.776之间。结论 建立的社会功能性衰老指标体系,指标代表性好、认可度较高;量表的内容和结构效度较理想,指标分值及离散度与总分的相关系数大部分达到统计学标准,具有较好的应用价值和实用价值。     

基于SHA2011的全民医保政策评价指标体系构建

以全民医疗保障系统为例,提供SHA2011卫生政策评价指标体系构建思路。首先,总结全民医疗保障体系的筹资相关政策,接着将政策目标与SHA2011指标进行一一对应,最终构建出基于SHA2011的政策分析指标体系。该指标体系将政策与具体的SHA2011指标对接,可有效评价政策施行效果,也有助于解读SHA2011指标的政策应用意义。     

What are we measuring? Comparison of household food security indicators in the Eastern Cape Province,South Africa

The development of national food security information systems is constrained by a lack of guidance on which indicators to use. This paper compares food security indicators across two seasons (summer and winter) in one of the most deprived areas of the Eastern Cape province of South Africa. The results show that only anthropometric indicators are sensitive enough to differentiate levels of food insecurity. The lack of consistent classification across indicators means that surveys must use a combination of food consumption and experience of hunger measures backed up by anthropometric measures. Targeting interventions is difficult if the measures cannot be relied on. Further investigation is needed to identify a suite of appropriate indicators for a national information and surveillance system.     

医院个人绩效管理系统研发难点与对策探讨

本文首先分析了医院个人绩效管理系统的定义及作用,在此基础上分析了个人绩效管理系统在研发中的难点问题,即体系结构的确定、指标体系的建立、绩效展示三个方面。最后,针对三个难题提出了三点对策,即加强风险-回报和投入产出分析,采用最优集成算法建立指标体系,个人绩效管理多维度和分层展示。     

二尖瓣狭窄治疗质量评价指标体系的建立

目的建立评价二尖瓣狭窄治疗质量的指标体系。方法参考Dnobedian关于建立治疗质量评价模型的思想,应用德尔菲（Delphi）法进行问卷咨询,利用统计软件分析结果。结果初步建立了共19个指标的评价体系,其中治疗过程指标13个,治疗结局指标4个,医院结构指标2个。结论该指标体系能够通过治疗过程,治疗结局和医院结构对二尖瓣狭窄的治疗质量进行全面客观的评价,从而改变以往只是利用结局进行治疗质量评价的方法。     

基于BSC的医院绩效考核指标体系构建

采用BSC的理念和方法,围绕财务指标、患者指标、内部业务和业务创新指标来思考并设计医院绩效考核指标体系。在医院实践过程中,从医院、科室、员工三个层面构建三级指标体系,以使医院的发展战略与短期目标、整体发展与员工发展、业务拓展与科研进步相结合,从而实现医院全面持续协调的发展,并就构建绩效考核体系过程中可能出现的问题提出了建议。     

The equity lens in the health care performance evaluation system

The main objective of this paper is to describe how indicators of the equity of access to health care according to socioeconomic conditions may be included in a performance evaluation system (PES) in the regional context level and in the planning and strategic control system of healthcare organisations. In particular, the paper investigates how the PES adopted, in the experience of the Tuscany region in Italy, indicators of vertical equity over time. Studies that testify inequality of access to health services often remain just a research output and are not used as targets and measurements in planning and control systems. After a brief introduction to the concept of horizontal and vertical equity in health care systems and equity measures in PES, the paper describes the ‘equity process’ by which selected health indicators declined by socioeconomic conditions were shared and used in the evaluation of health care institutions and in the CEOs' rewarding system, and subsequently analyses the initial results. Results on the maternal and child path and the chronicity care path not only show improvements in addressing health care inequalities, but also verify whether the health system responds appropriately to different population groups. Copyright © 2013 John Wiley & Sons, Ltd.     

基于EMRS的医疗风险预警模型的建立

文章通过对"以电子病历为核心"的医院信息系统相关数据的实时监控,运用建立的医疗预警模型,实现医疗风险的提前预判.首先,通过文献检索收集引起医疗风险的相关因素,然后运用德尔菲法筛选相关风险指标,运用层次分析法量化指标,确定风险指标权重,并将三级指标评估值录入到风险预警模型中进行评估.然后,经过多轮分析分别从患方基本情况、...     

政府购买绩效合同管理基本农村公共卫生服务评价指标体系的研究

目的:建立政府购买绩效合同管理基本农村公共卫生服务的评价指标体系.方法:采用德尔菲专家咨询法建立评价指标体系,并采取模糊综合评判法确定评价指标权重.结果:2轮专家咨询回收率均在85.0％以上,专家的权威程度的平均值均在0.8以上,协调系数差异有统计学意义(P＜0.01).一级指标权重系数分别为0.504 2和0.495 8.结论:评价指标体系具有较为合理的结构,评价内容方面较为完整和全面.评价指标体系的效度及信度较高,具有较好的稳定性和可操作性.     

Measuring quality: from the system to the provider.

The literature on quality has often focused on process indicators. In this paper we outline a framework for describing and measuring the quality of health systems in terms of a set of desirable outcomes. We illustrate how it can be measured using data collected from a recent evaluation of health system performance conducted by the World Health Organization (WHO). We then explore the extent to which this framework can be used to measure quality for all components of the system; for example, regions, districts, hospitals, and providers. There are advantages and disadvantages to defining quality in terms of outcomes rather than process indicators. The advantage is that it focuses the attention of policy makers on whether systems are achieving the desired goals. In fact, without the ability to measure outcomes it is not possible to be sure that process changes actually improve attainment of socially desired goals. The disadvantage is that measuring outcomes at all levels of the system poses some problems particularly related to the sample sizes necessary to measure outcomes. WHO is exploring this, initially in relation to hospitals. The paper discusses two major challenges. The first is the question of attribution, deciding what part of the outcome is due to the component of the system under discussion. The second is the question of timing, including all the effects of current health actions now and in the future.     

Robust data to close the gap: current vascular and maternal/newborn indicators as measures of progress in Aboriginal health in New South Wales

Objective: Focussing on maternal/newborn health and vascular diseases, to review NSW Health's reporting, by Aboriginal status, against national performance indicators relevant to preventable chronic diseases. Methods: We reviewed seven indicator documents and the Australian Institute of Health and Welfare Chronic Disease Indicator Database to identify national indicators. Indicators from six NSW Health reports were then compared with these national indicators to assess reporting by Aboriginal status and region. Results: NSW Health routinely reports against six maternal/newborn indicators and fourteen vascular national indicators. Five of the former report performance by both Aboriginal status and region. Eight of the latter report by Aboriginal status, one of which (diabetes hospitalisations) also reports by region. Indicator quality and breadth was substantially limited by under‐enumeration of Aboriginal status, small or potentially unrepresentative samples, inadequate longitudinal or regional data and few primary health care indicators. Notwithstanding these limitations, we found wide and persistent disparities in outcomes for Aboriginal people for all indicators in all regions. Conclusions: NSW Health reports adequately, by Aboriginal status, for maternal/newborn health monitoring (albeit constrained by under‐enumeration), but provides limited information about vascular health. A minimum, national chronic disease indicator dataset against which all jurisdictions would report performance by Aboriginal status and region is needed. Improved monitoring requires sustained efforts to address under‐enumeration, better survey sampling, and population representative data from the primary care system.