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开发中国精神科医院基于病历的医疗质量指标:改良德尔菲-层次分析法研究。

Developing medical record-based, healthcare quality indicators for psychiatric hospitals in China: a modified Delphi-Analytic Hierarchy Process study.

机构信息

School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Institute for Hospital Management of Tsinghua University, Beijing, China.

出版信息

Int J Qual Health Care. 2019 Dec 31;31(10):733-740. doi: 10.1093/intqhc/mzz005.

Abstract

OBJECTIVES

To develop a medical record-based, comprehensive system of healthcare quality indicators for psychiatric hospitals in China.

DESIGN

A modified Delphi process with analytic hierarchy process (AHP) was used.

PARTICIPANTS

Twenty nationally-recognized experts were invited to participate in two rounds of Delphi expert consultation and AHP.

METHODS

Fifty potential indicators were included based on literature review, and 20 experts were asked to rate the importance of each indicator using two rounds of email surveys. The AHP was used to determine the relative importance of the finalized quality indicators.

RESULTS

The average authoritative coefficient was 0.92 ± 0.07. After two rounds of Delphi consultation, 47 healthcare quality indicators were identified for Chinese psychiatric hospitals. The mean importance ratings ranged from 7.06 to 8.84 on a nine-point scale, with variation coefficients ranging from 0.04 to 0.22. The percentage of full score for potential indicators ranged from 16% to 74%. In two rounds, the Kendall's W coefficients ranged from 0.423 to 0.535. The weights of structure, process and outcome were 0.175, 0.211 and 0.614, respectively.

CONCLUSION

We developed the first set of healthcare quality indicators for psychiatric hospitals in mainland China, and it will provide a standardized and meaningful guide to evaluate the healthcare quality of psychiatric hospitals across the country.

摘要

目的

开发一套基于病历的、全面的中国精神病医院医疗质量指标体系。

设计

采用改良 Delphi 法结合层次分析法(AHP)。

参与者

邀请了 20 名全国知名专家参加了两轮 Delphi 专家咨询和 AHP。

方法

基于文献回顾纳入了 50 个潜在指标,通过两轮电子邮件调查请 20 名专家对每个指标的重要性进行评分。采用 AHP 确定最终质量指标的相对重要性。

结果

平均权威系数为 0.92±0.07。经过两轮 Delphi 咨询,确定了 47 个中国精神病医院的医疗质量指标。均值重要性评分范围为 9 分制的 7.06-8.84,变异系数范围为 0.04-0.22。潜在指标的满分率为 16%-74%。两轮的 Kendall's W 系数范围为 0.423-0.535。结构、过程和结果的权重分别为 0.175、0.211 和 0.614。

结论

我们开发了中国大陆精神病医院的第一套医疗质量指标,将为评估全国精神病医院的医疗质量提供标准化且有意义的指导。

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