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中国基层医疗中全科医生诊所的绩效测量系统的发展。

Development of a performance measurement system for general practitioners' office in China's primary healthcare.

机构信息

General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.

Business School, Sichuan University, Chengdu, 610065, China.

出版信息

BMC Health Serv Res. 2022 Sep 21;22(1):1181. doi: 10.1186/s12913-022-08569-z.

Abstract

BACKGROUND

General practitioners are the main providers of primary care services. To better strengthen the important role of general practitioners in primary healthcare services, China is promoting the general practitioners' office system. There is a lack of well-accepted methods to measure the performance of general practitioner offices in China. We thus aim to develop a systematic and operable performance measurement system for evaluating the general practitioner's office.

METHODS

We establish an index pool of the performance measurement system of general practitioners' offices by a cross-sectional study and the literature research method and adopt the focus group method to establish the preliminary system. The Delphi method is then used to conduct three rounds of consultation to modify indices, which aims to form the final indicator system. We determine the weight of each index by the analytic hierarchy process method, which together with the final indicator system constitutes the final performance measurement system. Finally, we select three offices from three different cities in Sichuan Province, China, as case offices to conduct the case study, aiming to assess its credibility.

RESULTS

Our results show that the first office scored 958.5 points, the second scored 768.1 points, and the third scored 947.7 points, which corresponds to the reality of these three offices, meaning that the performance measurement system is effective and manoeuvrable.

CONCLUSIONS

Our study provides support for standardizing the functions of China's general practitioner's office, improving the health service quality of generalists, and providing a theoretical basis for the standardization of the general practitioner's office.

摘要

背景

全科医生是基层医疗服务的主要提供者。为了更好地加强全科医生在基层医疗服务中的重要作用,中国正在推行全科医生诊所制度。目前,中国还缺乏被广泛认可的全科医生诊所绩效评估方法。因此,我们旨在为评估全科医生诊所开发一个系统且可行的绩效评估体系。

方法

我们通过横断面研究和文献研究方法建立了全科医生诊所绩效评估指标体系,并采用焦点小组法建立了初步体系。然后采用德尔菲法进行三轮咨询,对指标进行修改,最终形成指标体系。我们采用层次分析法确定各指标的权重,与最终指标体系共同构成最终的绩效评估体系。最后,我们选择四川省三个不同城市的三个诊所作为案例进行案例研究,旨在评估其可信度。

结果

我们的结果表明,第一家诊所得分为 958.5 分,第二家得分为 768.1 分,第三家得分为 947.7 分,与这三家诊所的实际情况相对应,这意味着绩效评估体系是有效且可行的。

结论

本研究为规范中国全科医生诊所的职能、提高全科医生的卫生服务质量提供了支持,为全科医生诊所的规范化提供了理论依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f096/9491001/e635dcd41375/12913_2022_8569_Fig1_HTML.jpg

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