| 引用本文：方纪元, 张浩成, 陈文琴, 沈阳, 王杉杉, 居晨浩, 郭清.医养结合型养老机构卫生服务质量指标体系构建研究[J].中国卫生政策研究,2020,13(4):24-30 |
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| 医养结合型养老机构卫生服务质量指标体系构建研究 |
| 投稿时间：2020-02-13 修订日期：2020-04-01 PDF全文浏览 HTML全文浏览 |
| 方纪元1, 张浩成1, 陈文琴1, 沈阳1, 王杉杉1, 居晨浩2, 郭清3 |
1. 杭州师范大学医学院 浙江杭州 311121;
2. 浙江中医药大学基础医学院 浙江杭州 310000;
3. 浙江中医药大学 浙江杭州 310000 |
| 摘要:目的：构建基于SERVQUAL模型的医养结合型养老机构卫生服务质量评价指标体系。方法：围绕医养结合型养老机构卫生服务的概念、特性、内涵、内容等，采用文献研究法、半结构式访谈法、Delphi-AHP法等定性与定量相结合的研究方法，构建指标体系并确定指标权重。结果：构建了具有7个一级指标，27个二级指标和77个三级指标的养老机构卫生服务质量评价指标体系。指标体系三轮咨询专家权威系数Cr均高于0.84，专家综合权威性系数均高于0.83；总体专家协调系数Kendall W第一、二轮为0.309，第三轮为0.706，且均通过显著性检验；内容效度指数I-CVI介于0.90~1.00之间，S-CVI为0.94，kappa值均高于0.74；信度系数Cronbach α总体为0.972，各维度Cronbach α系数在0.792~0.921之间。评价指标体系具有较好的稳定性、可靠性和一致性。结论：本研究建立的评价指标体系有利于医养结合型养老机构全面建立贴近老年人卫生服务需求的内设医疗机构，改善机构内卫生服务质量。在对指标体系进行应用时，可转化为机构中老年人对各指标项目的感受（P）与期望（E），以两者的差值（P-E）代表机构的卫生服务质量。根据专家赋权结果，应重点加强医养结合养老机构对可靠性、有效性、经济性等指标项目的建设。 |
| 关键词:医养结合 养老机构 卫生服务质量 评价指标体系 |
| 基金项目:国家自然科学基金（71774147） |
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| Study on the establishment of health service quality evaluation index system of the pension institutions combined with medical service |
| FANG Ji-yuan1, ZHANG Hao-cheng1, CHEN Wen-qin1, SHEN Yang1, WANG Shan-shan1, JU Chen-hao2, GUO Qing3 |
1. School of Medicine, Hangzhou Normal University, Hangzhou Zhejiang 311121, China;
2. School of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou Zhejiang 310000, China;
3. Zhejiang Chinese Medical University, Hangzhou Zhejiang 310000, China |
| Abstract:Objective:To establish an evaluation index system for the quality of health services in the pension institutionscombined with medical service based on the SERVQUAL model. Methods:Based on the concept, characteristics, connotation and content of healthcare services in the pensioninstitutions combined with medical services, the evaluation system indicesand the weight of each index were determined by means of literature analysis, semi-structured interview, Delphi-AHP methods and other qualitative and quantitative research methods.Results:The evaluation index system comprised 7 primary indicators, 27 secondary indicators, and 77 tertiary indicators. In the index system,the authority coefficient (Cr)was higher than 0.84 and the comprehensive authority of experts was higher than 0.83 forthe three rounds of consultation.The overall coordination coefficient, Kendall (W) was 0.309for the first two rounds and 0.706 for the third round, and passed the significance test.The content validity index I-CVI variedbetween 0.90 and 1.00, the S-CVI was 0.94, and the kappa values were all higher than 0.74. The overall Cronbach αcoefficientwas 0.972, and the Cronbach α coefficients of each dimension rangedbetween 0.792-0.921.It was proved that the appraisal index system had good stability, consistency and reliability. Conclusions:The evaluation index system established in this study is conducive to the comprehensive establishment of internal medical institutions that are close to the elderly's healthcare service demands. It can be transformed into the feelings and expectations of the elderly in the institution for each item when applied, and the result of the subtraction represents healthcare service quality. According to the results ofexpert consultation, more attention should be paid to the establishment of an index such as reliability, effectiveness, and economics in pension institutions are combined with medical care. |
| Key words:Pension combined with medical service Pension institution Health service quality Evaluation index system |
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