Zhongguo quanke yixue (Sep 2023)
Development of the Coordinated Regional Health Development Assessment System
Abstract
Background Coordinated regional health development aims to optimize resource allocation by constructing a well-structured and functional regional collaborative system to provide continuous medical services, and to leverage the unique features and strengths of medical centers and community health centers within a region via fully integrating resources and sharing information. However, current available systems for assessing coordinated regional health development mainly focus on outcomes, which are relatively non-diversified and unsystematic, thus further research is required to fill this gap. Objective We aimed to construct an evaluation system for coordinated regional health development, to provide scientific evidence for evaluating the coordinated development capacities of regions. Methods We collected essential factors related to coordinated regional health development through a literature review and semi-structured interviews, and used them to construct a draft version of the Coordinated Regional Health Development Assessment System (CRHDAS) . Then we selected 19 experts who were familiar with coordinated regional health development (engaging in general medicine, medical education, administrative management, and public health management) from Shanghai to attend two rounds of online combined with offline Delphi questionnaire surveys from December 2020 to March 2021 to determine the weights of the indicators and test the logical consistency of the weights of indicators at each level using Analytic Hierarchy Process. After that, we established the final version of CRHDAS. Results The effective response rate and authoritative coefficient were 95.0% and 0.87, respectively, for the first round of survey, and were 100.0% and 0.92, respectively, for the second round of survey. The CRHDAS consists of four first-level indicators (with corresponding weights of 0.387, 0.296, 0.187 and 0.130) , 12 second-level indicators, and 31 third-level indicators. The consistency ratios for the weights of three levels of indicators are <0.100. Conclusion The CRHDAS is of high-level scientificity and practicality, which can help identify problems and deficiencies of the collaboration mode between community health centers, providing a theoretical and practical basis for guiding coordinated regional health practice in the future.
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