Evaluation index system of medical quality in clinical departments under the high-quality development of public hospitals / 现代医院

Objective To establish an evaluation index system that can be used for medical quality assessment in clini-cal departments.Methods Based on literature analysis and key informant interview,the Delphi method was used to analyze the-importance and operability of the evaluation index system of medical quality in clinical departments.Results A clinical depart-ment medical quality assessment and evaluation system was established,consisting of 3 primary indicators,14 secondary indica-tors,and 24 tertiary indicators.Conclusion By building a medical quality assessment and evaluation index system in clinical departments,a simple,standardized,and highly operational management model is established for medical institutions to carry out medical quality management.It is conducive to directing clinical departments to focus on medical quality management,improving their medical quality awareness and management level,and promoting the high-quality development of public hospitals.

Study on the Establishment of Risk Evaluation Index System in Clinical Surgery Department / 中国医院管理

Objective To establish the risk assessment index system of clinical surgery department and determine the weight of each index,so as to provide reference for hospital performance management department.Methods Delphi method was used to construct the risk assessment index system of clinical surgery department,and the weight of each index was calculated by analytic hierarchy process.Results The risk assessment index system of clinical surgery departments was successfully constructed,including 4 first-level indicators,12 second-level indicators and 33 third-level indicators.Conclusion Clinical surgical department risk evaluation index system can more reasonably and fairly reflect the clinical risk borne by the surgical department,but also can more truly reflect the results of clinical department performance assessment,which is conducive to the reform of the hospital's internal performance appraisal and distribution system is more rational.

Empirical Study on Risk Evaluation Index System of Clinical Surgery Department / 中国医院管理

Objective To evaluate the application effect of the risk evaluation index system in clinical surgery departments.Methods A questionnaire was designed based on the risk evaluation index system of clinical surgery departments,and the risk evaluation were graded with RSR method.Results Among the risk evaluation of clinical surgery departments in the two hospitals,the results of first hospital were low,medium and high risk departments,and the results of second hospital were low and high risk departments,respectively.The differences among them were statistically significant.Conclusion In the process of clinical performance evaluation,it suggests that the hospital management department refer to the risk evaluation index system of clinical surgery departments as a risk assessment tool to promote more scientific and fairer performance distribution,which has certain social promotion value.

Construction and Empirical Study of Hospital Mobile Portal Evaluation Model Based on Cloud Model / 中国医院管理

Objective To explore the construction of comprehensive evaluation model of hospital mobile portal from the perspective of user maintenance.Methods The index system was constructed based on CRM-BSC(customer relationship management-the balanced score card)theory.A comprehensive evaluation model of hospital mobile portal was constructed by introducing cloud model.Finally,three hospital official Apps were selected for empirical research to verify the validity of the model.Results Although the construction status of the hospital's official App is good,it varies greatly in different evaluation dimensions.In the"user value"and"user perceived value"dimension performs well,but in the"user knowledge"and"user interaction"dimension performs poorly,need to be further optimized and improved.Conclusion The comprehensive evaluation model can provide comprehensive evaluation standards and tools for mobile portals,and the research results can provide decision support for medical institutions to improve the services of mobile portals.

Survey on the recognition of the post competency index system among Chinese rural general practice assistant physicians and analysis of influencing foctors / 中华全科医师杂志

Objective:To investigate the recognition of the post competency index system among rural general practice assistant physicians and its influencing factors.Methods:This study was a cross-sectional survey. A questionnaire survey on the recognition of post competency index system was conducted from October 2020 to September 2021 among rural general practice assistant physicians from 10 provinces/municipalities selected by stratified cluster sampling method. The recognition of rural general practice assistant physicians at all levels of indexs and the factors influencing recognition were analyzed.Results:A total of 1 123 questionnaires were distributed and 1 024 valid ones were collected with a recovery rate of 91.18%. Of the 1 024 respondents, 529 were male(51.7%) and 435 were aged 40-49 years(42.5%), which was the highest proportion by age group. The average overall recognition score of the index system was 4.41, and the scores of the primary indexes were 4.32-4.45. Three primary indexes had the highest recognition scores: professional competence, basic health care services, and interpersonal communication and teamwork. The recognition scores on the second level index were 4.18-4.61, and the proportion of recognition scores greater than 4 was over 80%. There were significant differences in the recognition scores of the index system among assistant physicians with different working years, educational background, professional title and work unit ( F/H=6.41, 14.83, 12.45, 7.53, P<0.01). Educational background(associate degree: B=0.091, P=0.015; bachelor degree and above: B=0.196, P<0.001) and professional title(intermediate professional title and above: B=-0.234, P<0.001) were the independent factors influencing the recognition degree of the index system for rural general practice assistant physicians. Conclusions:The post competency index system is generally recognized by rural general practice assistant physician, and academic qualifications and professional title status may influence its recognition.

Construction of residents' healthy lifestyle cognitive index system in the context of carbon peaking and carbon neutrality / 环境与职业医学

Background Healthy lifestyle is one of the important factors affecting individual health. How to promote residents' cognition of healthy lifestyle has become an urgent practical problem for the whole society. However, there is no residents' healthy lifestyle cognitive indexes available with consideration of carbon peaking and carbon neutrality. Objective To construct a cognitive index system for providing effective assessment on residents' cognition of healthy lifestyle under the background of carbon peaking and carbon neutrality. Methods Based on the health belief model, a preliminary cognitive index system of residents' healthy lifestyle under the background of carbon peaking and carbon neutrality was proposed after literature study and relevant policy review. Then three rounds of indicator importance evaluation and screening by Delphi method were conducted before the index system was finally constructed. The weights of all levels of indicators were determined using analytic hierarchy process. In addition, a self-assessment questionnaire was developed based on the index system. The questionnaire was utilized to conduct a survey among 200 residents by convenience sampling in Shenyang, Liaoning Province from November to December 2021. The survey was used to examine the reliability and validity of the indicator system. Results The effective recovery rates of the three rounds of Delphi method were all 100%. The authority coefficient was 0.84. The Kendall's W consistency test showed good expert consistency (P<0.001). Finally, a cognitive index system of residents' healthy lifestyle under the background of carbon peaking and carbon neutrality was initially constructed, including 4 first-level indicators, 8 second-level indicators, and 35 third-level indicators. Among them, the weights of the first-level indicators were 0.4541 for practice cognition, 0.2248 for benefit and obstacle cognition, 0.1626 for action clue cognition, and 0.1585 for risk cognition, respectively. The correlation coefficients between each indicator were from 0.586 to 0.977 (P<0.01). The overall Cronbach's α coefficient was 0.95, indicating high reliability. Invited experts agreed that the entries were representative and the content validity of the constructed indicator system was good. The factor analysis also showed that the structure validity was good. Conclusion The proposed index system for residents' cognition of healthy lifestyle show good reliability and validity, which can be used as an effective assessment tool for residents' healthy lifestyle cognition under the background of carbon peaking and carbon neutrality. It can provide a scientific and theoretical basis for promoting residents' cognition and practice of healthy lifestyle.

Construction and Interpretation of Clinical Comprehensive Evaluation Index System for Chinese Patent Medicine Based on EVIDEM Framework / 中国实验方剂学杂志

ObjectiveTo establish the clinical comprehensive evaluation index system for Chinese patent medicine（CPM） based on Evidence and Value：Impact on DEcisionMaking（EVIDEM） framework， so as to promote the scientific， systematic and standardized implementation of clinical comprehensive evaluation of CPM. MethodThe clinical comprehensive evaluation index system was determined through literature review， semi-structured interview and Delphi method， and the weights of each index were clarified by analytic hierarchy process（AHP）. ResultThe recovery rates of both rounds of expert consultation were 100%， and the authority coefficient of experts was 0.90 and 0.905， respectively. Kendall's coordination coefficients（W） of the second- and third-level indicators in the first-round consultation were 0.320 and 0.283（P<0.001）， and in the second round were 0.411 and 0.351， respectively（P<0.001）. The finally constructed clinical comprehensive evaluation index system for CPM included 6 first-level indicators， 13 second-level indicators and 28 third-level indicators. Among the first-level indicators， the weights of effectiveness， safety， economy， innovation， suitability and accessibility were 37.34%， 32.68%， 11.85%， 5.87%， 5.79% and 6.47%， respectively. ConclusionThis study has constructed a universal clinical comprehensive evaluation index system for CPM， and the domain and criteria are introduced and interpreted in detail， which can provide reference and information for carrying out the clinical comprehensive evaluation of CPM， but it needs to be refined and improved in combination with the clinical practice of CPM for specialized diseases.

Construction and Application of Operation Quality and Effectiveness Evaluation Index System of Compact City Medi-cal Group / 中国卫生经济

Objective:To construct an evaluation index system of operation quality and effectiveness of compact urban medical groups and provide references for evaluation of compact urban medical groups.Methods:The evaluation index system was constructed by Delphi method,and the weight was determined by analytic hierarchy process.Results:The evaluation index system consisted of 5 primary indexes,12 secondary indexes and 40 tertiary indexes.Providing assessment methods for the construction of medical groups,the evaluation index system is scientific and authoritative.Conclusion:At the initial stage,policy support should be strengthened,innovative governance mechanisms should be explored,and measures such as implementing a community of responsibilities,strengthening information interconnection,and improving profit distribution mechanisms should be taken to gradually promote the construction of close urban medical groups.

Construction of evaluation index system of entrustable professional activities in psychiatric residents / 中国心理卫生杂志

Objective:To construct an evaluation the index system of entrustable professional activities for resident training doctors in psychiatric department,and to provide reference for formulating training strategies and assessment standards.Entrustable professional activities refers to the ability of trainees to perform and complete spe-cific clinical tasks independently after they have been trusted.Methods:Through documental analysis and semi-structured interviews,the item database of entrustable professional activities for psychiatric resident training physi-cians was established.Delphi consultation was conducted among 63 experts in the field of psychiatry from 7 national resident training bases and 3 medical colleges in China.Indicators were comprehensively screened and sorted out,and indicators at all levels and their weights were determined by the analytic hierarchy process.Results:A hierarchi-cal evaluation index system of entrustable professional activities for psychiatric resident training doctors was con-structed,including 4 first-level indicators,17 second-level indicators and 68 third-level indicators.The weights of the first-level,second-level and third-level indicators were determined.Conclusion:The evaluation index system of en-trustable professional activities is comprehensive and systematic,which is suitable for clinical work and convenient for practical application.It could provide quantitative standards for the assessment of psychiatric residents and pro-mote the improvement of training quality.

Construction and verification of a quantitative index system to evaluate the medical and nursing care for the elderly service needs / 中南大学学报(医学版)

OBJECTIVES@#To construct a quantitative index system with the integrated medical and nursing care assessment for the elderly service needs, this system can assess the cost of medical and care services accurately and objectively, so as to provide scientific basis for the allocation of old-age service resources in China.@*METHODS@#Based on the survival needs of the Existence, Relation and Growth theory, an index system is constructed through literature analysis, group discussion, and expert correspondence. Analytic hierarchy process was used to determine the weights of indicators at all levels. The 3-grades service items corresponding to each index were quantified through the measurement of working hours, and the medical and nursing care needs of 624 disabled/demented elderly people over 60 years old in Changsha were investigated to evaluate their reliability and validity.@*RESULTS@#The authoritative coefficients of the 2 rounds of expert correspondence were 88.5% and 88.6%, respectively, and the opinion coordination coefficients were 0.159 and 0.167, respectively. The final quantitative evaluation index system included 4 first-level indicators, 17 second-level indicators, and 105 third-level indicators. The service time of doctor ranged from 6.01 to 22.64 min, the service time of nurses ranged from 0.77 to 24.79 min, and the service time of caregiver ranged from 0.12 to 51.88 min. The Cronbach's αcoefficient was 0.73, the split-half reliability was 0.74, the content validity was 0.93, and the calibration validity was 0.781.@*CONCLUSIONS@#The quantitative evaluation index system of medical and nursing service need for the elderly can be used to accurately evaluate the medical and nursing service need.

Study on the clinical comprehensive evaluation of blood lipid-regulating drugs in five provinces and regions in Northwest China / 中国药房

OBJECTIVE To explore standardized evaluation process for clinical comprehensive evaluation of blood lipid- regulating drugs and perform rapid assessment of clinical comprehensive evaluation of blood lipid-regulating drugs with different mechanisms so as to provide reference for the drug catalogue selection and rational drug use of medical institutions. METHODS Referring to guidelines and consensus such as the guideline for the management of comprehensive clinical evaluation of drugs， the methods such as literature research， expert interviews， and Delphi expert consultation were used to establish a multi-dimensional and multi-criteria clinical comprehensive evaluation index system and quantitative scoring table for blood lipid-regulating drugs around the two main lines of technical evaluation and policy evaluation. Then 13 blood lipid-regulating drugs with different mechanisms in 21 third-grade class-A medical institutions from five provinces and regions of Northwest China were scored from both technical and policy dimensions to form a comprehensive evaluation result. RESULTS The clinical comprehensive evaluation index system and corresponding rapid evaluation quantitative scoring table were constructed for blood lipid-regulating drugs in the five northwest provinces and regions. The technicalevaluation section included 6 primary indicators， 13 secondary indicators， and 34 tertiary indicators， totaling 110 points. The policy evaluation section included 4 primary indicators and 6 secondary indicators， with a total score of 40 points （30 points for some drugs） and a total score of 150 points （or 140 points）. The scoring results showed that the highest score was atorvastatin， followed by rosuvastatin and simvastatin. CONCLUSIONS Statins are still the cornerstone of drug therapy for patients with dyslipidemia； the rapid evaluation quantitative scoring table constructed in this study is comprehensive， systematic and operable. The evaluation process in this study can provide empirical references for other groups to exploring the standardized path and quality control mechanism of clinical comprehensive evaluation of drugs.

Construction of drug clinical comprehensive evaluation index system and quantitative grading by using analytic hierarchy model / 中国药房

OBJECTIVE To construct the drug clinical comprehensive evaluation index system and quantitative grading in China， and to provide a reference for scientifically carrying out comprehensive clinical evaluation of drugs. METHODS The analytic hierarchy model was used to establish the drug clinical comprehensive evaluation index system， the weight of the evaluation index and the quantitative grading of each index were determined through expert consultation and model calculation. RESULTS The results of expert consultation were integrated by using the analytic hierarchy model， and the drug clinical comprehensive evaluation index system was obtained： including six first-level indicators of effectiveness， safety， economy， suitability， accessibility and innovation， as well as twenty-three second-level indicators of recommended status， medication for special populations， and drug treatment costs； the weight of each indicator was calculated through estimation-matrix method. CONCLUSIONS The analytic hierarchy model can construct the drug clinical comprehensive evaluation index system and quantitative grading in China， which can provide methodological references for comprehensive analysis and decision-making， thus making the clinical comprehensive evaluation of drugs completer and more scientific.

Preliminary Construction of Evaluation Index System for Traditional Chinese Medicine Medicated Diet based on Delphi Method and Analytic Hierarchy Process / 中医杂志

ObjectiveTo build an evaluation index system for traditional Chinese medicine （TCM） medicated diet， promoting the scientific and standardized development of medicated diet in TCM. MethodsThe framework of the evaluation index system was constructed through literature review and Delphi expert consultation method. The analytic hierarchy process was used to construct a hierarchical structure model. Pairwise comparisons between the indicators were conducted using the Saaty 1-9 scale method， and the weight of each indicator was calculated using Yaahp 10.3. ResultsThe response rates for the two rounds of expert consultation were 93.33% and 100%， respectively. The Kendall's W coefficients for the first-level and second-level indicators in the second round were 0.270 and 0.281， respectively （both P＜0.001）. Finally， an evaluation index system for TCM medicated diet therapy was constructed， consisting of 6 primary indicators and 27 secondary indicators. The weightings of the primary indicators were as follows： sensory appearance （0.1843）， health value （0.3569）， ingredient compatibility （0.1271）， packaging （0.0370）， production and preparation （0.1005）， and reliability （0.1940）. ConclusionA comprehensive and universally applicable evaluation index system for TCM medicated diet has been developed， taking into conside-rations of color， taste， appearance， efficacy， preparation， quality and others. This system can provide valuable reference for the evaluation of the value of medicated diet as well as its development.

Construction of an evaluation index system of public health emergency preparedness capacity in county-level centers for disease control and prevention / 预防医学

Objective@#To construct an evaluation index system of public health emergency preparedness capacity in county-level centers for disease control and prevention (CDC), so as to provide the evidence for improving the public health emergency preparedness capacity in county-level CDC.@*Methods@#An index system framework was created based on review of health emergency policies, laws and regulations released in China from 2003 to 2023. The importance, sensitivity and accessibility of indicators were scored and screened through two rounds of Delphi expert consultations, and the weights of indicators were calculated using precedence charts. The efficiency of Delphi expert consultations was evaluated using the active coefficient, authority coefficient and coordination coefficient. @*Results@#Eighteen experts participated in consultations, including 9 men, 15 with educational levels of master degree and higher, 12 with preventive medicine or public health as the specialty, and 12 with deputy senior professional titles and higher. The active coefficients of two rounds of consultations were 100.00% and 94.44%, and the authority coefficients were 0.83 and 0.84, respectively. The coordination coefficients of secondary and tertiary indicators during the second round consultation were 0.341 and 0.241, which were both higher than those during the first round (both P<0.05). The final evaluation index system included 8 primary indicators, 21 secondary indicators and 58 tertiary indicators. Among primary indicators, health emergency organization and management (0.203 1), health emergency team building (0.203 1) and financial support for health emergency (0.203 1) had the highest weights, and of secondary indicators, completion degree of health emergency administration regulations (initial weight/global weight: 0.750 0/0.152 3), health emergency team building (0.750 0/0.152 3) and financial support for emergency (0.750 0/0.152 3) had the highest weights, while among tertiary indicators, defining the duty of health emergency administration sectors had the highest weight (0.750 0/0.114 2). @*Conclusion@#The created evaluation index system is feasible for evaluation of the public health emergency preparedness capacity in county-level CDC.

Construction of the evaluation index system for pharmacist training effectiveness based on Kirkpatrick evaluation model / 药学实践与服务

Objective To construct the evaluation index system for pharmacist training effectiveness in China. Methods The initial framework of index system based on Kirkpatrick evaluation model was constructed through literature research and expert interview method. Delphi method was used to analyze the index system. Results The evaluation index system for pharmacist training effectiveness in China included 4 first-level indicators, reaction evaluation, learning evaluation, behavior evaluation and result evaluation, 9 second-level indicators, training scheme, teaching staff, training conditions, theoretical knowledge, practical skills, the change of work ability, the change of professional attitude, personal income and organizational income, as well as 32 third-level indexes such as pharmaceutical professional knowledge. Conclusion This evaluation index system for pharmacist training result is highly scientific and systematic. It covers the whole-process and follow-up evaluation of the training activities. It can optimize the pharmacist training schedule and improve the program design for the effective pharmacist training evaluation.

Construction of a surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin / 中国血吸虫病防治杂志

OBJECTIVE@#To establish a surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin, so as to provide insights into creation of a sensitive and highly efficient surveillance and early warning system for schistosomiasis.@*METHODS@#National and international publications, documents, laws and regulations pertaining to schistosomiasis control were retrieved with keywords including schistosomiasis, surveillance, early warning and control interventions from 2008 to 2022, and a thematic panel discussion was held to preliminarily construct surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin. The index system was then comprehensively scored and screened using the Delphi method, and the weight of each index was determined using analytic hierarchy process and the modified proportional allocation method. In addition, the credibility of the Delphi method was evaluated using positive coefficient, authority coefficient, degree of concentration and degree of coordination of experts.@*RESULTS@#Following two rounds of expert consultation, a surveillance and early warning index system for schistosomiasis transmission risk in endemic areas along the middle and lower reaches of the Yangtze River basin was preliminarily constructed, including 3 primary indicators, 9 secondary indicators and 41 tertiary indicators. The normalized weights of primary indicators epidemics, natural and social factors and comprehensive control were 0.639 8, 0.145 6 and 0.214 6, respectively, and among all secondary indicators, snail status (0.321 3) and schistosomiasis prevalence (0.318 5) had the highest combined weights, while social factors had the lowest combined weight (0.030 4). Of all tertiary indicators, human egg-positive rate (0.041 9), number of acute schistosomiasis cases (0.041 5), number of stool-positive bovine and sheep (0.041 1), and prevalence of Schistosoma japonicum in free-ranging livestock (0.041 1) had the highest combined weights. During two rounds of consultation, the positive coefficient of experts was both 100%, and the authority coefficient was both 0.9 and greater, while the coordination coefficients were 0.338 to 0.441 and 0.426 to 0.565 (χ2 = 22.875 to 216.524, both P values < 0.05).@*CONCLUSIONS@#The established surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin is of great scientific values and authority, which may provide insights into construction of the sensitive and highly efficient surveillance and early warning system for schistosomiasis in the context of low prevalence and low intensity of infection in China.

Construction of following-up index system for ICU patients with acute kidney injury based on the Omaha nursing outcome classification system / 中国实用护理杂志

Objective:To construct follow-up index system of ICU patients with acute kidney injury based on the Omaha nursing outcome classification system, and to provide a reference for the clinical care quality and the follow-up work of ICU patients after discharge.Methods:Based on the Omaha nursing outcome classification system, the Delphi method was used to establish the content of the follow-up index system for ICU patients with acute kidney injury, and determine the weight of all levels of indicators.Results:After two rounds of expert consultation, questionnaire response rates were 95.00%and 100.00%, expert authority coefficients were 0.861 and 0.892 (both P<0.01), coordination coefficients ranged from 0.296 to 0.667 and 0.240 to 0.804, the difference were statistically significant ( χ2 values were 60.77-288.17, and P<0.01). The final index system consisted of 4 first-level indicators, 16 second-level indicators, and 52 third-level indicators. The analytic hierarchy process was used to determine the weights of all indexes, and the consistency test (consistency ratio<0.1) was performed. Conclusions:The follow-up index system of ICU patients with acute kidney injury was constructed to provide a reference for the clinical care quality and the follow-up work of ICU patients after discharge, and to provide a theoretical basis for the follow-up mode after ICU.

Construction of an evaluation index system for the construction of key medical disciplines in medical institutions in Shanxi Province / 中华医学科研管理杂志

Objective:Exploring the establishment of an objective and scientific evaluation index system for the construction of key medical disciplines in medical institutions in Shanxi Province.Methods:Literature review, Delphi method, and analytic hierarchy process were jointly adopted to screen the indicators and construct the evaluation index system of key medical disciplines in medical institutions in Shanxi province.Results:Two rounds of expert consultation were carried out, and the response rate was higher than 90%, and the expert authority coefficient was ≥0.75. Four primary indicators, 10 secondary indicators, and 41 tertiary indicators were established and given weights at all levels. The four primary indicators were medical operation 25.46%, scientific research management 36.01%, medical education 27.36%, and basic conditions 11.17%. The medical operation showed no significant difference from the original indicators, but its specific content was closer to the core indicator system of public hospitals′ performance evaluation reflecting social service capacity. The proportion of scientific research management increased by 12.5% and medical education increased by 17.39%. The results of the comprehensive quantitative evaluation of medical education and basic condition were P<0.05, respectively. The average score of discipline construction increased from 78.8, with excellent disciplines accounting for 56.66%, good accounting for 23.3%, qualified accounting for 6%, and unqualified accounting for 13.3%, to an overall average of 85.89, of which 76.7% were excellent, subjects accounting for 16.7% were good, 3% were qualified, and 3% were unqualified. Conclusions:The evaluation index system provided a quantitative tool for the evaluation of the construction of key medical disciplines in medical institutions in Shanxi Province. The expert authority and consistency were high and the index system was scientific. The weight coefficient of ″scientific research management″ in the index system was the highest, followed by medical education, in line with the evaluation purpose. The application of the system clarified the goal of current discipline construction, motivated the construction of scientific research management, promoted the transformation of achievements to a certain extent, and improved social service capacity.

Construction of an evaluation index system for clinical research innovation in medical institutions / 中华医院管理杂志

Objective:To constructe an evaluation index system for clinical research innovation in medical institutions, for references for enhancing the research and innovation capabilities of medical institutions and formulating policies related to clinical research innovation.Methods:From March 2022 to May 2023, relevant literature and policies on the evaluation system of scientific and technological innovation at home and abroad were analyzed to establish the preliminary screening clinical research innovation indicators. Two rounds of Delphi method were used to construct a clinical research innovation index evaluation system, analytic hierarchy process was used to calculate the weights of each indicator.Results:The effective response rates of the two rounds of consultation questionnaires were both 100.00%, with expert authority coefficients of 0.95 and Kendall coordination coefficients of 0.85 and 0.87, respectively. The clinical research innovation index evaluation system ultimately established 4 primary indicators, 13 secondary indicators, and 42 tertiary indicators. The first level indicators included infrastructure construction, innovation support environment, clinical research activity, and innovation effectiveness, with weight coefficients of 18.00%, 21.00%, 30.00%, and 31.00%, respectively.Conclusions:The clinical research innovation evaluation index system constructed in this study covered the investment, environment, and output aspects of research innovation, and could comprehensively and objectively reflect the clinical research innovation ability of medical institutions.

Construction of the evaluation index system for comprehensive budget management in public hospitals / 中华医院管理杂志

Objective:To construct an evaluation index system for comprehensive budget management at public hospitals and conduct empirical research for reference in evaluation of comprehensive budget management at public hospitals.Methods:From May to June 2022, based on the Implementation Measures for the Comprehensive Budget Management System of Public Hospitals and its interpretations, literature analysis, and expert interviews, a preliminary evaluation index system was developed for comprehensive budget management of public hospitals. Then the Delphi method was applied for two rounds of expert consultation, with experts invited to evaluate the importance of indexes, while the analytic hierarchy process was used to calculate the weight values of indexes. Based on such a comprehensive budget management evaluation index system, a questionnaire was developed, and tertiary public hospitals were selected based on the principle of convenient sampling. Then a questionnaire survey was conducted from June to October 2022. The questionnaire was filled out by hospital level leaders(chief accountants), finance/audit leaders, and directors of finance/audit/operation management departments from the sample hospitals with professional knowledge and rich operational management experience in budget management. The comprehensive budget management level of the sample hospital was thus evaluated based on the survey results. Results:The comprehensive budget management evaluation index system for public hospitals was composed of 2 first-level indexes, 4 second-level indexes, and 20 third-level ones. The weights for the 2 first-level indexes of target building and management orientation were both 0.500, while the weights for the 4 second-level indexes, namely strategic implementation, comprehensive coverage, performance evaluation, and adaptation matching were all 0.250. Among the third-level indexes, the weights of budget execution, system improvement, system establishment, organizational construction, and revenue and expenditure business ranked top five, with weights of 0.070, 0.069, 0.066, 0.066, and 0.064, respectively. A total of 95 hospitals were selected for questionnaire survey, and the evaluation found 46 of them with a comprehensive budget management level of " excellent" and " good" , 27 with a " moderate" level, and 22 with a " poor" and " very poor" level. Scores of the third-level indexes were between 39-94 points, while the score of 6 third-level indexes were below 60 points, namely interconnection, budget analysis, compatibility and adaptation, system improvement, participation level, and assessment application.Conclusions:The evaluation index system for comprehensive budget management at public hospitals in this study proves rational and practical, serving as a reference for the evaluation of comprehensive budget management at public hospitals and related researches.