社区卫生服务中心公共卫生服务绩效评价研究

华中科技大学硕士学位论文社区卫生服务中心公共卫生服务绩效评价研究姓名：程勇申请学位级别：硕士专业：社会医学与卫生事业管理指导教师：张亮;郭清20080501_____11.2.3.4.MicrosoftOfficeExcel2003SPSS11.51.39282.23.3524.5.α0.6478VC0.69701.39282.3.4.5.3AbstractObjective:Screenoutmainpublichealthserviceconsideringtheimportanceandpriorityofitinourcountrycityatpresent,Definetheperformanceofcommunitypublichealthserviceprimarilyonthebasisofthefunctionofcommunityhealthservice,anddeterminetheperformanceindicatorswithweights,thenconstructtheindicatorsystemofperformanceassessment.Basedonit,establishthecomprehensiveassessmentmodeloftheperformanceofcommunityhealthservicecenterinpublichealthservicewithperformanceindexascore.Thusprovidethegovernmentandthecommunityhealthservicecenterwithakindofinstrumenttoassesstheperformanceofpublichealthservice,andimproveitsserviceMethods:1.Documentstudy:Consultdomesticandforeignliteratureabouttheperformancetheory,performanceassessment,healthsystemperformanceassessment,hospitalperformanceassessment,communityhealthserviceassessmentandpublichealthserviceassessment,andsoon.2.Delphimethod:TodeterminetheperformanceindicatorsanditsweightsofpublichealthserviceinthecommunityhealthservicecenterconsulttheexpertsbyDelphiinquiry.3.Questionnairesurvey:Collecteddataofperformanceindicatorsofpublichealthserviceinthecommunityhealthservicecenterwhichassamplesbyquestionnaire.4.Statisticsmethod:EstablishmentdatabaseandcomputethevalueofstandardizedindicatorsandperformanceindexbyMicrosoftOfficeExcel2003.Descriptivestatistics,Nonparametrictest,Reliabilityanalysis,CorrelationanalysisareappliedbySPSS11.5.Results:1.Asonepublicproduct,publichealthservicerepresentgovernment’sresponsibilityintheserviceprovision.Accordingtotheprinciplesasadaptingtotheeconomicdevelopmentprinciple,cost-benefit(effect)principle,equityprinciple,efficiencyprinciple,thepublichealthserviceinourcountrycitycommunitycanbedividedintothepublichealthserviceandthehypo-publichealthservice,39publicitemsand28hypo-publicitemsaltogether.2.Theperformanceofcommunityhealthservicecenterinpublichealthserviceisdefinedasfunctionattainmentofpublichealthserviceinthecommunityhealthservice4centerundertheresourcescondition.Itsperformanceassessmentinvolvestwomeanings:First,relativetotheorganizationfunction,theextentthatcommunityhealthservicecenterattaineditsfunctionsinpublichealthservice;Second,undertheresourcescondition,theactualstatethatcommunityhealthservicecenteractualizeitsfunctionsinpublichealthservice.3.Theindicatorsystemofcommunityhealthservicecenterinpublichealthservicedividesthreelayers.Thefirstlayerisoverallperformance.Thesecondlayerisdimension,comprisedofserviceefficiency,servicequalityandsatisfaction.Thethirdlayerisperformanceindicator,whichefficiencyincludethreeindicatorsasoutput-input;qualityincludefiveindicatorsasEPIvaccinationrate;satisfactionincludestaffsatisfactionandresidentsatisfactiontwoindicators4.Thecomprehensiveassessmentmodeloftheperformanceofcommunityhealthservicecenterinpublichealthserviceisafunctionofperformanceindex.Thevalueofperformanceindexreflectingtheoverallperformanceleveliscomputedbyitsfunctionformula,andthefunctionmodelofperformanceindexreflectingtheperformancecharacteristicswillrevealtheperformancestructure.5.Theresultsofperformanceassessmentinpublichealthserviceshowedthatthecommunityhealthservicecentersweredifferentinperformanceanditsstructure.Then,carriedonthereliabilityandvalidityanalysistotheindicatorsystem,andthevalueofCronbach’sαcoefficientwas0.6478,thevalueofcontentvaliditywas0.6970.Conclusion:1.Atpresent,thepublichealthserviceinourcountrycitycommunitycanbedividedintothepublichealthserviceandthehypo-publichealthservice,39publicitemsand28hypo-publicitemsaltogether2.Theperformanceofcommunityhealthservicecenterinpublichealthserviceisthefunctionattainmentofpublichealthserviceinthecommunityhealthservicecenterundertheresourcescondition.Theperformancedimensionsincludingefficiency,qualityandsatisfaction.3.Thereliabilityandvalidityofthecomprehensiveassessmentmodelofcommunityhealthservicecentersperformanceinpublichealthservicearebetter,sothemodelcould5assesstheperformanceofcommunityhealthservicecentersreliablyandvalidlyinpublichealthservice,andalsocoulditsstructure4.Thecommunityhealthservicecentersactualperformancestructureinpublichealthservicecoulddivideintofivekindsoftypes,whicharethetypesofexcellence,all-inferior,poor-efficiency,poor-qualityandpoor-satisfaction.5.ServiceefficiencymorereflecttheoverallperformanceofcommunityhealthservicecenterinpublichealthserviceandalsodetermineitKeywords:CommunityHealthServiceCenter;PublicHealthService;Performance;Assessment6180%199027200120[1],7,,,,??822.1,,,2.21,,,,2,,[2],,,,,,,911.1Medline,ProquestElsevierScienceSDOSInternet1.2231.3567200622.1Medline,Proquest,ElsevierScienceSDOSInternet102.2DelphiDelphi,[3-5]2.3Delphi392.4MicrosoftOfficeExcel2003,SPSS11.5CronbachαVC1111.1l81920JohnLast19952003728[10]12[10][11]1.21320042007[10-19]9392822.1“performance”“performance”“”[21]14[21]Brumbrach[21][20]“”“”“”“”[20]15[22]TheWorldHealthReport2000[23]162.2JenniferKates(2001)[24]1WHO