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目的 在医养结合视角下构建社区老年人健康管理服务效果评价指标体系,为开展现场评估奠定理论基础.方法 以定性分析为主.主要通过改良安德森卫生服务利用模型,结合德尔菲专家咨询进行指标体系的构建.专家咨询的所有数据用Excel录入,应用SPSS 22.0统计软件对专家咨询表各级指标重要性、可操作性得分进行包括均数、标准差、变异系数等定量统计分析;对专家积极系数进行构成比分析;对专家权威系数、协调系数采用卡方检验;对指标权重进行均数法、连乘累积组合权重计算.结果 构建了社区老年人健康管理服务效果评价指标框架,开发了社区老年人健康管理服务效果评价指标体系.该体系包括4项一级指标,12项二级指标,35项三级指标,且通过专家咨询对每个指标进行赋权.结论 社区老年人健康管理服务效果评价指标体系是考核老年人健康管理服务成效的有效方式,其指标的筛选应符合老年人新型养老模式下健康管理的内涵和特征.接下来还需要经过实证调查,根据应用情况对指标体系进行修正,才能更好地为规范老年人健康管理服务以及推动医养结合提供决策依据.

Objective To develop an evaluation index system of health management services for the elderly with the perspective of combining medical service and long term care, and laying the foundation for the field assessment. Methods Using Delphy expert consultation method to improve Andersen health service utilization model. Excel was used for data input, SPSS 22.0 statistical software was used for analyzing the data from the expert consultation questionnaire to determine the importance and feasibility of the scores including mean, standard deviation and coefficient of variation. Constituent ratio analysis was done for expert positive coefficient, and the expert authority coefficient and coordination coefficient were analyzed by chi square test. The indicator's weight was calculated by using average method and multiplicative cumulative combination weighting. Results We constructed the framework for evaluating the effectiveness of health management service for the elderly in the community, the evaluation index system of the community health service was established. The system included 4 first level indicators, 12 second level indicators, 35 third level indicators, each index had a corresponding weight. Conclusions The evaluation index system is an effective way to assess health management service, selection of the indexes should be consistent with the connotation and characteristics of elderly health management under new aging care policy. Further empirical investigation is needed to modify the index system in order to provide decision-making basis for improving and regulating health management services for the elderly.