医学院校附属医院科研能力评估指标体系构建

目的 构建医学院校附属医院科研能力评估指标体系。方法 运用德尔菲法筛选并确定各项评价指标。 结果 经过两轮德尔菲法专家咨询,构建出医学院校附属医院科研能力评估指标体系,包括一级指标3个,二级指标8个,三级指标25个。结论 所构建的指标体系具有较高的信度、效度,可以作为评估医院科研能力的工具。     

国家综合性医疗中心评价指标筛选研究

目的 探索建立国家综合性医疗中心评价指标框架，为我国国家区域医疗中心的建设和评价工作提供参考。方法 综合运用文献分析法、专题小组讨论法和专家咨询法，对国家综合性医疗中心评价指标进行了筛选研究。结果 确定了包括6个一级指标、22个二级指标、94个三级指标在内的国家综合性医疗中心评价指标框架。结论 评价指标的专家积极系数和权威系数较高，但二级和三级指标的协调系数偏低，需要经过多轮专家咨询后进一步提高专家意见的一致性。     

基于RBRVS的临床医师绩效分配模式指标体系构建研究

目的 构建科学的临床医师绩效分配模式,着力体现医师技术劳务价值。方法 综合运用文献研究法、专家咨询法、关键绩效指标法构建评价指标体系,利用非参数检验对专家评价数据进行统计分析。结果 构建了基于资源消耗为基础的价值评估体系医师绩效分配模式,重点突出医师技术劳务价值。结论 构建的指标体系能有效评估各诊疗项目中资源投入情况,可有效测量医师在医疗服务过程中的劳动付出,对于形成科学的绩效分配机制有重要意义。     

基于德尔菲法的公立医院党建工作评价指标构建

目的 构建公立医院党建工作评价指标,为有效提升公立医院党建工作科学化水平提供评价及考核依据。方法 通过文献研究和理论分析,建立初步的评价指标,运用德尔菲法选择35名专家进行两轮函询,对指标进行修订,确定公立医院党建工作评价指标。结果 两轮函询专家积极系数分别为94.3%、100%,专家权威系数0.837,第二轮专家意见协调程度系数为0.374（P＜0.001）,建立了包括思想建设、组织建设、作风建设、反腐倡廉建设、制度建设及党建工作创新6个一级指标、14个二级指标、35个三级指标的评价体系。结论 所构建的公立医院党建工作评价指标获得专家认可,能够为进一步规范公立医院党建工作、加强党的建设提供依据。     

县级公立医院综合改革成效评估指标体系构建研究

在文献回顾确定评估维度的基础上,结合相关政策,确定原始指标体系,利用两轮专题小组讨论和两轮专家咨询法对指标进行筛选,最终确定一套由3个一级指标、14个二级指标组成的县级公立医院综合改革成效评估指标体系,在利用层次分析法确定指标权重。同时,对指标体系信度效度进行检验,证明所构建的指标体系能对县级公立医院综合改革成效作出合理的评估。     

医院补偿能力评价指标体系初步研究

目的 探讨有效的医院补偿能力评价工具。方法 在文献查阅的基础上,通过专家小组讨论,初步建立医院补偿能力评价指标体系。采用Delphi法组织3轮专家咨询,汇总专家意见,通过指标筛选与修正,确立医院补偿能力评价指标体系。结果 构建了一个包括4项一级指标和23项二级指标的医院补偿能力评价指标体系。结论 3轮专家咨询结果具有可靠性,所构建的医院补偿能力评价指标体系为综合评价医院的补偿能力提供了内容依据和量化标准,为政府深化医院补偿改革提供参考依据。

     

基于RBRVS理论框架的骨外科手术项目工作量核算研究

目的 基于以资源为基础的相对价值比率理论框架,通过对骨外科手术项目的核算评价得出各种手术的综合排名,为医院准确量化医生工作、合理分配绩效工资提供技术支持。方法研究通过文献研究法以及专家咨询法甄选出所需的55种骨科手术项目,并将所得到的手术项目加入到德尔菲咨询表中,利用Delphi法对咨询表中手术项目的“工作投入程度”“执业成本投入程度”和“风险程度”进行分别考量并给出相应分值。结果 通过对骨科手术项目的两轮Delphi专家咨询后,Kendall协调系数大于0.7,可判断专家咨询意见趋于集中。结论 研究的结果产出,对医院骨科医生的工作量进行了科学、准确的评价,能够为医院的医生绩效考核工作提供至关重要的技术支持。     

基于循证评价的现代化综合性中医院医疗质量评价指标体系的建立

目的 建立一套科学合理、量化可比、简便易行的现代化综合性中医院医疗质量评价指标体系。方法 对我国现有的医疗质量评价的文献进行循证分析,按循证医学的标准和引用频率提取综合性医院的共性指标和中医院特有的非共性指标,从而拟定指标体系草案。运用德尔菲法,进行3轮专家咨询,采用相乘模型的综合指数法筛选指标,用层次分析法和比例分配法确定指标权重。结果 指标体系由5个一级指标、23个二级指标构成,其中反映中医院特色的二级指标6个,占26%。结论 整套指标体系既有医院的共性指标,又强调了综合性中医院的特性指标,既能突出中医医疗质量管理与质量控制的特色,又能结合中医医院现代化发展的需要。     

森林声景资源评价指标体系构建研究

森林声景资源是森林公园旅游资源的重要组成部分, 对其进行科学评价关系到森林景观资源的开发, 也对森林公园景观规划及景观林的科学经营具有重要意义。采用频度统计法、理论分析法、专家咨询法构建了森林声景资源评价指标体系, 指标体系包括声景资源旅游价值和生态环境价值2 个因素23 个指标, 明确了各指标的内涵, 并采用层次分析法(AHP 法)确定了各指标的权重。参照国家标准和现有旅游资源评价、生态评价等相关研究成果, 建立了森林声景资源评价体系的评分标准。根据不同指标的特性与评价依据来源, 确定了相应的评价方法, 并制定了评价结果对应的评价等级。     

基于价值链理论的医院标准非经济效益评估体系构建

目的 构建基于价值链理论的标准非经济效益评估指标体系。方法 采用Delphi专家咨询法。结果 通过两轮Delphi专家咨询,筛选出基于价值链理论的标准非经济效益评估指标,初步构建评估体系。指标涉及医疗效力、医疗缺陷、医疗安全、运营效率、时间效率和信息效率六大价值驱动因素。结论 两轮专家咨询后,基于价值链理论的标准非经济效益评估指标体系初步形成。     

基于PATH模型的远程医疗绩效评价体系构建

目的 探索构建适用于我国远程医疗发展的绩效评价体系。方法 采用文献法、头脑风暴法初步构建评价框架和指标库,运用德尔菲法和层次分析法确定指标及其权重。结果 基于PATH模型建立了远程医疗绩效评价体系,包括以病人为中心、医疗效果与效率、员工为导向、安全性、反应性管理5个一级指标、11个二级指标和32个三级指标。结论 PATH模型适用于远程医疗绩效评价体系的建立,此外,以病人为中心的指标权重最高,因此,应加强对远程医疗服务费用的控制,同时从各个角度入手,提高患者满意度。     

基于德尔菲法的外科手术风险因素评价指标构建

目的 构建外科手术风险因素评价指标体系,为有效监管外科手术质量与安全提供参考依据。方法 运用文献分析法、德尔菲法、层次分析法进行外科手术风险因素评价体系的构建和指标权重的确定。结果 建立了一个由手术固有风险、医疗机构风险、医务人员风险、患者风险4 个一级指标和手术本身风险、医务人员专业技术水平、患者个体差异、医务人员责任心、医学科学的局限性、医院诊疗流程、医务人员团队协作,医院诊疗服务水平、工作负荷等等20 个二级指标组成的手术风险因素评价指标体系。结论 建立一套完善的外科手术风险因素评价指标体系,对于保障手术患者安全、有效进行外科手术质量与安全监管具有重要意义。     

Towards objectivity in research evaluation using bibliometric indicators – A protocol for incorporating complexity

Publications are thought to be an integrative indicator best suited to measure the multifaceted nature of scientific performance. Therefore, indicators based on the publication record (citation analysis) are the primary tool for rapid evaluation of scientific performance. Nevertheless, it has to be questioned whether the indicators really do measure what they are intended to measure because people adjust to the indicator value system by optimizing their indicator rather than their performance. Thus, no matter how sophisticated an indicator may be, it will never be proof against manipulation. A literature review identifies the most critical problems of citation analysis: database-related problems, inflated citation records, bias in citation rates and crediting of multi-author papers. We present a step-by-step protocol to address these problems. By applying this protocol, reviewers can avoid most of the pitfalls associated with the pure numbers of indicators and achieve a fast but fair evaluation of a scientist's performance. We as ecologists should accept complexity not only in our research but also in our research evaluation and should encourage scientists of other disciplines to do so as well.     

公立医院绩效评价PATH优化模型指标体系的构建

目的 构建适用于三级公立医院的绩效评价体系,为医院开展绩效考核与管理工作提供决策参考。方法 应用文献法、个人访谈法和头脑风暴法构建评价模型和初始指标库,运用德尔菲法和层次分析法确定指标权重。结果 运用医院质量改进的绩效评价工具（The Performance Assessment Tool for Quality Improvement in Hospitals,PATH）理念构建了以病人为中心、以员工为导向、临床效率效果、运营表现、响应治理、卓越提升6个核心维度的三级公立医院绩效评价体系。结论 指标体系的可信程度较高、权威性高、具有较好的适用性。

     

Provincial level-based emergy evaluation of crop production system and development modes in China

This paper presented a multi-objective indicator system for the performance evaluation of crop production system based on emergy method. Eight emergy indicators were selected to analyze the crop production system in the 31 provinces of mainland China to compare intensive use, scale management, investment density, environmental pressure, output benefit, output density, output per capita, and economic benefit. This paper conducted a comparison of each indicator in different provinces, and divided the 31 provinces into 10 groups by cluster analysis. The results show that: the crop production system among provinces has a significant difference and it is summarized into 10 development modes; with the development of modern agriculture, Chinese crop production system still complies with the input–output balance; the majority of provinces cannot achieve win-win between economic investment and environmental health; most of the underdeveloped provinces with high productivity may not be able to obtain good economic benefit; there is a significant positive correlation between the scale management degree and emergy output per capita in the crop production system; 10 development modes and policy suggestions are deduced. It is concluded that emergy-based multi-objective indicators can serve as an effective method in the evaluation of crop production system.     

Two-dimensional grey cloud clustering-fuzzy entropy comprehensive assessment model for river health evaluation

Abstract

The river health evaluation is typically complex non-linear system with characteristics of fuzziness and randomness. However, conventional gray clustering method has difficult to effectively describe fuzzy and random information simultaneously. For this purpose, the cloud model and fuzzy entropy theory are introduced to establish 2D gray cloud clustering-fuzzy entropy comprehensive evaluation model. Different with health level models, it reflects river health situation from aspects of health level and corresponding water body complexity simultaneously. The health level is obtained by gray cloud whitened weight function (first sub-system) and fuzzy entropy represents complexity and fuzziness of river health situation (second sub-system). Moreover, multi-level river health evaluation indicator system is constructed with dividing indicators into common and distinct sections according to differences on river characteristics. Meanwhile, indicator weights are determined by renewed combined weighting method based on minimum deviation principle. Finally, we conduct health evaluation work for rivers in the Taihu basin. The evaluation health levels and fuzzy entropy for river A–G are H3 (0.4888, relatively significant); H2 (0.5476, relatively fuzzy); H2 (0.7526, fuzzy); H2 (0.4731, relatively significant); H2 (05138, relatively fuzzy); H3 (0.5822, relatively fuzzy), and H2 (0.4064, relatively significant), respectively. Results are consistent with current river health situation and more intuitive than compared models. Furthermore, evaluation results with four different weighting methods are compared to further demonstrate rationality of the weighting method and evaluation model. Hence, the model proposed is demonstrated to provide new insight for solving river health assessment problem effectively.     

国家卫生系统绩效评价：经验及启示

通过对英美等发达国家卫生系统进行绩效评价分析,总结国家卫生系统绩效评价理论方法和经验。研究发现,国家卫生系统绩效评价核心过程包括参与对象确定、概念模型选择、政策背景分析、框架构建、评价实施和激励机制形成6个关键步骤。其中国家卫生系统绩效评价制定需要利益相关者全程参与,Lalonde健康影响因素模型和平衡计分卡是目前主要理论基础,国家政策背景决定了评价框架的重点和导向,成立卫生系统绩效评价管理部门是评价实施的保障,而建立激励机制是提高卫生系统绩效评价价值的重要手段。     

A model for developing a target integrated low carbon city indicator system: The case of Xiamen,China

Carbon intensity targets, namely carbon emissions per unit of GDP, are used as macro-level indicators of low carbon performance at the province- and city-level in China. However, this measure is too aggregated to provide a meaningful indication of low carbon performance and inform practical management strategies. Most traditional low carbon city indicators have no direct relationship with national carbon intensity reduction targets and do not provide municipal government administrators with the practical information they need to inform low carbon development at the local level. This paper integrates city-level carbon intensity targets with a low carbon city indicator system by means of a decomposed method to offer a better approach for carbon intensity reduction performance evaluation. Using Xiamen as a case study, one of the NDRC's low-carbon project areas, a target integrated indicator system is presented, including indicator values which have been determined through scenario analysis and calculation. The indicators and values can help local municipal governments to meet their carbon intensity reduction targets by providing an indication of current performance and identifying sectors where there is scope for further improvement. The methodology provides the theoretical basis and reference values for the evaluation of a city's low carbon performance within the context of achieving a carbon reduction target, thereby enhancing the potential for scientific and operational evaluation at the local level.     

上海市医疗质量控制综合评分体系研究

目的 构建一套客观通用的医疗质量综合评分体系,从而加强对各医疗机构总体医疗质量的控制,促进医疗机构质量不断提升,为政府有关部门提供可操作性的政策建议。方法 在文献综述的基础上应用德尔菲法（Delphi Method）对医疗机构质量控制综合评分指标体系的重要性、评估难度以及理想评估次数进行评价,建立评价指标体系。结果 构建的指标体系包含三个层级结构,共32个指标,各级指标的重要性评价意见的协调系数均有统计学意义,专家们较一致的认为管理类别的评价指标评估难度较大,理想的评估频次是一年2次。结论 构建的评价指标体系符合上海市的实际情况,可以应用到实际质量控制综合评价工作中。