Comprehensive evaluation of the implementation of close-type county medical alliance in Shandong Province using entropy weight TOPSIS method and non-integer rank sum ratio method
Year: 2024
Type: article
Abstract: Background To improve the capacity of county medical and health services, China encourages all localities to pilot the close-type county medical alliance. In Shandong Province, medical alliances have been piloted in 47 counties, ranking first in the country. The objective of this study is to comprehensively evaluate the implementation of close-type county medical alliance in Shandong Province and provide a reference for the construction of a new county medical and health service system with clear goals, powers and responsibilities, and division of labor. Methods The implementation of the close-type county medical alliance was comprehensively evaluated in 47 national pilot counties in Shandong Province using entropy weight TOPSIS method and non-integer rank sum ratio method. Variance analysis was used for comparison of the comprehensive evaluation results. Results The weight coefficient of evaluation indicators was highest for information interconnection, at 18.06%, and lowest for orderly referral of patients, at 3.64%. There was no difference in results of the comprehensive evaluation of entropy weight TOPSIS method and non-integer rank sum ratio method. Comprehensively order the implementation status of each pilot county according to the relative paste progress, 13 counties Y5, Y11, Y14, Y16, Y20, Y25, Y26, Y27, Y28, Y32, Y33, Y40 and Y42 were ranked highest, whereas county Y37 was ranked lowest. Non-integer rank sum ratio method graded counties into three grades: excellent, good and average. Kruskal-Wallis nonparametric test showed that the difference between the grades was statistically significant (H=37.099, p <0.001). Variance analysis based on comprehensive evaluation results showed that implementation status was not correlated with the county economic development level, the level of health resources input and the medical service ability of the lead hospital. Conclusions Our findings indicated that the implementation of the close-type county medical alliance is significantly different between pilot counties, with a marked differentiation within the same urban area. Therefore, effective measures are recommended to reduce this gap, including promoting informatization empowerment of the county medical community, strengthening government responsibility and improving policy effectiveness.
Source: BMC Health Services Research
Institution: Shandong University of Traditional Chinese Medicine
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,190
OpenAlex ID: W4403174202