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重庆市紧密型城市医疗集团药学服务质量评价体系构建及实证调查
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| 篇名： | 重庆市紧密型城市医疗集团药学服务质量评价体系构建及实证调查 |
| TITLE： | Construction of pharmaceutical service quality evaluation system for Chongqing’s compact urban medical groups and empirical investigation |
| 摘要： | 目的 构建药学服务质量评价体系，识别药学服务一体化建设短板，为紧密型城市医疗集团药学服务的同质化、高质量发展提供参考。方法以Servperf模型五大核心维度为框架，采用Delphi法筛选、优化条目，构建适配紧密型城市医疗集团特征的医、药、患三方药学服务质量评价体系；采用该评价体系，对重庆市6家紧密型城市医疗集团开展多中心横断面实证调查。结果经12名专家两轮Delphi调研，成功构建了包含5个维度、78项条目（临床药师24项、医护人员23项、患者及家属31项）的三方药学服务质量评价体系，问卷各维度Cronbach’sα系数均大于0.81，KMO值均大于0.7。共回收有效问卷1339份，其中临床药师279份、医护人员727份、患者及家属333份。实证调查结果显示，区域药学基础服务质量整体优良，但医、药、患三方服务感知存在显著群体差异，三方在5个维度上的组间评分差异均有显著统计学意义（均P＜0.001），除有形性维度医护人员评分显著低于临床药师与患者及家属外，其余4个维度中，患者及家属评分均显著高于医护人员与临床药师（P＜0.05）。78项条目的专家预期与三方主体感知基本匹配，平均差值为0.08分；仅13项条目的差值超过0.5分，为显著缺口，其中“参与多学科团队会诊并提出有效建议”的差值最大，为0.94分。结论本研究构建的医、药、患三方评价体系科学可靠；实证调查证实受访的医疗集团药学基础保障服务扎实稳固，但高阶协同服务建设存在明显短板，且三方群体服务感知异质性显著。 |
| ABSTRACT： | OBJECTIVE To construct a pharmacy service quality evaluation system， identify weaknesses in the integrated development of pharmacy services， and provide a reference for the homogenized and high-quality development of pharmacy services in compact urban medical groups.METHODS Guided by the five core dimensions of the Servperf model， the Delphi method was used to screen and optimize items， and a tripartite pharmacy service quality evaluation system， covering clinicians， pharmacists， and patients， adapted to the characteristics of compact urban medical groups was constructed. A multicenter cross-sectional empirical investigation was conducted in six compact urban medical groups in Chongqing using the evaluation system.RESULTS Through two rounds of Delphi consultation with 12 experts， a tripartite pharmacy service quality evaluation system was successfully constructed， comprising 5 dimensions and 78 items （24 for clinical pharmacists， 23 for clinical medical staff， and 31 for patients and family members）. The Cronbach’s α coefficients for all dimensions exceeded 0.81， and the KMO values all exceeded 0.7. A total of 1 339 valid questionnaires were collected， including 279 from clinical pharmacists， 727 from clinical medical staff， and 333 from patients and family members. The empirical investigation showed that the overall quality of regional basic pharmacy services was good， but significant inter-group differences existed in service perceptions among the three groups. The score differences across the five dimensions were all statistically significant among the three groups （all P ＜0.001）. Except for the tangibles dimension， in which clinical medical staff scored significantly lower than clinical pharmacists and patients/family members， patients/family members scored significantly higher than clinical medical staff and clinical pharmacists in the other four dimensions （ P ＜0.05）. For the 78 items， expert expectations largely matched the perceptions of the three groups， with a mean difference of 0.08 points； only 13 items showed a difference exceeding 0.5 points， representing marked gap，with “participating in multidisciplinary team consultation and making effective recommendations” showing the largest difference of 0.94 points.CONCLUSIONS The physician‑ pharmacist‑patient tripartite evaluation system constructed in this study is scientific and reliable. Empirical investigation confirms that the basic pharmaceutical support services of the medical groups are well established， whereas the development of high‑level collaborative services has notable weaknesses， and marked heterogeneity exists in service perception among the three groups. |
| 期刊： | 2026年第37卷第20期 |
| 作者： | 陈雁；邓正；廖彬彬；周永维；王光宪；杨柳 |
| AUTHORS： | CHEN Yan，DENG Zheng，LIAO Binbin，ZHOU Yongwei，WANG Guangxian，YANG Liu |
| 关键字： | 紧密型城市医疗集团;药学服务;质量评价;Delphi法;SERVPERF模型 |
| KEYWORDS： | compact urban medical group;Pharmacy service;Quality evaluation;Delphi method;Servperf model |
| 阅读数： | 1 次 |
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