目的 基于数据包络分析法（DEA）构建医养结合型养老机构护理人力资源效率评价指标体系并进行评价。 方法 本研究属于横断面调查研究。运用文献研究及调查法初步建立护理人力资源效率评价指标体系库，采用德尔菲法对17名专家（护理管理、养老机构管理、医养结合型养老机构管理、卫生经济学管理、公共卫生等领域的专家）展开两轮函询。通过专家积极性、专家权威程度、专家意见集中程度与协调程度等因素判断指标体系的可靠性，结合专家意见对指标进行调整、修改及完善，以确立最终的指标体系。并于2022年8—12月在该指标体系基础上运用DEA模型对海口市12家医养结合型养老机构进行效率评价。 结果 构建的评价指标体系分为3级68项，包括一级指标9项，二级指标19项，三级指标40项。两轮专家函询积极系数为100%和94.1%，权威系数为0.88与0.92，肯德尔和谐系数为0.471和0.348，变异系数均值为0.16和0.12（P<0.001）。DEA评价的12家医养结合型养老机构结果显示，综合效率（OE）、技术效率（TE）和规模效率（SE）值均为1.000的DEA有效机构有5家；非DEA有效机构有7家，其中包括SE值<1.000但TE值=1.000的4家，SE值及TE值均<1.000的3家。 结论 构建的评价指标体系其函询专家的参与积极性高，权威系数和协调度好，对指标体系认可性高，内容涵盖全面、层次分明、可获取强、具有较强的专科特性。DEA模型评价的结果能客观有效地反映医养结合型养老机构护理人力资源效率发挥情况，实用性较强。 Objective To construct an evaluation indicator system for the efficiency of nursing human resources in integrated medical and elderly care institutions using Data Envelopment Analysis (DEA) and subsequently evaluate its effectiveness. Methods This cross-sectional survey utilized literature review and investigative methods to initially establish a library of evaluation indicators for nursing human resource efficiency. The Delphi method was employed in two rounds of consultations with 17 experts from various fields, including nursing management, elderly care institution management, integrated medical and elderly care institution management, health economics management, and public health. The reliability of the indicator system was assessed based on factors such as expert enthusiasm, authority, concentration of opinions, and coordination. Adjustments, modifications, and improvements were made to the indicators based on expert opinions to establish the final indicator system. From August to December 2022, the DEA model was applied to evaluate the efficiency of 12 integrated medical and elderly care institutions in Haikou city based on this indicator system. Results The constructed evaluation indicator system comprised 68 items divided into three levels: 9 primary indicators, 19 secondary indicators, and 40 tertiary indicators. The positive coefficients of the two rounds of expert consultations were 100% and 94.1%, with authority coefficients of 0.88 and 0.92, Kendall harmony coefficients of 0.471 and 0.348, and mean coefficients of variation of 0.16 and 0.12 (P<0.001). DEA evaluation results for the 12 integrated medical and elderly care institutions showed that 5 were DEA effective institutions with comprehensive efficiency (OE), technical efficiency (TE), and scale efficiency (SE) values all equal to 1.000, while 7 were non-DEA effective institutions, including 4 with SE <1.000 but TE=1.000 and 3 with both SE and TE<1.000. Conclusions The constructed evaluation indicator system demonstrates high enthusiasm, authority coefficients, and coordination in expert consultations, indicating high acceptability and comprehensive content with distinct levels and strong specialty characteristics. The DEA model′s evaluation results objectively and effectively reflect the efficiency of nursing human resources in integrated medical and elderly care institutions, demonstrating practical utility.
Construction and evaluation of an indicator system for nursing human resource efficiency in integrated medical and elderly care institutions using Data Envelopment Analysis
Objective To construct an evaluation indicator system for the efficiency of nursing human resources in integrated medical and elderly care institutions using Data Envelopment Analysis (DEA) and subsequently evaluate its effectiveness. Methods This cross-sectional survey utilized literature review and investigative methods to initially establish a library of evaluation indicators for nursing human resource efficiency. The Delphi method was employed in two rounds of consultations with 17 experts from various fields, including nursing management, elderly care institution management, integrated medical and elderly care institution management, health economics management, and public health. The reliability of the indicator system was assessed based on factors such as expert enthusiasm, authority, concentration of opinions, and coordination. Adjustments, modifications, and improvements were made to the indicators based on expert opinions to establish the final indicator system. From August to December 2022, the DEA model was applied to evaluate the efficiency of 12 integrated medical and elderly care institutions in Haikou city based on this indicator system. Results The constructed evaluation indicator system comprised 68 items divided into three levels: 9 primary indicators, 19 secondary indicators, and 40 tertiary indicators. The positive coefficients of the two rounds of expert consultations were 100% and 94.1%, with authority coefficients of 0.88 and 0.92, Kendall harmony coefficients of 0.471 and 0.348, and mean coefficients of variation of 0.16 and 0.12 (P<0.001). DEA evaluation results for the 12 integrated medical and elderly care institutions showed that 5 were DEA effective institutions with comprehensive efficiency (OE), technical efficiency (TE), and scale efficiency (SE) values all equal to 1.000, while 7 were non-DEA effective institutions, including 4 with SE <1.000 but TE=1.000 and 3 with both SE and TE<1.000. Conclusions The constructed evaluation indicator system demonstrates high enthusiasm, authority coefficients, and coordination in expert consultations, indicating high acceptability and comprehensive content with distinct levels and strong specialty characteristics. The DEA model′s evaluation results objectively and effectively reflect the efficiency of nursing human resources in integrated medical and elderly care institutions, demonstrating practical utility.
Nursing careHealth resourcesEvaluation of efficiencyElderly care institutionCombination of medical care and elderly careData envelopment analysis
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