A quality assessment index framework for public health services: a Delphi study

Area of Science:

• Public Health
• Healthcare Quality Management
• Health Services Research

Background:

• Evaluating public health service quality is crucial for improving healthcare delivery.
• Existing quality assessment tools may lack comprehensive and consensus-based metrics.
• Standardized frameworks are needed for consistent evaluation across different regions in China.

Purpose of the Study:

• To establish consensus-based indices for the Quality Assessment of the Public Health Service (QAPHS).
• To develop a hierarchical framework for evaluating public health service quality in China.
• To validate the applicability and practicability of the proposed QAPHS framework.

Main Methods:

• A qualitative study employing a two-round Delphi technique with 30 experts.
• Development of initial quality assessment indices based on Donabedian theory.
• Statistical analysis including specialist authority coefficient (Cr) and Kendall's W to establish consensus and reliability.

Main Results:

• Consensus was achieved on a three-tiered framework: 4 first-grade, 9 second-grade, and 28 third-grade indices.
• High specialist authority coefficients (Cr: 0.88-0.92) indicated expert agreement.
• Kendall's W coefficients were statistically significant (P < 0.05, W > 0.5), confirming high inter-rater reliability.

Conclusions:

• A unified, hierarchical QAPHS index framework was successfully established through expert consensus.
• The developed framework demonstrates high reliability and practicability for assessing public health service quality.
• Further practical testing and refinement of the QAPHS framework are recommended.