Construction of an index system for workplace services by family doctors in China: a two-round Delphi study

Primary health care for young and middle-aged individuals is often overlooked, with insufficient placed on workplace services provided by family doctors. This study aims to establish expert consensus on a comprehensive set of scientific and systematic indicators for workplace services provided by family doctors.

Based on prior literature and the established Structure-Process-Outcome (SPO) model, we designed two rounds of expert consultation using the Delphi method. A panel of 35 experts from diverse fields-including academia, medical institutions, and relevant health authorities-was composed, collectively possessing substantial expertise in healthcare delivery. The experts indicated their levels of agreement regarding the importance of different indicators for assessing workplace services provided by family doctors. Consensus was defined as achieving a threshold of 70% agreement.

After two Delphi rounds, 42 out of 46 indicators reached high consensus, with authority coefficients > 0.7 and coefficients of variation < 0.25. Consensus on high importance (scores 7-9) ranged between 71.43% and 97.14% across four dimensions: organizational structure and management (5 indicators, 88.57%-94.29% consensus); content and form of services (17 indicators, 77.14%-94.29% consensus); synergy, incentive, and feedback mechanisms (10 indicators, 85.71%-97.14% consensus); and effectiveness of services (10 indicators, 71.43%-85.71% consensus).

This study establishes four dimensions and 42 potential indicators that serve as a foundational framework for assessing and improving workplace services offered by family doctors, and provide essential guidance for health management among individuals in the workplace. The high consensus achieved among experts concerning specific indicators associated with such workplace services prompts their practical implementation to provide an objective basis for evidence-based health management within workplace populations.