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Construction and Efficiency Estimation of a Nursing Human Resource Evaluation System in Integrated Medical-Nursing
Mingxin He1, Pengfei Cheng2, Yan Liu3
1Department of Intensive Care Unit, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, China, pkuszh.com.
Background:
Efficient allocation of nursing human resources (NHR) is critical for optimizing care quality in integrated medical-nursing elderly care institutions. However, standardized tools for assessing NHR efficiency remain underdeveloped.
Objective:
This study aimed to develop and validate a data envelopment analysis (DEA)-based evaluation system for nursing human resource efficiency in integrated elderly care institutions, with empirical application in clinical settings.
Methods:
Employing a cross-sectional design, the research evaluated NHR efficiency in integrated medical-nursing elderly care institutions. A preliminary indicator system was developed through comprehensive literature review and field investigations, followed by two rounds of Delphi consultations with 17 multidisciplinary experts specializing in nursing management, elderly care administration, integrated medical-nursing operations, health economics, and public health. Expert reliability was determined by assessing response rates, authority levels (qualifications and experience), consensus (agreement rates), and coordination (Kendall's W test). Based on this established indicator system, the DEA model was employed to evaluate the operational efficiency of 12 integrated medical-nursing elderly care institutions in Hainan Province, China.
Results:
The constructed evaluation system featured a three-level hierarchical structure totaling 68 indicators (9 first-level, 19 second-level, and 40 third-level indicators). Two rounds of expert consultation demonstrated strong participation (response rates: 100% and 94.1%, respectively) and high reliability (authority coefficients: 0.88 and 0.92). Expert consensus was confirmed through statistical analysis (Kendall's W: 0.471 and 0.348; average coefficient of variation: 0.16 and 0.12; all p < 0.001). Subsequent DEA implementation across 12 institutions revealed 5 were fully efficient (OE = TE = SE = 1.000), while the remaining 7 showed varying inefficiency patterns: 4 exhibited pure technical efficiency (TE = 1.000) with scale inefficiency (SE < 1.000), and 3 demonstrated both technical and scale inefficiency (TE < 1.000, SE < 1.000).
Conclusion:
The nursing human resource efficiency evaluation system developed in this study demonstrated strong validity through a rigorous Delphi expert consultation process, showing high expert engagement and authoritative consensus. The comprehensive three-level indicator system exhibits well-organized structure with strong specialty-specific relevance for integrated medical-nursing care settings. DEA application confirmed the system's effectiveness in objectively evaluating nursing efficiency, supporting its practical utility for healthcare management in elderly care institutions.
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