Developing medical record-based, healthcare quality indicators for psychiatric hospitals in China: a modified Delphi-Analytic Hierarchy Process study

Abstract

Objectives: To develop a medical record-based, comprehensive system of healthcare quality indicators for psychiatric hospitals in China.

Design: A modified Delphi process with analytic hierarchy process (AHP) was used.

Participants: Twenty nationally-recognized experts were invited to participate in two rounds of Delphi expert consultation and AHP.

Methods: Fifty potential indicators were included based on literature review, and 20 experts were asked to rate the importance of each indicator using two rounds of email surveys. The AHP was used to determine the relative importance of the finalized quality indicators.

Results: The average authoritative coefficient was 0.92 ± 0.07. After two rounds of Delphi consultation, 47 healthcare quality indicators were identified for Chinese psychiatric hospitals. The mean importance ratings ranged from 7.06 to 8.84 on a nine-point scale, with variation coefficients ranging from 0.04 to 0.22. The percentage of full score for potential indicators ranged from 16% to 74%. In two rounds, the Kendall's W coefficients ranged from 0.423 to 0.535. The weights of structure, process and outcome were 0.175, 0.211 and 0.614, respectively.

Conclusion: We developed the first set of healthcare quality indicators for psychiatric hospitals in mainland China, and it will provide a standardized and meaningful guide to evaluate the healthcare quality of psychiatric hospitals across the country.

Keywords: China; Delphi; analytic hierarchy process; healthcare quality; psychiatric hospital; quality indicator.