Abstract:

Objective To construct a scientific quality evaluation indicator system aligned with hospice care practice in China，and to provide a standardized reference for service homogenization and specialty nursing talent training. Methods Taking Donabedian’s Structure-Process-Outcome（SPO） model as the framework，an initial indicator pool was formed through systematic literature review and policy text analysis at national，provincial-municipal and institutional levels. Two rounds of anonymous Delphi consultation were conducted with 21 multidisciplinary experts from eight provinces and municipalities in China. The Analytic Hierarchy Process （AHP） was used to calculate the combined weights of each indicator. Two palliative care specialty nurses used this evaluation index system to conduct a retrospective application evaluation on the case data of 30 patients. Results The effective response rates of the two rounds of consultation were 100% and 95%，respectively. The expert authority coefficient was 0.916，and Kendall’s coefficients of concordance were 0.087 and 0.110，respectively（both P<0.001）. The final system comprised three first-level，13 second-level，and 44 third-level indicators. Process quality had the highest weight（0.474），covering full-scenario care across institution，community，and home settings. Preliminary clinical application evaluation showed good inter-rater reliability（ICC=0.823，P<0.001），with an average evaluation time of 25.4 minutes per case. Conclusion The constructed indicator system aligns with relevant policies and practice guidelines and shows preliminary feasibility in the inpatient setting. Further studies are needed to examine the applicability and performance of the indicators in community and home care settings.

Key words: Hospice Care, Health Service Quality Evaluation, Delphi Method, Indicator System, Nursing