背景:随着经济发展和社会进步，公众健康需求发生转变，康复医学的重要 性日益凸显。全球康复服务市场需求持续增长，我国康复医疗机构数量不断增加， 但康复服务质量管理水平参差不齐。现有质量评估体系在康复治疗过程考核、指 标体系适用性及质量改进循环构建等方面仍存在不足。国际上基于 SPO (Structure, Process, Outcome)理论的质量控制实践已取得一定成效，为我国提 供了重要的经验借鉴。因此，构建符合我国国情的康复治疗质量控制指标体系， 提升康复医疗质量管理水平，具有重要的现实意义。

目的:基于 SPO 理论，构建适用于康复专科医院和综合医院康复医学科的康 复治疗质量控制指标体系，筛选并整合评价指标，确定各层级指标权重，为临床 实践、政策制定及医疗资源配置提供数据支持。

方法:检索国内外文献数据库，收集权威机构政策文件，分析并总结康复治 疗质量控制相关研究成果。初步构建包含结构、过程、结果 3 个一级维度，10 个 二级维度，67 个三级维度的指标体系框架。随后，成立专家小组，选取 28 名符 合条件的专家，开展两轮德尔菲函询，根据专家意见对指标进行调整，最终确定 指标体系。进一步建立层次结构模型，邀请专家对各层级指标进行两两重要性比 较，采用和积法计算判断矩阵相对权重，并进行一致性检验。

结果:专家组成员来自 3 个省市的 19 所康复医院，第一轮问卷有效回收率 为 78.57%，第二轮为 100%。两轮函询共调整指标 41 项，最终形成包括 3 项一 级指标、11 项二级指标、87 项三级指标的康复治疗质量控制指标体系。两轮专 家权威系数分别为 0.90 和 0.91。构建的层次结构模型包括总目标层、准则层和 指标层，各级指标均通过一致性检验。结构维度、过程维度和结果维度的权重分 别为 0.3460、0.3493 和 0.3047。其中，每床康复治疗师配比、三级治疗师负责制 执行率、日常生活活动(ActivitiesofDailyLiving,ADL)改善率等指标权重较高。

结论:本研究构建的康复治疗质量控制指标体系，其权重分配遵循过程优先、 动态平衡的设计原则，为卫生行政部门制定专科质量评价标准提供了科学依据， 也可作为医院开展质量自评与持续改进的参考工具。然而，本研究仍存在一定局 限性，例如专家意见可能受到地域及文化因素的影响，指标体系尚未经过大规模 实证研究的验证。因此，未来需开展多中心实证研究，以进一步优化指标的敏感 性和适用性，确保其在不同机构和环境中的推广应用价值。

Background: With the economic development and social progress, the public's health demands have shifted, and the importance of rehabilitation medicine has become increasingly prominent. The demand in the global rehabilitation service market continues to grow, and the number of rehabilitation medical institutions in China is constantly increasing. However, the quality management level of rehabilitation services varies widely. The existing quality assessment system still has deficiencies in aspects such as the assessment of the rehabilitation treatment process, the applicability of the indicator system, and the construction of the quality improvement cycle. Internationally, quality control practices based on the SPO (Structure, Process, Outcome) theory have achieved certain results, providing important experience and references for China. Therefore, it is of great practical significance to establish a quality control indicator system for rehabilitation treatment that is in line with China's national conditions and to improve the quality management level of rehabilitation medical care.

Objective: Based on the SPO theory, construct a quality control indicator system for rehabilitation therapy applicable to specialized rehabilitation hospitals and rehabilitation departments of general hospitals, screen and integrate evaluation indicators, determine the weights of indicators at each level, and provide data support for clinical practice, policy formulation, and medical resource allocation.

Methods: Search databases of domestic and foreign literature, collect policy documents of authoritative institutions, analyze and summarize relevant research results on quality control of rehabilitation treatment. Initially, an index system framework has been constructed, which includes three first-level dimensions of structure, process, and result, ten second-level dimensions, and 67 third-level dimensions. Subsequently, establish an expert group, select 28 eligible experts, conduct two - round Delphi inquiries, adjust the indicators according to expert opinions, and finally determine the indicator system. Further establish a hierarchical structure model, invite experts to compare the importance of indicators at each level pairwise, calculate the relative weights of the judgment matrix using the sum - product method, and conduct consistency tests.

Results: The members of the expert group are from 3 rehabilitation hospitals in 19 provinces and cities. The effective recovery rate of the first-round questionnaire is 78.57%, and the recovery rate of the second round reaches 100%. A total of 41 indicators were adjusted in the two rounds of Delphi inquiries. Ultimately, a quality control indicator system for rehabilitation treatment came into being. The system encompasses three first - level indicators, eleven second - level indicators, and eighty - seven third - level indicators. As for the expert authority coefficients, those of the two rounds reach 0.90 and 0.91 respectively. The constructed hierarchical structure model includes the general objective layer, the criterion layer, and the indicator layer, and all indicators at all levels have passed the consistency test. The weights of the structure dimension, process dimension, and outcome dimension are 0.3460, 0.3493, and 0.3047 respectively. Among them, indicators such as the ratio of rehabilitation therapists per bed, the implementation rate of the three-level therapist responsibility system, and the improvement rate of ADL have relatively high weights.

Conclusion: The quality control indicator system for rehabilitation treatment constructed in this study follows the design principles of process - priority and dynamic balance in weight allocation. It provides a scientific basis for the health administrative department to formulate specialist quality evaluation standards and can also be used as a reference tool for hospitals to conduct quality self - evaluation and continuous improvement. However, this study still has some limitations. For example, expert opinions may be affected by regional and cultural factors, and the indicator system has not been verified by large - scale empirical research. Therefore, in the future, multi - center empirical research needs to be carried out to further optimize the sensitivity and applicability of the indicators and ensure their promotion and application value in different institutions and environments.