Developing online medical service quality indicators in China from the perspective of online and offline integration: a modified Delphi-analytic hierarchy process study

Online medical services (OMSs) are developing rapidly worldwide, and policies encourage the integrated development of online and offline services in China. However, there is a lack of comprehensive and systematic quality indicators for OMSs to ensure patients' safety. This study aimed to construct a set of quality indicators from the perspective of online and offline integration to provide a basis for the evaluation and management of OMS quality. Based on the literature review, we included 53 potential indicators. In two rounds of consultations, we invited 21 and 19 experts, respectively, to rate the importance and feasibility of each indicator via email. We used the modified Delphi method and analytic hierarchy process to determine the final indicators and their weights. We used experts' positive coefficient, authority coefficient, and opinion coordination degree to test the reliability and validity of experts. After two rounds of Delphi consultation, the experts' positive coefficients were 90.48% and 89.47%, respectively, and the authoritative coefficients were both >0.7. An OMS quality index system for public hospitals in China was developed with 4 primary indicators, 13 secondary indicators, and 34 tertiary indicators. Among the primary indicators, the weights of structure, process, outcome, and integration quality were 0.22, 0.26, 0.34, and 0.18, respectively. We constructed the first set of OMS quality indicators for public hospitals in China from the perspective of online and offline integration. It could be applied as a standardized and meaningful guide for OMS evaluation and quality development.