Development of a Delphi–AHP evaluation framework for medical collaboration in tertiary hospitals: a multicenter study with preliminary feasibility assessment

Medical collaboration has been increasingly adopted to improve care coordination and optimize healthcare resource utilization. However, standardized approaches for evaluating the performance of medical collaboration initiatives remain limited. This study aimed to develop a structured evaluation framework for medical collaboration and examine its preliminary operational feasibility in real-world settings. A multi-dimensional evaluation framework was developed through a literature review and a two-round Delphi consultation involving 15 experts, and the relative weights of its domains and indicators were determined using the Analytic Hierarchy Process (AHP). Preliminary operational feasibility was examined by assessing whether selected indicators could be identified, obtained, and organized using routinely collected data from tertiary hospital collaboration projects. The final framework comprised six primary domains and fifteen secondary indicators. The expert authority coefficient was 0.76, and all judgment matrices met the consistency requirements (CR < 0.1). In the preliminary application, routinely collected data on selected indicators, including bidirectional referrals, service volume, and bed utilization, could be identified, obtained, and organized within the proposed framework. Descriptive increases were observed in bidirectional referral activities, outpatient visits, hospital admissions, and bed utilization during the study period. As the pilot application did not include complete measurement of all 15 secondary indicators, domain-level and overall collaboration scores were not calculated. A Delphi–AHP-based evaluation framework for medical collaboration was developed and demonstrated preliminary operational feasibility in organizing selected indicators using real-world data. The proposed framework provides a methodological basis for the structured assessment of medical collaboration projects, although future research is required to establish and formally validate a complete scoring system. A Delphi–AHP-based framework was developed for evaluating medical collaboration in tertiary hospitals. The framework incorporates multiple dimensions of healthcare collaboration performance and management. Preliminary real-world application demonstrated the operational feasibility of organizing selected indicators using routinely collected data.