基于平衡计分卡的宜宾市公立综合性医院绩效评估研究

Study of Performance Evaluation of Public Comprehensive Hospital Based on Credit Balance Card in Yibin

目的开展公立综合性医院绩效评估具有十分重要的意义。但是,通过文献检索发现,目前,国内还没有比较实用、权威的绩效评估体系和方法。因此,如何建立适应新形势下医疗卫生体制改革和医院管理需要的综合医院绩效评估体系,已成为卫生行政部门和医院管理者关注的焦点。本文在公立综合性医院绩效评估的指标体系和评估方法方面进行了研究,旨在提出一套科学、简约、实用的医院绩效评估体系和方法,供卫生行政部门和医院借鉴和运用。方法采用文献法,对美国、英国、日本等主要西方国家的医院绩效评估体系进行了比较,对国内医院评价的历史与现状也进行了回顾与分析。在此基础上,依据平衡计分卡思想,设计、选择影响医院绩效的指标体系,在财务、顾客、内部流程和学习与成长四个方面的40个指标中筛选出14项关键指标,通过特尔菲法、西肖尔模型和层次分析等方法科学确定指标权重,然后用层次分析法和综合指数法建立评估模型,并依据卫生行政部门统计数据和检查考核资料,对宜宾市的8家公立综合性医院进行评估运用,以检验评估方法的可行性和可信度。结果本研究的理论依据充分,评估体系模型构造简约而科学,并经实际运用检验,具有较好的实际效果;指标体系中的各项指标均为常用的、易于获取的、可量化的指标,通常在医疗卫生单位的统计报表中即可获取,使评估工作具有可操作性。结论本研究的指标体系、权重、评估模型与方法可供卫生行政部门和医院借鉴与运用。

Objective To study performance evaluation of public comprehensive hospitals. However,review of literature shows that currently there are still no relatively effective and authoritative performance evaluation system or methods in China. Therefore,how to establish a comprehensive hospital performance evaluation system based on the needs of the medical care system reform and hospital management has become a focus of attention for health administration departments and hospital managers. This paper studies the indexes system and the evaluation methodology of public comprehensive hospital performance evaluation, and intends to suggest a set of scientific,simple, and pragmatic hospital performance evaluation system and methods for health administration departments and hospitals to use and refer to. Methods The author of the paper uses literature review .to compare the hospital performance evaluation systems of leading western countries including the US, UK and Japan, etc., and reviews and analyzes the history and current status of hospital evaluation in China. Based on the literature review and the idea of credit balance card,the author designs and selects a system of indexes that affects hospital performance,picking out 14 core indexes out of 40 indexes covering the four aspects of finance, customer, internal process and learning and growth. The author then uses scientific methods such as Delphi method, Seashore model and analytic hierarchy process （AHP） to determine the weighing coefficient and establishes an evaluation model with AHP and comprehensive index method. The author utilizes data and checking and assessment information from health administrative departments and conducts evaluation of eight public comprehensive hospitals in Yibin City to examine the feasibility and reliability of the evaluation method. Results The study has a solid basis in its theoretic reference. The evaluation system model is simple, yet scientific. Furthermore,results of actual application show that it has satisfactory effect. All the indexes in the indexes system are common,easy to harvest, quantifiable, and generally available in the statistical report charts of medical institutions ,which gives operability to evaluation work. Conclusion Hospital may apply or use as a reference the index system, weighing coefficient, evaluation model, and methodology of this study.