应用RSR动态综合评价医院临床手术科室绩效的探讨

Discussing the dynamical and comprehensive evaluation on the performance of surgery department by RSR method

目的:探讨用RSR动态综合评价医院临床手术科室绩效。方法:建立反映医疗指标同比增幅,以及手术工作负荷与效率2个方面的绩效评价指标体系,采用秩和比法(RSR)对某院9个临床手术科室2008～2009年绩效进行纵向动态的加权综合评价。结果(1)总体评价,以RSR表达的2009年各项医疗指标同比增长水平较2008年略有下降(2008年:0.5506±0.1691,2009年:0.5050±0.2352)(t=0.7241,P=0.4896);手术负荷的绩效水平2009年比2008年相比有明显提升(t=3.2741,P=0.0013)。综合以上2个方面来看,2009年手术科室总体绩效水平较2008年有所下降,但统计学意义不显著(t=0.4321,P=0.6771)。(2)普外科、妇产科、眼科、耳鼻咽喉科2009年度绩效提升明显(P<0.05);而骨科、泌尿外科2009年度绩效下降明显(P<0.05)。结论:采用秩和比法(RSR),将多种指标进行分类分析,可以从不同层面,不同侧面反映被评价单位的总体水平,有助于发掘更深层问题。医院管理者可以藉此从多个侧面分层次地了解临床科室工作情况,对客观全面地评价临床手术科室的工作绩效、考核临床科主任履行岗位职责情况有重要价值。

Objective To discuss the dynamical and comprehensive evaluation on the performance of surgery department by RSR method.Methods The index system for evaluating performance was developed,which defined the increment of main medical indexes,quantity and efficiency of operations.Rank Sum Ratio（RSR） method was adopted to comprehensively evaluate the weighted performance of nine surgery departments from 2008 to 2009.Results The increment of main medical indexes defined by RSR declined in 2009 than that in 2008.While the quantity and efficiency of operations significantly increased in 2009 than that in 2008.It can be concluded that the comprehensive performance decreased in 2009 than that in 2008.As for the department,performances of surgery,gynecology and the obstetrics,ophthalmology and ENT significantly increased in 2009（P〈0.05）,but performances of orthopedics and urology significantly decreased in 2009（P〈0.05）.Conclusion The method of Rank Sum Ratio（RSR） can be applied to evaluate performance with different indexes,and from many aspects.Furthermore,it would be helpful to find out problems for development.