财政养医体制下基层医疗卫生机构绩效管理制度的缺陷

Studying on the defects of performance management system of grass-roots medical institutions in finance system

在财政养医体制下,在基层医疗卫生机构引入绩效管理制度,是提升医疗绩效的必然选择。文章以绩效财政补偿机制与收支两条线制度的"悖论",及绩效工资分配制度与定岗定编制度的"悖论"为切入点,提出基层医疗卫生机构绩效管理制度必然"失灵"的核心观点。然后从指标、信息、归因和奖惩四个方面探讨基层医疗机构绩效管理制度失灵的原因,并得出结论:考核指标难以科学、绩效信息难以充分、绩效归因难以准确,绩效奖惩难以公正是基层医疗机构绩效管理制度失灵的主要原因。

The introduction of performance management system in grass-roots medical institutions was the inevitable choice to promote the performance of medical services in finance system： Starting from the paradox between fiscal-compensation mechanism and separation of revenue and expenditure system, and paradox between performance salary system and constitution-post immobility system,the viewpoint of inevitable failure of performance management system of grass-roots medical institutions was put forward, which was analyzed from four aspects of indexes, information, attribution and rewards and punishment. Based on which, it can be concluded that its main reasons were unscientific indexes, insufficient performance information, inaccurate performance attribution, and unfair performance rewards and punishment system.