公立医院绩效考核实施效果及对策探讨——广东省9所公立三级综合医院绩效评价结果分析

Implementation Effect and Countermeasures on Performance Appraisal of Public Hospitals——Analysis on the Performance Appraisal Results of 9 Three level Public Hospitals in Guangdong Province

目的建立具有广东特色的公立医院绩效考核机制,引导医院树立正确的办医方向,促进医院转变发展方式和管理模式,不断提高医疗服务质量和效率,增进医院的活力,实现医院的健康可持续发展。方法建立完善广东省三级公立医院绩效评价指标体系,通过社会效益、激励约束机制、运行效率与效益、质量与安全、可持续发展等5个维度(一级指标)和25个二级指标、39个三级指标,对广东省9所三级公立综合医院进行绩效考核试点。结果绩效考核成绩呈现三级分化态势,大部分医院成绩在均线以上。试点医院在考核中暴露出一些问题,也呈现出不少亮点。总的看来,医院坚守公立医院公益性质的精神内核,开展常见病、重大疾病规范化诊疗,加强精细化管理,重视医、教、研的全面发展。结论实践证明,公立医院绩效考核试点工作是成功的,考核指标体系基本可行,虽然仅仅经历了一年的时间,但促进了试点医院全面发展,实现了公立医院绩效考核的预期目的,为下一步全面推开这项工作打下了基础。

Objective To set up a performance appraisal mechanism for public hospitals with Guangdong character- istics, help formulate a sound operational guideline for public hospitals, accelerate a transformation for public hospitals in their development and management modes, steadily improve the quality and efficiency of their health care service and increase the vitality of public hospitals so as to achieve the sound and sustainable development of public hospitals. Methods Set up a perfect index system for performance appraisal of three - level public hospitals in Guangdong Province and initiate pilot pro- jects on performance appraisal of 9 three - level public hospitals under 5 first - level indexes of social benefits, incentive and disciplinary mechanism, operational efficiency and effectiveness, quality and security, and sustainability, 25 second - level indexes and 39 third - level indexes. Results There is a three - level polarization in the performance appraisal with the ma- jority of hospitals concerned standing above the average line. Generally speaking, public hospitals, which are firmly devoted to public good, provide standardized diagnosis and treatment of common disease as well as severe ones, advance delicacy management and attach great importance to the all - round development of medical treatment, teaching and research. Conclu- sion Practice has proved that the pilot projects on performance appraisal of public hospitals have been successful. The ap- praisal index system is basically feasible. The one - year - old system has promoted the all - round development of the select- ed hospitals, and accomplished the anticipated purpose of performance appraisal of public hospitals and lay a solid foundation for further overall implementation of the appraisal.