以健康价值为导向的城市医疗集团绩效考核指标体系构建

Value-Based Construction of Performance Evaluation Index System for the Urban Heath Group Reform and Development

目的:以深圳市罗湖区政府的改革实践为例,初步探索以健康价值为导向的城市医疗集团的绩效考核评价指标体系构建,破解政府改革"放权不放手、放手不放心"、集团建设"形似神不似、联体不联心"、改革建设"理念设计多,工作落实少"三大困局.方法:深圳罗湖区政府通过明确政府功能定位、落实集团管理自主权、整合资源提升价值等改革措施,建立以区域医疗联合体为主的整合型医疗卫生服务体系,区政府对集团围绕健康绩效、运行绩效、管理绩效三个维度开展绩效考核.结果:对医联体建设绩效进行科学评价考核有助于正确评价医联体改革的政策效果,也将医联体功能从"疾病治疗组织"向"健康维护组织"转变,为实现价值医疗打下了坚实的基础.结论:以健康产出为目标的绩效考核评价是实现医联体建设改革效果的重要保障.

Objective: Taking the reform practice of Luohu District Government in Shenzhen as an example, it preliminarily explored the construction of performance evaluation index system of urban medical group guided by health value, and resolved the three predicaments of government reform:^decentralization without letting go, relaxation without reassurance”,group construction "without resemblance of spirit, union without reassurance", and reform construction with more concepts and less implementation. Methods: The government of Luohu District in Shenzhen had established an integrated medical and health service system based on Regional Medical Community by defining the government's functional orientation, implementing the autonomy of group management and integrating resources to enhance the value. The district government carried out performance appraisal in three dimensions: health performance, operation performance and management performance. Results: Scientific evaluation and the performance evaluation of the construction of the medical community were helpful to correctly evaluate the policy effect of the reform of the Medical Community. It also changed the functions of the medical community from "disease treatment organization” to “health maintenance organization”, laying a solid foundation for the realization of value medicine. Conclusion: The performance appraisal evaluation aimed as the health output was importment insurance for realizing the reform effect of medical unionconstruction.