标准化工作量法在京郊山区社区卫生服务机构绩效考核中的应用及问题探究

The application and problems of the standard chemical quantity method in the performance evaluation of the community health service institutions in the suburb of Beijing

目的了解京郊山区社区卫生服务机构运用标准化工作量法开展绩效考核的情况,分析考核效果及其影响因素并提出解决对策。方法在绩效工资总额限定的情况下,将考核可用于自主分配的绩效工资人为分成单项考核部分和月考核部分,再将月考核部分根据考核项目细分为工作数量、工作质量及满意度,每项对应一定的绩效工资,并根据该项考核结果进行发放。工作数量部分将一致性高的医疗服务项目的标准化工作量值直接与绩效工资挂钩,而岗位差异性大的部分将标准化工作量值转化为定性指标与绩效工资挂钩。结果 3年来,中心家庭医生签约服务人数年均增长4.68%,高血压规范管理率年均增长25.96%,糖尿病规范管理率年均增长27.37%,门诊诊疗人次年均增长31.26%;预防保健岗位工作人员本岗位工作量增长94.5%,家庭医生签约工作的工作量增长41.5%,医疗岗位工作人员本岗位工作量增长48.0%,家庭医生签约工作工作量增长83.1%。结论运用标准化工作量法在山区社区卫生服务机构开展绩效考核能够调动职工工作积极性,促进各项工作开展。但是标准化工作量法开展绩效考核工作,要对医疗服务项目进行分类,因此在医务人员较少的山区,对于家庭医生签约服务等一致性高、标准统一的服务项目,可以直接将标准化工作量值与绩效工资挂钩;对于差异性较大的服务项目,可以将定量资料转化为定性资料,充分体现绩效考核调动医务人员积极性、促进管理和提升综合服务水平的目的。

Objective To understand the situation of performance evaluation of community health service institutions in the suburb of Beijing,analyze the effect and influencing factors,and put forward countermeasures.Methods When the total amount of performance pay is limited,the performance pay that can be used for independent distribution can be divided into single assessment part and monthly assessment part.Then,the monthly assessment part is divided into work quantity,work quality and satisfaction according to the assessment items.Each item corresponds to a certain performance pay and is paid according to the assessment results.In the part of work quantity,the standardized work quantity of medical service projects with high consistency is directly linked to the performance salary,while in the part with large post difference,the standardized work quantity value is transformed into the qualitative index linked to the performance salary.Results For three years,the number of contracted family doctors increased by 4.68%annually.The standard management rate of hypertension increased by 25.96%every year.The standard management rate of diabetes increased by 27.37%every year.Annual growth of outpatient visits 31.26%.The workload of prevention and health care staff increased by 94.5%,41.5%increase in contracted work of family doctors.The workload of medical staff increased by 48.0%,83.1%increase in contracted work of family doctors.Conclusion Using the method of standard chemical work quantity to carry out performance appraisal in community health service institutions in mountainous areas can arouse the enthusiasm of workers.To promote the implementation of various work.But the standard chemical work quantity method develops the performance appraisal work to classify medical service items.Therefore,in mountainous areas with fewer medical staff,high consistency in signing up services for family doctors and standard agreed services can directly link the standard chemical work volume value with the performance salary.For services with large differences,quantitative data can be transformed into qualitative data to fully reflect the enthusiasm of performance appraisal,promote management and improve comprehensive service level.