公立医院绩效考核背景下三级儿童专科医院质量效益变化

Changes in Quality and Benefit of Tertiary Children’s Specialized Hospitals under the Background of Public Hospitals Performance Assessment

目的:探索公立医院绩效考核指标推动下三级儿童专科医院质量效益变化;方法:以南京市某三级儿童专科医院为例,紧扣国家公立医院绩效考核关键性指标,构建医院层面综合目标绩效考核管理体系,分析比较绩效考核前后医院质量、效益指标变化;结果:绩效考核后代表医院质量的四级手术率、微创手术占比、危重病人占比、手卫生依从性、洗手正确率较前有明显上升,出院病人常见病种占比明显下降;代表效益的医疗服务收入、日间手术占比较前上升,次均药费及百元收入中卫生材料消耗均得到有效控制;代表可持续发展的每百名医务人员科研经费上升。结论:围绕国家公立医院绩效考核指标的医院综合目标绩效考核管理体系有效改善了医院质量与效益指标,推动了医院病种结构调整,促进了儿科常见病及多发病向基层医院下沉,医院科技能力逐步提升。

Objective:To explore the changes of quality and benefit oftertiary children’s specialized hospitals driven by the public hospitals performance assessment indexes.Methods:Taking acertain tertiary children’s specialized hospital in Nanjing as an example,the paper constructs the comprehensive target performance assessment management system at the hospital by closely following the key indicators of public hospitals performance assessment,and analyze and compare the changes of quality and benefitindexes before and after performance assessment.Results:After the performance assessment,the four-level operation rate,the proportion of minimally in⁃vasive surgery,the proportion of critically ill patients,the compliance of hand hygiene and the correct rate of hand washing represent⁃ing the quality of the hospital have increased significantly,and the proportion of common diseases of discharged patients has decreased significantly.The income of medical services and the proportion of daytime surgery representing benefits have increased compared with the previous year,and the average drug cost per time and thehealth material consumption per 100 yuan income has been effectively con⁃trolled.The scientific research funds per 100 medical personnel representing sustainable development has increased.Conclusion:The hospital comprehensive target performance assessment management system around the national public hospital performance assess⁃ment indexes has effectively improved the hospital quality and benefit indexes,promoted the structural adjustment of hospital diseases,promoted the common and frequently occurring diseases in pediatrics to sink to grass-roots hospitals,and gradually improved the scien⁃tific and technological ability of the hospital.