价值共创视角下公立医院绩效考核体系优化路径与实践

The Optimization Path and Practice of Public Hospital Performance Appraisal System from the Perspective of Value Co-creation

目的:通过对公立医院绩效考核体系的优化,提升公立医院公益属性,激发医护人员工作热情,使其医疗服务质量和水平持续提升。方法:在价值共创视角下考虑医院、患者、科室三方价值主体,引入DRG核心指标和RBRVS核算方法,构建公立医院医疗科室层面的绩效考核体系。结果:样本医院在应用基于DRG和RBRVS的医疗科室绩效考核体系中发现:科室医务人员绩效考核评价的公平性、医院运营能力的效率性、患者和科室医务人员的满意度均得到显著提升。结论:基于价值共创理论,样本医院绩效考核体系优化为费用控制考核、KPI指标考核和工作量考核3个维度,进而实现绩效考核工作目标和价值共创的结果变量相一致,促进医疗服务提供者的服务质量和数量达到均衡,促使医院、科室和患者的效益最大化。

Objective:To improve the public welfare attributes of public hospitals through the optimization of the performance ap⁃praisal system of public hospitals,stimulate the enthusiasm of medical staff,and continuously improve the quality and level of medi⁃cal services.Methods:From the perspective of value co-creation,the three-party value subjects of hospitals,patients and depart⁃ments are considered,and the core indicators of Diagnosis Related Group(DRG)and Resource-based Relative Value Scale(RBRVS)accounting methods are introduced to construct a performance appraisal system at the level of medical departments in public hospi⁃tals.Results:The sample hospital applied DRG and RBRVS-based medical department performance appraisal system,and found that the equity of performance evaluation,the efficiency of hospital operation ability,and the satisfaction of patients and medical staff were significantly improved.Conclusion:Based on the theory of value co-creation,the performance appraisal system of the case hos⁃pital is optimized into three dimensions:cost control assessment,KPI index assessment and workload assessment,so as to achieve consistency between performance appraisal work objectives,and the the result variables of value co-creation,promote the balance of service quality and quantity of medical service providers,and promote the optimization of the effect of hospitals,departments and pa⁃tients.