基于五项核心指标的公立医院高质量发展路径探析

Exploring the high-quality development path of public hospitals based on five core indicators

高水平公立医院高质量发展试点目标确定的五项核心指标及目标值,即病例组合指数达到2左右,四级手术占比、技术服务性收入占医疗收入比例、人员支出占业务支出比例、人员薪酬中固定部分占比均达到60%,是评价公立医院发展质量和效益的核心指标。本研究从医院内部改革创新举措以及"三医"协同发展和治理的角度出发,结合某所高质量发展试点医院现状,逐一梳理针对五项核心指标的优化提升举措,并提出当前"三医"协同发展和治理推进公立医院高质量发展的发力点,包括落实政府投入责任、理顺医疗服务比价关系、深化医保支付方式改革、加快药品耗材集中采购扩面、促进前沿技术产品应用等,以期为深入推动公立医院高质量发展提供参考。

The five core indicators(the case mix index,the proportion of level-4 surgery,the proportion of technical service income in medical income,the proportion of personnel expenditure in business expenditure,and the proportion of fixed part in personnel salary)and target values determined by the pilot goal of high-quality development of high-level public hospitals jointly built by National Health Commission and Provincial Government had become the core indicators for evaluating the quality and efficiency of public hospital development.The authors proposed the optimization and improvement measures for the five core indicators one by one from the internal reform and innovation in hospitals,as well as the synergetic development and governance of"insurance-medical-medicine linkage",combined with the current situation of a pilot hospital.The authors also proposed the starting points and driving force for promoting the high-quality development of public hospitals through the synergetic development and governance of"insurance-medical-medicine linkage",including implementing government investment responsibilities,streamlining the price evaluation of medical services,deepening the reform of medical insurance payment,accelerating the expansion of drug and consumable procurement,and promoting the application of advanced technologies and products,in order to provide reference for the in-depth promotion of high-quality development of public hospitals.