基于标杆理论的公立医院现代化绩效管理的关键问题、范式创新与实现路径

Key Issues,Innovative Paradigms and Realization Paths of Modernized Performance Management in Public Hospitals under the Perspective of Benchmarking Theory

目的:基于标杆理论,阐述我国公立医院现代化绩效管理的关键问题、范式创新与实现路径,为政府和医院提供政策建议。方法:采用文献收集、专家咨询和原型设计等方法。结果:医院绩效管理的关键问题包括缺乏管理标准、多变量的动态指标体系和实现工具,未建立“数字技术+管理制度”的数字治理模式,未实现基于标准的地域、医院、科室、病种等之间的横向和纵向比对。创新范式包括建立基于病种、指数、床日、手术者、医生等最小功能单位的标准范式;构建动态指标库,挖掘不同指标排列组合和内在耦合关系,建立评价范式;建立病种纵向评价,“专科、医院、行业”评价,医院内部功能定位、资源效率、医疗质量评价的应用范式。结论:打造基于大数据的多变量、多维度、动态评估方式和可视化的评价工具和实现路径。解放思想,进一步提升数字治理的认知水平;创新范式,加快构建公立医院现代化绩效管理体系;搭建平台,推进公立医院现代化绩效管理体系应用。

Objective:Based on the benchmarking theory,to elaborate the key issues,paradigm innovations and realization paths of modernized performance management in China’s public hospitals,and to provide policy recommendations for the government and hospitals.Methods:Literature/document collection,expert consultation and prototyping were used as methodological support.Results:Hospital performance management lacks management standards,multivariate dynamic indicator systems and realization tools;the digital governance model of“digital technology+management system”has not been established;and horizontal and vertical comparisons among geographic regions,hospitals,departments,and disease types based on standards have not been realized.Innovative paradigms include the establishment of a standard paradigm based on the smallest functional units such as disease types,indexes,bed days,operators,doctors,etc.;the construction of a dynamic index library,the mining of different combinations of indexes and their internal relationships,and the establishment of an evaluation paradigm;the establishment of a longitudinal evaluation of disease types,the evaluation of“specialties,hospitals,and industries”,and the positioning of internal functions of hospitals,resource efficiency and the application of healthcare quality evaluation.It creates a multivariate,multidimensional,dynamic evaluation method and visualized evaluation tool and realization path based on big data.Conclusion:It is needed to emancipate the mind to further enhance the cognitive level of digital governance,innovate the paradigm to accelerate the construction of modernized performance management system in public hospitals,and build a platform to promote the application of modernized performance management system in public hospitals.