公立医院预算绩效管理问责对预算绩效的影响机制研究

A Research on the Influence Mechanism of Budget Performance Management Accountability on Budget Performance in Public Hospitals

为解决公立医院预算管理缺乏预算和管理底层逻辑支撑而导致预算责任不明、绩效管理流于形式等现实问题,本文基于社会交换理论,聚焦于公立医院预算绩效管理问责,从责任标准、执行、激励、监督四个维度构建结构方程模型,对这一重要管理举措影响预算绩效的机制展开研究。228份公立医院预算参与人员的问卷数据结果证实:(1)公立医院预算绩效管理问责能够有效提升预算绩效,其中责任激励的软性引导作用相对更明显;(2)公立医院预算绩效管理问责有利于建立高质量的员工-组织关系,其中社会交换关系的作用效果相对优于经济交换关系的作用效果;(3)员工-组织关系在预算绩效管理问责大幅提升预算绩效的过程中发挥中介作用。这为我国公立医院更好地围绕共同目标开展预算绩效管理提供了实践指导,实现绩效管理“事半功倍”。

To address the issues of unclear budgetary responsibilities and formalism of performance management due to the lack of logic support for budget and management,based on social exchange theory,this paper focuses on budget performance management accountability in public hospitals,constructs a structural equation model from the four dimensions of responsibility standards,execution,incentives and supervision to investigate the mechanism.The results of questionnaire data of 228 budgeting participants in public hospital were confirmed that(1)budget performance management accountability in public hospitals effectively enhances budget performance,in which the incentives is relatively more obvious;(2)budget performance management accountability is conducive to the establishment of high-quality employee-organization relationship,in which the effect of social exchange relationship is relatively better than that of economic exchange relationship;(3)employee-organization relationship plays an mediating role in the relationship between budget performance management accountability in public hospitals and budget performance.This provides practical guidances for public hospitals to carry out budget performance management around their common goals,and achieve“double the result with half the effort”in performance management.