近年来,医疗机构陆续建立以公益性为导向的绩效分配制度,充分利用以资源为基础的相对价值比率(resource-based relative value scale,RBRVS)等方法和经验,将技术水平、疑难系数、工作质量、患者满意度等作为绩效分配重点考核指标,使医...近年来,医疗机构陆续建立以公益性为导向的绩效分配制度,充分利用以资源为基础的相对价值比率(resource-based relative value scale,RBRVS)等方法和经验,将技术水平、疑难系数、工作质量、患者满意度等作为绩效分配重点考核指标,使医务人员收入真正体现劳动价值和技术价值,实现优绩优酬。口腔专科医院具有“大门诊小病房”特色,口腔患者更需要一个团队为其提供优质、有效的个体化综合性治疗方案。文章以口腔正畸学科为例,重点分析某口腔医院在实行绩效二次分配过程中遇到的痛点及难点,旨在多维度探讨主诊医师负责制在口腔专科医院的应用,加快推进绩效核算在二次分配层面的落实,提升工作积极性,实现医务人员及患者的“双满意”。展开更多
Studies examining the trends in public trust in physicians have provided a considerable amount of valuable policy implications for policymakers compared with cross-sectional studies on this topic in many countries. Th...Studies examining the trends in public trust in physicians have provided a considerable amount of valuable policy implications for policymakers compared with cross-sectional studies on this topic in many countries. This study investigated changes in public trust in physicians in China based on two cross-sectional national surveys conducted in 2011 and 2016 and identified the determinants of these changes. The results indicated 83.4% of respondents in 20H reported trust or strong trust in physicians in China, which decreased to 64.2% by 2016. The results of ordinal logistic regression demonstrated that public trust in physicians in China had decreased significantly from 2011 to 2016 (P < 0.001) after adjusting for other independent variables. Selfreported health status, self-rated happiness, and self-identified social class were all associated positively with public trust in physicians in China. The results also confirmed that decreasing public satisfaction with the most recent treatment experience was the major determinant of decreasing public trust in physicians in China. The findings of this study suggest that decreasing public trust in physicians deserves considerable attention from national policymakers and that improving satisfaction with treatment experiences would be the most effective strategy for enhancing public trust in physicians in China.展开更多
绩效管理是公立医院高质量发展的重要支撑。DS医院通过建立RBRVS(以资源为基础的相对价值比率)绩效管理方案,构建医师工作量RBRVS规则体系和绩效成本RBRVS规则体系,特别是采用体现医务人员劳务价值的诊疗组模式,为资深带组医师带来了更...绩效管理是公立医院高质量发展的重要支撑。DS医院通过建立RBRVS(以资源为基础的相对价值比率)绩效管理方案,构建医师工作量RBRVS规则体系和绩效成本RBRVS规则体系,特别是采用体现医务人员劳务价值的诊疗组模式,为资深带组医师带来了更高的声誉和激励,形成良好的“医学研”生态竞争模式。在医师工作量RBRVS规则体系方面,医院将参与医疗绩效管理的科室分为六类,对研判、执行、服务量进行分类评价,借鉴美国联邦医疗保险对医师支付口径的项目统计方式,比照CPT(cost per treatment,每次治疗费用)编码对不同资源消耗的项目赋予相应点值。在绩效成本RBRVS规则体系方面,DS医院的成本核算可分为四类。一是人力成本。二是不计入患者承担费用的卫生材料成本。三是固定资产折旧、商品和服务支出等其他执业成本。四是床单元成本。这一系统化的考核和分配方式促进了考核标准的多维度结合,初步达成了精细化管理的目标。展开更多
文摘近年来,医疗机构陆续建立以公益性为导向的绩效分配制度,充分利用以资源为基础的相对价值比率(resource-based relative value scale,RBRVS)等方法和经验,将技术水平、疑难系数、工作质量、患者满意度等作为绩效分配重点考核指标,使医务人员收入真正体现劳动价值和技术价值,实现优绩优酬。口腔专科医院具有“大门诊小病房”特色,口腔患者更需要一个团队为其提供优质、有效的个体化综合性治疗方案。文章以口腔正畸学科为例,重点分析某口腔医院在实行绩效二次分配过程中遇到的痛点及难点,旨在多维度探讨主诊医师负责制在口腔专科医院的应用,加快推进绩效核算在二次分配层面的落实,提升工作积极性,实现医务人员及患者的“双满意”。
基金This study was supported by the SMC-Chenxing Foundation of Shanghai Jiao Tong UniversityPhilosophy and Social Science Foundation of Shanghai (No. 2014BGL002).
文摘Studies examining the trends in public trust in physicians have provided a considerable amount of valuable policy implications for policymakers compared with cross-sectional studies on this topic in many countries. This study investigated changes in public trust in physicians in China based on two cross-sectional national surveys conducted in 2011 and 2016 and identified the determinants of these changes. The results indicated 83.4% of respondents in 20H reported trust or strong trust in physicians in China, which decreased to 64.2% by 2016. The results of ordinal logistic regression demonstrated that public trust in physicians in China had decreased significantly from 2011 to 2016 (P < 0.001) after adjusting for other independent variables. Selfreported health status, self-rated happiness, and self-identified social class were all associated positively with public trust in physicians in China. The results also confirmed that decreasing public satisfaction with the most recent treatment experience was the major determinant of decreasing public trust in physicians in China. The findings of this study suggest that decreasing public trust in physicians deserves considerable attention from national policymakers and that improving satisfaction with treatment experiences would be the most effective strategy for enhancing public trust in physicians in China.
文摘绩效管理是公立医院高质量发展的重要支撑。DS医院通过建立RBRVS(以资源为基础的相对价值比率)绩效管理方案,构建医师工作量RBRVS规则体系和绩效成本RBRVS规则体系,特别是采用体现医务人员劳务价值的诊疗组模式,为资深带组医师带来了更高的声誉和激励,形成良好的“医学研”生态竞争模式。在医师工作量RBRVS规则体系方面,医院将参与医疗绩效管理的科室分为六类,对研判、执行、服务量进行分类评价,借鉴美国联邦医疗保险对医师支付口径的项目统计方式,比照CPT(cost per treatment,每次治疗费用)编码对不同资源消耗的项目赋予相应点值。在绩效成本RBRVS规则体系方面,DS医院的成本核算可分为四类。一是人力成本。二是不计入患者承担费用的卫生材料成本。三是固定资产折旧、商品和服务支出等其他执业成本。四是床单元成本。这一系统化的考核和分配方式促进了考核标准的多维度结合,初步达成了精细化管理的目标。
