】——周明华 谭红 何思长 赵大仁
【摘要】目的 对我国公立医院绩效考核政策进行评述，为推动我国公立医院绩效考核提供参考。方法 从宏观、中观、微观3个层面，按照坚持公益性、调动积极性和提升群众获得感三个方面，从利益相关者角度进行绩效考核政策分析。结果 宏观层面将公立医院综合改革纳入绩效考核，中观层面建立健全绩效考核指标体系,对院长年度工作进行考评，微观层面主要是以服务质量和效率为核心。坚持公益性要建立健全以公益性质为核心的绩效考核体系，调动积极性要充分发挥绩效考核的激励、导向作用，提升群众获得感主要是控制医疗费用。利益相关者在公立医院绩效考核中利益损益各有不同。结论 宏观层面顶层设计不够清晰，需建立健全行政能力考核机制；中观层面多部门治理协调性不足，需要加强部门联动性；微观层面绩效考核配套政策缺位，需落实考核指标的范围和内容。
【关键词】公益性；积极性；公立医院；绩效考核；政策分析
中图分类号：R197.322文献标识码：A
Analysis of Performance Appraisal Policy of Public Hospitals in China from the Perspective of Public Welfare and Enthusiasm/ZHOU Minghua,TAN Hong,HE Sichang,et al.//Chinese Health Quality Management，2020,27(6):107-110
Abstract Objective To review the performance appraisal policy of public hospitals in China, and provide reference for promoting the performance appraisal of public hospitals in China.Methods The performance appraisal policy analysis was based on the three aspects of macro, meso and micro, in terms of adhering to public welfare, mobilizing enthusiasm and enhancing the sense of gain of the masses, from the perspective of stakeholders.Results At the macro level, comprehensive reform of public hospitals was incorporated into performance appraisal. At the meso level, a performance appraisal indicator system was established and the dean's annual work was evaluated. The micro level was mainly based on service quality and efficiency. Adhere to the public welfare, it must establish and improve the performance appraisal system with the public welfare nature as the core. To mobilize the enthusiasm, it must give full play to the incentive and guiding role of performance appraisal,and take the control medical expenses as the core to improve the sense of gain of the masses. Stakeholders had different interests and benefits in the performance appraisal of public hospitals.Conclusion The top-level design at the macro level was not clear enough, and it was necessary to establish a sound administrative capacity assessment mechanism. The coordination of multi-sectoral governance at the meso level was insufficient, and it was necessary to strengthen departmental linkage. The micro-level performance appraisal supporting policy was absent, and the scope and content of the appraisal indicators needed to be implemented.
Key words Public Welfare; Enthusiasm; Public Hospitals; Performance Appraisal; Policy Analysis
Firstauthor's address Luzhou People's Hospital, Luzhou, Sichuan, 646000, China
2019年1月，国务院办公厅公布了《关于加强三级公立医院绩效考核工作的意见》，明确了55个绩效考核指标，随后国家卫健委办公厅公布了《国家三级公立医院绩效考核操作手册（2019版）》，对指标进行了详细的释义，三级公立医院绩效考核正式开始。维护公益性、调动积极性是医药卫生体制改革的根本方向和核心任务［1］；公立医院改革的重要任务是体现公益性，核心是医务人员职业行为的公益性［2］。公立医院既要接受国家的绩效考核，努力维护公益性，也要开展内部绩效考核，降低服务成本、提高医疗质量［3］，调动医务人员的积极性，更好地提升群众看病就医获得感。本研究搜集和整理了我国公立医院绩效考核相关政策文献，总结各个层面政策的内容和特点，分析存在的问题和不足，为推动我国公立医院绩效考核提供参考。
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