[1]钮登魏靖高晶.上海市家庭医生签约服务绩效考核指标体系的合理性评价[J].中国卫生质量管理,2023,30(03):87-92.[doi:10.13912/j.cnki.chqm.2023.30.3.18 ]
　NIU Deng,WEI Jing,GAO Jing.The Rationality Evaluation of the Performance Evaluation Index System of Contracted Service for Family Doctors in Shanghai[J].Chinese Health Quality Management,2023,30(03):87-92.[doi:10.13912/j.cnki.chqm.2023.30.3.18 ]

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上海市家庭医生签约服务绩效考核指标体系的合理性评价

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 第30卷期数: 2023年03期页码: 87-92 栏目: 基层卫生质量出版日期: 2023-03-15

Title:: The Rationality Evaluation of the Performance Evaluation Index System of Contracted Service for Family Doctors in Shanghai

作者:: 钮登魏靖高晶; 上海市徐汇区徐家汇街道社区卫生服务中心

Author(s):: NIU Deng; WEI Jing; GAO Jing; Community Health Service Center of Shanghai Xuhui District Xujiahui Sub-District

关键词:: 家庭医生; 签约服务; 绩效考核; 指标体系; 合理性; SMART原则; 结构-过程-结果模型理论

Keywords:: Family Doctor; Contract Service; Performance Evaluation; Index System; Rationality; SMART Principle; Structure-Process-Result Theory

分类号:: R197.6

DOI:: 10.13912/j.cnki.chqm.2023.30.3.18

文献标志码:: A

摘要:: 目的对上海市家庭医生签约服务绩效考核指标的合理性进行评价，为指标修订提供参考。方法利用半结构访谈法，借助SMART原则和结构-过程-结果模型理论框架，设计调查问卷。对上海市徐汇区13家社区卫生服务中心的229名家庭医生和26名家庭医生管理者进行调查。采用EXCEL 2016和SPSS 25.0软件对数据进行整理分析。结果上海市家庭医生签约服务关键绩效考核指标体系共涵盖22个指标，家庭医生管理者在指标SMART总分以及各维度上评分显著高于家庭医生（P＜0.001），签约居民人均医保费用、签约居民因高血压相关疾病住院比例、签约居民因糖尿病相关疾病住院比例得分均较低。22个指标可聚类为5类，各类指标可实现性欠佳。除过程评价外，各类指标的结构和结果评价平均得分均具有统计学意义（P＜0.001）。结论家庭医生与家庭医生管理者对签约服务绩效考核指标评价存在差异。可实现性欠佳是考核指标存在的主要问题。家庭医生签约服务绩效考核指标体系的制订应征询家庭医生意见，更多地考虑家庭医生发展现状，以符合现阶段家庭医生工作实际。

Abstract:: ObjectiveTo evaluate the reasonableness of the performance evaluation index of contracted service of family doctors in Shanghai, and to provide reference for the revision of the index.MethodsUsing semi-structured inter view method,a questionnaire was designed with the help of SMART principle and structure-process-result theoretical framework. 229 family doctors and 26 family doctor managers from 13 community health service centers in Xuhui District of Shanghai were investigated. EXCEL 2016 and SPSS 25.0 software were used to sort out and analyze the data.ResultsThere were 22 indicators in the key performance evaluation index system of family doctor contract service in Shanghai, and the scores on the total SMART and all dimensions of family doctor managers were significantly higher than those of family doctors (P< 0.001). The per capita medical insurance cost of signed residents, the proportion of signed residents hospitalized for hypertension-related diseases, and the proportion of signed residents hospitalized for diabetes-related diseases were all lower. The 22 indicators can be clustered into 5 categories, and the realizability of all indicators was poor. Except for the process evaluation, the average scores of each index in the structural and outcome evaluation were statistically significant (P< 0.001).Conclusion There were differences between family doctors and family doctor managers in the evaluation of contract service performance evaluation indicators. The poor realization was the main problem of evaluation index. The establishment of the performance evaluation index system of the contracted service of family doctors should consult the opinions of family doctors, and more consideration should be given to the development status of family doctors, which is in line with the practical work of family doctors at the present stage.

参考文献/References:

［1］上海市卫生健康委员会.关于印发《本市家庭医生签约服务费实施细则》的通知：沪卫基层〔2018〕9号［Z］.2018-11-19. ［2］张凯.公立医院内部绩效考核与SMART原则［J］.中国医药科学，2018，8（14）：254-257. ［3］陈丽，王素平，周红玉，等.结构-过程-结果三维评价模式在科室管理中的价值［J］.中医药管理杂志，2020，28（17）：41-42. ［4］杨水光，马可.家庭医生签约服务政策执行的阻滞因素与优化路径［J］.卫生经济研究，2022，39（3）：56-59. ［5］王芮平.企业员工绩效考核工作的实践与思考［J］.经济师，2020（7）：261-262. ［6］杨建玲，朱洪其，魏新萍，等.家庭医生签约服务模式下全科团队年度考核指标体系构建［J］.中国卫生质量管理，2022，29（1）：86-90. ［7］孙彩霞，司驷骏，蒋锋，等.我国家庭医生签约服务绩效评价指标体系构建研究［J］.中国全科医学，2021，24（34）：4378-4385.

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更新日期/Last Update: 2023-03-15