伴随着我国经济!社会的快速发展,人民群众对医疗卫生的需求也越来越高 当前,造成/看病难!看病贵0问题的一个重要原因是,医疗卫生服务能力与人 民群众日益增长的医疗服务需求之间的矛盾越来越突出长期以来,中医药和西 医药互相补充!协调发展,共同担负着维护和增进人民健康的任务从全国范围 来看,提高我国医疗卫生服务能力工作的重点之一在于设计科学有效的医院绩效 评价方案,难点在于医院绩效评价指标体系的设计与实施县级政府提供的公共 服务占我国政府公共服务的绝大部分,县级政府提供的公共服务质量和效率是我 国建设服务型政府目标得以实现的重要影响因素县级中医院作为医疗服务主体 之一,中医药服务简便廉验,深受老百姓欢迎G省是一个农业人口占多数的西 部欠发达省份,中医药文化厚重,县级中医院绩效评价指标体系的设计与实施, 对于提高G省中医院服务绩效,满足人民群众日益增长的中医药服务需求,破解 /看病难!看病贵0问题,推动公立医院改革和发展等具有十分重要的现实意义 近年来,随着我国新一轮医疗卫生体制改革的逐步深入,政府在卫生事业建 设中的主导地位逐步确立,卫生事业的投入也逐渐加大,中医药事业也日见蓬勃 发展之势然而,我国中医药事业发展仍然存在一些不尽完善之处如中医药人 才流失严重,中医院特色不鲜明!倾向西化等这些都与我国中医院绩效评价体 系不够完善有密切的关系,如绩效评价指标单一!绩效评价单向度!未充分考虑 患者的医疗卫生服务需求等这些问题的存在,不仅造成了我国中医院绩效服务 效率低下,无法满足人民群众的医疗卫生服务需求,也在一定程度上制约了我国 经济社会的全面!协调和可持续发展因此,对县级中医院绩效评价的研究就显 得尤为重要 本文综合运用访谈法!文献研究和实地调查等方法,结合笔者多年的实际工 作经验,研究了G省县级中医院发展的绩效评价方案本文介绍了县级中医院 绩效评价的现状,剖析了存在的问题及主要原因;构建了G省县级中医院绩效 评价指标体系,包括基本目标与总体思路!评价对象与主体!评价工具与方法的 选择!评价指标体系设计!应用与实施及相关对策本文的初步结论是县级中医 院作为公立医院,必须担负起社会责任,体现县级公立医院的/公益性0;必须 将原来的/经济管理0模式转变为/绩效管理0模式,即以服务质量及工作量为 主;新设一计一的绩效评价方案必须以G省县级中医院现有的绩效考核体系为基础, 结合G省实际,使新设计的绩效评价方案更具有科学性和可行性 关键词:中医院,绩效评价,方案MPA学位论文作者:!一么G省县级中医院绩效评价方案侧卜究 ABSTRACT WiththeraPiddeveloPmentoftheeeonornyandsoeietyofoureountry,the demandofmediealandhealthofPeoPle15moreandmorehigh.AtPresent,thernain reasonleadtotheProblemof/Pooraeeessandhighfeetomediealserviee15thatthe eontradietionbetweenthemediealandhealthservieeabilityandPeoPle,5growing demandformediealserviee15moreandmoreProminent.Nationally,toraisethe mediealandhealthservieeabilityofourcountry,itshouldfoeusonthedesigningof seientifieandeffeetivehosPitalPerformaneeevaluationseheme,andthediffieulties arethedesignandimPlementationofhosPitalPerformaneeevaluationindexsystem. GProvinee15alessdeveloPedwestemProvineewhiehhasalargeagrieultural PoPulation,thedesignandimPlementationofhosPitalPerformaneeevaluationindex systemateounty一levelhaveveryimPortantPraeticalsignifieaneeonimProvingthe hosPital.5servieePerformaneeofGProvinee,meetingthePeoPle,5growingdemand formediealserviee,earefullygrasPingtheobjeetivelawofthedeveloPmentofour hosPitals,effeetivelyresolvingtheProblemof/Pooraeeessandhighfeetomedical servieeandPromotingthehosPitalreformanddeveloPment. Overtheyears,withthedeveloPmentofmediealandhealthsystemreformin China,thedominantPositionofthegovernmentintheeonstruetionofhealthserviee hasProgressivelyestablished,thehealthservieeoPerationmeehanismofoureountry hasbeenfurtherimProved,thehealthinvestment15alsoinereasinggraduallyandthe managementandbehaviorofstate一ownedhosPitalbeeomemoreseientificand standardized.However,therearestillsomeimPerfectioninmediealandhealthserviee inoureountry,suehas/Pooraeeessandhighfeetomediealserviee,theseriousdrain ofbrainofthehosPitals,the1055offeaturesandadvocatingwestemization.This PaPerarguesthattheseareassoeiatedwiththehosPitalPerformaneeevaluationin China15notPerfeetenough,suehasthesinglePerformaneeevaluationindex,the dimensionalityofPerformaneeevaluation,andtheydidnotfullyeonsiderthemedieal andhealthservieedemandofeustomerorPatients.TheexisteneeoftheseProblems, notonlyresultedintheloweffieieneyofourhosPitalserviee,andeannotsatisfythe healthservieesdemandofPeoPle,butalsotoaeertainextent,mayrestrietthe eomPrehensive,eoordinateandsustainabledeveloPmentoftheeeonomyandsoeietyM队学位论文作者:l石G省县级中医院绩效评价方案研究 ofoureountry.Therefore,thestudyonthePerformaneeevaluationoftraditional ChinesemedieinehosPitalateou爪y一IevelofGProvinee15PartieularlyimPortant. ThisPaPerusesinterviews,soeialsurveys,literatureandstatistiesmethods, conductin一dePthexPlorationandresearehontheinformationanddataofthe traditionalChinesemedieinehosPitalateounty一levelofGProvineewhiehhas colleeted,andeombinedwiththeauthor,5PraetiealexPerienee,thenmadeareseareh onthePerformaneeevaluationProgramoftraditionalChinesemedieinehosPitalofG Provinee.ThisPaperanalyzedthestatusquooftraditionalChinesemedieinehosPital ateounty一level,revealstheexistingProblemsandthemainreasons:ThenPuts forwardtheconstruetionofPerformaneeevaluationindexsystemoftraditional ChinesemedieinehosPitalofGProvinee一thebasiegoalandgeneralthought, evaluationobjectsandsubjeets,theehoieeofevaluationtoolsandmethods,thedesign ofevaluationindexsystem,theaPPlieationandimPlementationandsomerelated countermeasures.Finallydrawaeonelusion:traditionalChinesemedieinehosPitalat county一levelasaPubliehosPital,musttakesoeialresPonsibility,andrefleet0Publie benefit,.ofPubliehosPital;Mustehangetheoriginal/eeonomiemanagement0mode to/Performancemanagement0mode,andnamely,takethequalityofservieeand workloadastheimPortantthing;ThenewPerformaneeevaluationsehememusttake theexistingPerformaneeevaluationsystemofthetraditionalChinesemedieine hosPitalateounty一levelofGProvineeasthebasis,andeombinedwiththeaetual,to makethenewdesignofthePerformanceevaluationsehememoreseientifieand feasibility. Keywords:TraditionalChinesemedieinehosPital,Performaneeevaluation seheme 111M队学位论文作者:卜云G省县级中医院绩效评价方案研究 目录 一!导论.........................................1 (一)研究背景...........................................1 (二)研究意义...........................................2 (三)理论依据...........................................3 (四)研究思路与方法...............,..............10 二!G省县级中医院绩效评价现状!问题与原因分析.....12 (一)G省县级中医院概况与绩效评价现状...................12 (二)G省县级中医院绩效评价存在的问题...................16 (三)G省县级中医院绩效评价存在问题的原因分析...........18 三!G省县级中医院绩效评价指标体系构建,...........20 (一)县级中医院绩效评价指标体系构建基本目标与总体思路..20 (二)县级中医院绩效评价对象与主体......................21 (三)县级中医院绩效评价工具与方法选择..................21 (四)县级中医院绩效评价指标体系设计....................22 四!G省县级中医院绩效评价指标体系的应用与实施.....28 (一)实施机构)X县中医院.............................28 (二)实施流程...........................!..,!..30 (三)实施结果评估与反馈................................30 五!G省县级中医院绩效评价实施的配套措施..........32 (一)转变服务理念)坚持/以患者为中心0..............32 (二)制定长期绩效政策)制度化!法制化................33 (三)强化绩效沟通)激励机制..........................33 (四)加强内部管理)内部优化..........................34