分级诊疗背景下基层医疗卫生机构基本医疗服务绩效考核指标体系探讨

目的 在分级诊疗的背景下,尝试建立一套客观、合理的基层医疗卫生机构基本医疗服务绩效考核指标体系,为政府的监管考核提供参考。方法 在查阅相关卫生政策和大量文献的基础上,采用两轮德尔菲专家咨询法、界值法确定绩效考核指标,利用专家打分法和乘积法确定指标权重,形成基层医疗卫生机构基本医疗服务绩效考核指标体系。结果 构建了一套基层医疗卫生机构基本医疗服务绩效考核指标体系。一级指标3个,分别为医疗服务数量与效率、医疗服务质量与安全、医疗费用,其权重为0.328 1、0.344 3、0.327 7,二级指标21个。结论 客观、合理的绩效考核指标体系有利于激发基层医疗卫生机构医务人员的积极性,提升医疗服务能力,切实推进分级诊疗,最终达到提高人民健康水平的目的。

Performance evolution index system of basic medical services for primary medical settings based on the hierarchical medical system

Objective To establish an objective and reasonable performance evolution index system of basic medical services of primary medical settings based on the context of the hierarchical medical system,and to provide a reference for government supervision and evaluation. Methods Based on the relevant health policy and a large number of documents,we chose indicators by two rounds of Delphi consultation and boundary value method,calculated indicator weights by the expert scoring method and multiplication method,and established a performance evolution index system of basic medical services for primary medical settings. Results An index system was established,including 3 first-level indicators and 21 second-level indicators.First-level indicators included the number and efficiency of medical services,the quality and safety of medical services and medical expenses,of which indicator weights were 0.328 1,0.344 3 and 0.327 7 respectively. Conclusion An objective and reasonable performance evolution index system is conducive to stimulate the enthusiasm of primary health care institutions medical staff,improve the ability of medical services,effectively promote the hierarchical medical system and ultimately achieve the purpose of improving people′s health.