标化工作量在基层医疗卫生机构管理中的应用与价值研究  

Application of Standardized Workload in Primary Healthcare Management

作　　者：林吉祥[1] 顾静华 汪天英 黄淑贤[1] 焦露露 高俊 蒋文珍[1] 张文宇 马俊岭[1] 杨蕙兰 沈咏梅 康杰 陈飚 周静玉 张利娜 郭海英[1] 张瑛[1] 蔡成伟[1] 龚龑清 孙月[1] 李丽 孙欢 侯钦午[1] 郭美珍[1] 杨琦 陈利凤[1] 沈福来 张幸娜 LIN Jixiang;GU Jinghua;WANG Tianying;HUANG Shuxian;JIAO Lulu;GAO Jun;JIANG Wenzhen;ZHANG Wenyu;MA Junling;YANG Huilan;SHEN Yongmei;KANG Jie;CHEN Biao;ZHOU Jingyu;ZHANG Lina;GUO Haiying;ZHANG Ying;CAI Chengwei;GONG Yanqing;SUN Yue;LI Li;SUN Huan;HOU Qinwu;GUO Meizhen;YANG Qi;CHEN Lifeng;SHEN Fulai;ZHANG Xingna(Pudong New District Beicai Community Health Center,Shanghai 201204,China;Standardized Workload Reform Project Team,Pudong New District Beicai Community Health Center,Shanghai 200333,China)

机构地区：[1]上海市浦东新区北蔡社区卫生服务中心,201204 [2]上海市浦东新区北蔡社区卫生服务中心标化工作量改革项目组,200333

出　　处：《中国全科医学》2021年第25期3197-3204,共8页Chinese General Practice

摘　　要：背景在政府推进基层控费步伐越来越快的背景下,基层医疗卫生机构亟须发展出便捷、好用、通用的管理工具,来覆盖人力成本核算、服务绩效发放、新服务开发、服务对外定价、学科建设和人才培养等方方面面机构经营过程中常见问题的解决。标化工作量作为精确测算某个服务项目人力时消耗的工具,在测算过程中,用到的参数和变量涉及前述的方方面面问题,并可以通过精确的统计将上述问题的解决清晰化、定量化,并形成决策闭环。目的本研究拟清晰阐述标化工作量的内涵、定义、操作定义、各种应用方式,便于读者理解、把握、应用、用好这一工具,来进行机构的治理与经营,以解决上述问题,加快基层医疗卫生机构的发展,早日实现卓越经营和合理控费。方法从标化工作量的内涵出发,整理标化工作量的计算公式,得出与之关联的关键变量和参数,将参数进行不同的、有意义的组合和分析,逐一回答标化工作量助力机构经营与发展的各种应用场景。结果标化工作量可以用来解决人力成本核算、服务绩效发放、新服务开发、服务对外定价、学科建设和人才培养等问题。结论标化工作量既是用于政府经费拨付、内部绩效发放的计价工具,更是在开发自身特色服务时的定价工具、在开展服务改进和效率提升时的比对工具、在开展新技术和发展新业务时的循证思维工具,用好标化工作量可以加快社区卫生学科建设和人才培养。Background In the context of the government's increasing pace of controlling the cost of primary healthcare,primary healthcare institutions are in urgent need of convenient,easy-to-use,and popular management tools to help to address issues commonly encountered in labor cost accounting,service performance distribution,new service development,service pricing,academic construction and talent training.Various common problems solved in the operation process.The standardized workload has been applied to healthcare sector in 2015.As a tool for accurately measuring the manpower consumption in delivering a service,the parameters and variables used in the measurement process involve the aforementioned various aspects,and can be calculated through accurate statistics.The resolution of the above problems is clarified and quantified,forming a closed decision loop.Objective To clearly explain the meaning,definition,operation definition,and various application methods of the standardized workload,facilitating the understanding,grasp and application of this tool in institutional operation and management,thereby quickening the development of primary healthcare institutions to achieve successful operation and reasonable cost control.Methods On the basis of good understanding of the meaning of standardized workload,we chose key variables and parameters associated with each issue in institutional operation and development,and put them into the formula for calculating the standardized workload via various meaningful combinations,and analyzed them in detail.Results Standardized workload could address the issues commonly met in labor cost accounting,service performance issuance,new service development,service pricing,academic discipline construction and talent training.Conclusion Standardized workload may help to quantify the government funding,intra-institution performance allocation,and the price for newly developed featured services.Moreover,it may be used for estimating the value of service improvement by quantifying pre-and post-i

关 键 词：基层医疗卫生机构 标化工作量 人力时 技术难度 风险程度 学科建设 循证 

分 类 号：R197[医药卫生—卫生事业管理]