基于RBRVS的绩效考核对儿科医师医疗行为影响的研究  

A study of the influence of RBRVS based performance evaluation on the medical behavior of pediatricians

作　　者：李昃[1] 邓莉[1] 段洁 郭楚豪 龙莹纯 唐硕[1] LI Ze;DENG Li;DUAN Jie;GUO Chuhao;LONG Yingchun;TANG Shuo(Hunan Children’s Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院,湖南长沙410007

出　　处：《现代医院》2021年第12期1809-1811,1817,共4页Modern Hospitals

摘　　要：目的了解RBRVS绩效考核对儿科医师医疗行为的影响。方法对实施RBRVS绩效考核前后相关指标进行对比分析。结果实施RBRVS绩效考核后,医院门急诊人次、出院人次和手术台次分别增加了9.85%、6.82%和9.30%;四级手术占比、ICD-10和核心技术覆盖率分别增加了2.41%、10.76%和22.22%;医疗服务收入占比和患者满意度分别增加了8.37%和4.81%;药占比、耗占比、平均住院日和抗菌药物使用强度分别下降了1.22%、1.38%、0.7 d和30.22%。结论基于RBRVS绩效考核的实施,对医师技术劳务价值进行了合理考量,调动了医师积极性并让其主动改变医疗行为,使得医院医疗服务量提升,医疗质量和运营效率均明显改善,收治病种向疑难危重病调整。Objective To investigate the impact of Resource-Based Relative Value Scale(RBRVS) based performance assessment system on physicians’ medical behavior. Methods The relevant indicators were compared and analyzed before and after using RBRVS based performance assessment system. Results After applying the RBRVS based performance assessment system, the number of out-patients, out-patients and operating tables increased by 9.85%, 6.82% and 9.30%, respectively;the proportion of fourth-level operations, ICD-10 and the number of core technology development increased by 2.41%, 10.76% and 22.22%, respectively;the proportion of medical service income and patient satisfaction increased by 8.37% and 4.81%, respectively;the drug proportion, consumption proportion, average hospital stay and antibacterial intensity decreased by 1.22%,1.38%, 0.7 days and 30.22%, respectively. Conclusion The implementation of the RBRVS based performance assessment system reasonably evaluated the technical labor value of doctors, aroused the enthusiasm of doctors and changed their medical behaviors, and made the amount of medical services, medical quality and operation efficiency of hospitals increased significantly, and the types of diseases treated were adjusted to difficult and critical diseases.

关 键 词：相对价值比率 绩效考核 儿科医师 医疗行为 

分 类 号：R197.323[医药卫生—卫生事业管理]