公立医院高质量发展的绩效改革与实践路径——以DS医院的RBRVS绩效管理体系为例  

Performance Reform and Practice Path for High-Quality Development of Public Hospitals:Taking RBRVS Performance Management System of DS Hospital as an Example

作　　者：刘羽萌 Liu Yumeng

机构地区：[1]西安市人民医院(西安市第四医院)运营管理科

出　　处：《中国人事科学》2023年第9期1-9,共9页Chinese Personnel Science

摘　　要：绩效管理是公立医院高质量发展的重要支撑。DS医院通过建立RBRVS(以资源为基础的相对价值比率)绩效管理方案,构建医师工作量RBRVS规则体系和绩效成本RBRVS规则体系,特别是采用体现医务人员劳务价值的诊疗组模式,为资深带组医师带来了更高的声誉和激励,形成良好的“医学研”生态竞争模式。在医师工作量RBRVS规则体系方面,医院将参与医疗绩效管理的科室分为六类,对研判、执行、服务量进行分类评价,借鉴美国联邦医疗保险对医师支付口径的项目统计方式,比照CPT(cost per treatment,每次治疗费用)编码对不同资源消耗的项目赋予相应点值。在绩效成本RBRVS规则体系方面,DS医院的成本核算可分为四类。一是人力成本。二是不计入患者承担费用的卫生材料成本。三是固定资产折旧、商品和服务支出等其他执业成本。四是床单元成本。这一系统化的考核和分配方式促进了考核标准的多维度结合,初步达成了精细化管理的目标。Performance management is an important support for the high-quality development of public hospitals.Taking DS Hospital as an example,by establishing an RBRVS(resource-based relative value scale)performance management plan,a physician workload RBRVS rule system and a performance cost rule RBRVS system are constructed,especially by adopting a diagnosis and treatment team model that reflects the labor value of medical personnel.This has brought higher reputation and motivation to senior team doctors,thus forming a good"hospital-university-institute"ecological competition model.In terms of the physician workload RBRVS rule system,the hospital divides the departments involved in medical performance management into six classes:performs classified evaluation on study and determination,implementation and service volume,and assigns corresponding point values to each project for different resource consumption using the CPT(cost per treatment)code after drawing on the project statistics method of the US Federal Medical Insurance for physician payment caliber.In terms of the performance cost rule RBRVS system,the components of cost accounting in DS Hospital are divided into four classes.The first class is labor cost.The second class is cost of health materials excluding patient borne expenses.The third class is other operating cost such as depreciation of fixed assets and expenditure on goods and services.The fourth class is bed unit cost.This systematic assessment and allocation method has achieved a multi-dimensional combination of assessment criteria,and has initially achieved the goal of refined management.

关 键 词：RBRVS 公立医院 医师诊疗组 绩效管理 医学人才 

分 类 号：D035.2[政治法律—政治学]