基于签约服务费的家庭医生团队绩效“一次分配”指标体系构建研究  

Development of the"First Distribution"Indicator System of Family Doctor Team Performance Based on Contract Service Fee

作　　者：陈红 周蓉 石建伟 俞文雅 吕奕鹏 周良 高翔 黄雷 王朝昕 CHEN Hong;ZHOU Rong;SHI Jianwei;YU Wenya;LYU Yipeng;ZHOU Liang;GAO Xiang;HUANG Lei;WANG Zhaoxin(School of Public Health,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Wuliqiao Community Health Service Center,Huangpu District,Shanghai 200023,China;School of Management,Hainan Medical University,Haikou 571101,China)

机构地区：[1]上海交通大学公共卫生学院,上海市200025 [2]上海市黄浦区五里桥街道社区卫生服务中心,200023 [3]海南医学院管理学院,海南省海口市571101

出　　处：《中国全科医学》2024年第13期1556-1560,共5页Chinese General Practice

基　　金：国家重点研发计划项目(2022YFC3601500);国家自然科学基金资助项目(72004032);上海市社区卫生协会2021年社区科研重点项目(SWX21Z02)。

摘　　要：背景家庭医生签约服务正在被大力推进。与个人绩效考核方案相比,以家庭医生团队为单位的绩效考核方案包括“一次分配”和“二次分配”两个过程,更能调动家庭医生团队成员的工作积极性,进而提升服务效率和质量。目的构建基于签约服务费的家庭医生团队绩效“一次分配”指标体系。方法通过文献归纳分析与半结构访谈,初步拟定“家庭医生团队绩效‘一次分配’指标体系”草案。在草案基础上设计专家咨询问卷,并在2021年10月—2022年4月实施并完成两轮专家咨询,构建了基于签约服务费的家庭医生团队绩效“一次分配”指标体系。结果两轮专家咨询问卷的回收率均为100.0%。第一轮函询的专家权威系数为0.7616,两轮专家咨询的协调系数分别为0.067(P<0.001)和0.712(P<0.001)。最终构建了包括一级指标3个,二级指标15个的家庭医生团队绩效“一次分配”指标体系。结论本研究基于签约服务费构建的包括3个一级指标(有效签约、有效服务、有效控费)的绩效分配体系具备一定逻辑性和科学性,体现了家庭医生团队提供签约服务的劳务价值,有利于发挥签约服务费的专项激励作用。Background The family doctor contract service is being vigorously promoted.Compared with the individual performance appraisal scheme,the performance appraisal scheme based on the family doctor team including the two processes of"first distribution"and"secondary distribution"is more capable of mobilizing the work motivation of family doctor team members,thus improving service efficiency and quality.Objective To develop the"first distribution"indicator system of family doctor team performance based on contract service fee.Methods The draft of the"first distribution"indicator system of family doctor team performance was preliminarily formulated through literature analysis and semi-structured interviews.On the basis of the draft,an expert consultation questionnaire was designed,and two rounds of expert consultation were implemented and completed from October 2021 to April 2022 to develop the"first distribution"indicator system of family doctor team performance based on contract service fee.Results The recovery rate of the two rounds of expert consultation questionnaires was 100.0%.The authority coefficient of the first round of correspondence was 0.7616,and the Kendall coordination coefficients of the two rounds of consultations were 0.067(P<0.001)and 0.712(P<0.001),respectively.Finally,the"first distribution"indicator system of family doctor team performance was finally constructed,including 3 primary indicators and 15 secondary indicators.Conclusion The performance allocation system constructed in this study based on contract service fee,which includes three primary indicators(effective contracting,effective service,and effective fee control),has a certain degree of logic and scientificity that reflects the labor value of the contracted service provided by the family doctor team,and is conducive to special incentive effect of the contract service fee.

关 键 词：社区卫生服务 家庭医生签约服务 家庭医生团队 绩效考核 指标体系 

分 类 号：R197.1[医药卫生—卫生事业管理]