医院绩效管理标准体系研究应用.doc

摘 要 经过分析美国、英国、德国等国家医疗环境，发觉法人治理结构是各国在医院管理制度搭建问题上共识。中国现代化医疗服务体系脱胎于计划经济模式下低水平全民福利医疗服务体系。上世纪90年代以来，中国进行了多轮医疗改革，但这种不系统、拼接式医疗改革并没有处理群众“看病难，看病贵”问题。究其原因，中国医疗制度仍然存在着：管办不分，多头管理制度环境问题；产业链上下游不妥竞争问题；医院糟糕社会形象和人才队伍发展可连续性问题。 20XX年，绩效工资改革在全国推行，公立医院进行了一轮绩效工资改革。在学术研究领域，结合科学管理方法，学者们针对公立医院提出了很多绩效管理理论，但实施过程远远落后于理论建设。 TL医院是一所经历了国有企业转制三级甲等公立医院，20XX年推行了一轮以法人治理结构为特点医疗改革试点，因为政策环境制约以失败告终。TL医院现行绩效管理体系是基于全成本核实和责任目标管理搭建，存在着“对非业务部门缺乏有效绩效考评手段；偏重经济效益指标考评；对科室差异性关注不足；业务水平激励不足；对新技术培育、人才培养支持不足”等弊端。 在调研基础上，作者分模块对TL医院绩效管理体系进行了优化。对非创收科室，基于现代社会—心理—医学健康模式，设置岗位压力测量模型，测出科室岗位压力，设定岗位压力系数，结合工作质量评分，综合评判部门绩效水平。在创收部门，转变了设计理念，坚持成本核实思想，经过成本核实确立基础业务量指标；将责任目标融入绩效体系中；依据业务目标完成情况，累进制提升利润计提百分比；引入关键绩效指标（KPI），引发科室重视。分内科系统、外科系统、医技系统进行了实例模拟。并对10个特殊科室绩效管理方案作了针对性说明。提出了优化方案适用性和保障方法。 关键词：卫生政策 医疗改革 医院 绩效管理 责任目标 关键绩效指标 平衡计分卡 Abstract By analyzing the United States, Britain, Germany and other countries in the medical environment, corporate governance structure is found consensus on all countries. The modern health care system of China is grew out of a low level of universal health care system. Since the 1990s, China conducted several rounds of health care reform, But these are not system. It can’t address the masses difficult and expensive problem. Because some problems of medical system still exists. Such as, bull management, unfair competition in the industry chain from top to bottom. the bad public image of hospitals and few people want to study medicine. 20XX, In accordance with national policy, the implementation of performance pay reform in the hospital. there are many theories of performance management In the academic field , but the implementation is far behind the theory-building. TL hospital once belonged to state-owned enterprises, is now a public hospital. In 20XX, TL hospital as a pilot implementation of health care reform corporate governance structure, but the absence of policy support, the reform fails. TL hospital existing performance management is based on full-cost accounting and Management by