Study On The Performance Evaluation Index System Of County Public Hospitals In Chongqing

ObjectivesPublic hospitals as the backbone of China’s medical and health undertakings,bear the main task of national economy and people’s livelihood health services,district and county public hospitals as the leader of basic health care services,is also the link between urban and rural medical and health service system,public hospitals in almost monopoly status of development in the long-term,but also it exposed a lot of problems.The establishment of a scientific performance evaluation index system of county public hospitals is one of the important contents of comprehensively promoting the reform of county public hospitals,and is also a specific measure to deepen the reform of medical and health system.the purpose of this study is to explore a performance evaluation index system to promote the sustainable development of county public hospitals under the background of new medical reform.MethodsLiterature review method: query the domestic and foreign relevant literature of performance evaluation index system,focusing on the development and change process、the existing problems of performance evaluation of public hospitals in domestic and foreign,,and thinking the formulate of the relevant basis for the performance evaluation system of public hospitals at district and county level.Semi-structured interview: on the basis of literature searching,drawing up semi-structured interview outline,and one county was randomly selected from the different ecnomy dvelopment areas of Chongqing.the leaders of the health planning commission,finance,people’s organizations and other departments,and the managers of public hospitals were interviewed by semi-structured interview to understand the current situation of the evaluation system in public hospitals and their opinions and suggestions on the performance evaluation index system.Focus group discussion method: designing a preliminaryframework of the county public hospital performance evaluation index system,select 10-15 health administrative experts,health management experts,leader of county public hospitals for group discussion,discussing on the preliminary design of the index system framework,county public hospital financial subsidy policy,medical insurance payment policy,performance total wages policy.Delphi method: to form the preliminary draft of the performance evaluation index system of district and county public hospitals,formulate the expert‘s inquiry letter,select 10-15 experts such as leaders of relevant government departments,heads of county public hospitals,health management experts,etc.,and conduct expert by e-mail.Choosing the authority of the experts from academic attainments,judgment basis and familiarity.Analytic hierarchy process(AHP): on the basis of expert inquiry to determine the performance evaluation index system of county public hospitals,the AHP model is established to determine the weight coefficient of indicators at all levels.Results1 The performance evaluation index system of district and county public hospitals was established from the aspects of hospital management,service quality,operation efficiency and social satisfaction.2 County public hospital performance evaluation index system is divided into three levels of indicators,six first-level indicators,including function positioning and public welfare responsibilities,hospital management,rational drug use,cost control,operational efficiency,social satisfaction,13 second-level indicators,60 third-levelindicators.3 According to Delphi method and analytic hierarchy process(AHP),the weight of each index was determined.the weight of each index was 0.121 for function orientation and public welfare responsibility,0.317 for hospital management,0.113 for rational drug use,0.101 for cost control and 0.242 for operational efficiency.Conclusions1 The direction and ultimate goal of establishing performance appraisal system is not only to fully reflect the public welfare of public hospitals,remove profit-seeking behavior,improve patient satisfaction,but also to fully reflect the labor value of medical personnel,stimulate the initiative and enthusiasm of medical institutions and medical personnel,improve the satisfaction of medical personnel.2 The core of establishcounty public hospital performance evaluationindexsystem are public welfare and operation performance,highlight the function positioning,public welfare responsibilities,rational drug use,cost control,operation efficiency and social satisfaction and other assessment indicators.