| BackgroundPublic hospitals are the main body of China’s medical and health service system.Tertiary public hospitals are an important part of public hospitals.They have a large number of high-quality medical resources and shoulder important responsibilities for the treatment of acute and severe diseases,difficult and difficult diseases,personnel training,medical science,medical diagnosis,medical technology improvement and innovation in the region.Doctors are the direct providers of medical services in hospitals,and their ability and level are related to the development of hospitals and the life and health of patients.Therefore,performance assessment and evaluation of doctors is the core link of hospital management.Physician performance evaluation index is the specific reflection of hospital development strategy in doctors’ actual work process,the standard for doctors to evaluate their own ability in the work process,and also the baton of doctors’ work.In addition,it can also effectively measure and evaluate the management level of hospitals,so as to promote the implementation and improvement of hospital development strategy.With the deepening of the reform of the medical and health system,the payment system of medical insurance has changed,and the diagnosis and treatment behavior of physicians has been correspondingly affected.At the same time,the Party and the state require to explore the establishment of a physician performance evaluation and management system in line with the characteristics of the industry,to increase the value of knowledge as the orientation of performance distribution,to reflect the value of medical personnel technical labor,in order to mobilize the enthusiasm of medical personnel,and constantly improve the quality and level of medical services.Therefore,it is very necessary to construct a set of performance evaluation index system for doctors in third-level public hospitals,which conforms to the functional positioning of thirdlevel public hospitals,reflects the value of doctors’ labor service,and reflects the characteristics of doctors’ performance under the reform of payment system.PurposeBased on the theory of balanced scorecard and related theories of hospital performance management,specific conceptual indicators of each dimension are embodied according to the characteristics of doctors in third-level public hospitals,and a theoretical model of performance evaluation for doctors in third-level public hospitals is constructed.On the basis of the theoretical model,literature was extensively consulted,and relevant indicators of physician performance evaluation were analyzed and included to construct a specific threelevel public hospital physician performance evaluation index system.Taking a third-level public hospital in Henan Province as an example,this paper conducts sampling analysis on doctors’ performance,clarifies the current situation and finds problems,and puts forward corresponding suggestions to provide reference for improving doctors’ performance.Method1.Literature research method: Based on literature research method,the evaluation indicators of physician performance were sorted out,the core indicators of physician performance evaluation in third-level public hospitals were determined,and the initial framework of evaluation index system of physician performance evaluation in third-level public hospitals was constructed.2.Delphi Expert consultation method: Invite experts in related fields to carry out two rounds of expert consultation on the initial framework of the performance evaluation index system of doctors in third-level public hospitals initially established,and form the final performance evaluation index system of doctors in third-level public hospitals;3.Analytic hierarchy Process(AHP)and entropy method: Using analytic hierarchy process(AHP)and entropy method to calculate the weight of each dimension and each index of the performance evaluation index system of doctors in tertiary public hospitals,and finally calculate the combined weight;4.Systematic sampling method: In the stage of empirical investigation,the systematic sampling method is adopted to first number the physicians in the sample hospital,then divide them according to the total number of physicians and the sample size,and determine the interval of the segments.After determining the number of the first sample based on simple random sampling,the remaining sample numbers can be obtained by adding the interval of segments continuously according to the rules.Finally,specific performance measurement index data of 70 physicians were selected.Results1.Construction of the conceptual model of clinicians in tertiary public hospitalsBased on PEST-SWOT model,the development environment of three level public hospitals in China is analyzed,and the development strategy is to strengthen the fine management of hospital operation and establish a multi-dimensional assessment system.Standardize diagnosis and treatment behaviors to improve service quality and efficiency;Strengthen personnel training,improve the level of medical technology innovation;Emphasis should be placed on improving communication ability and building harmonious doctor-patient relationship and hospital internal relationship.This paper analyzes the specific concepts of the four dimensions of the balanced scorecard for clinicians in third-level public hospitals,makes clear the specific contents that should be evaluated in each dimension,and analyzes the application of the performance evaluation results to build a conceptual framework for the performance evaluation of clinicians in third-level public hospitals.2.Determined the performance evaluation index system of doctors in tertiary public hospitals.Based on the conceptual framework of physician performance evaluation in thirdlevel public hospitals,four dimensions including financial dimension,patient dimension,internal process dimension,learning and growth dimension are finally formed,and nine second-level indicators including medical cost,medical ethics,patient satisfaction,workload,work quality,professional ability,scientific research ability,teaching ability and selfimprovement are also included.The performance evaluation index system of doctors in tertiary public hospitals with 27 tertiary indexes has good reliability and validity.3.Empirical study on the performance evaluation index system of physicians in tertiary public hospitals: Among the 70 physicians surveyed in H Hospital,the comprehensive average score was 79.27,with the highest score being 91.82 and the lowest score being 69.10.The average score of the first level index was 19.21 points for financial dimension(A1),19.98 points for customer dimension(A2),34.48 points for internal process dimension(A3),and 5.68 points for learning and growth dimension(A4).4.Strategic suggestions for improving the performance of doctors in tertiary public hospitals: firstly,improve the internal business process management mechanism and improve the medical service ability;secondly,promote the improvement of the scientific research ability and level of doctors from various aspects and through various channels;thirdly,carry out the relevant research on the evaluation index of physician service value,improve the index system;and finally,strengthen the construction of the information platform.Conclusion Guided by the development strategy of tertiary public hospitals,this study analyzed the specific contents of the four dimensions of the balanced scorecard for clinicians,the principles of performance evaluation,the application of performance evaluation results and other related contents,and constructed a conceptual framework of performance evaluation for clinicians in tertiary public hospitals,which has certain reference value for the performance management of tertiary public hospitals in China.By means of literature research,expert consultation and interview,a performance evaluation index system for clinicians in tertiary public hospitals was constructed.Compared with previous studies,this index system integrated the performance evaluation thoughts of DRG and physician labor value,catering to the current policy and practical needs of physician performance evaluation.The weight of the index is determined by using the weighting method combining subjective and objective of analytic hierarchy process(AHP)and entropy value method,which makes up for the deviation caused by the subjective weighting method which only adopts analytic hierarchy process(AHP)in the previous research and is more scientific.The results of the empirical study show that the research ability and self-improvement of physicians in sample hospitals need to be strengthened.Due to various conditions,the number of samples in the empirical analysis of this study is not large enough.The next step will be to further expand the scope of the investigation of hospitals and the number of physicians,and further improve the performance evaluation index system of physicians on the basis of the current research. |
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