| With the continuing promotion of the new medical reform,the management mechanism of public TCM hospitals is facing great changes and challenges.In 2019,the General Office of the State Council issued the Opinions on Strengthening the Performance Assessment of Three-tier Public Hospitals,which requires public TCM hospitals to further implement their functional positioning based on the construction of a modern hospital management system and provide quality and efficient TCM medical services to the people.In 2021,the State Medical Insurance Bureau launched the DRG/DIP payment reform for all eligible medical institutions that carry out inpatient services,and planned to basically achieve full coverage of disease types and medical insurance funds by 2025.In March 2022,the 14th Five-Year Plan for the Advancement of Chinese Medicine was issued by the State Council’s General Office,which delineated the main tasks for the development of Chinese medicine in the new period in terms of service system construction,service capacity enhancement,talent team construction and Chinese medicine inheritance and innovation.The key tasks,including the participation of Chinese medicine in the prevention and control of major infectious diseases such as new pneumonia,are also mentioned.With all these changes,public TCM hospitals are forced to change their operation concept and adjust their development model,so it is especially important to establish a set of performance evaluation index system that meets the requirements of the new medical reform policy.Under the premise of ensuring public welfare,optimizing the performance evaluation system of hospital is conducive to motivating medical and nursing staff,optimizing the quality of medical services,and improving hospital management.This paper selects Chengdu X Traditional Chinese Medicine Hospital as the case study object,takes the new medical reform policy as the guidance,and the14 th Five-Year Plan of Chengdu X Traditional Chinese Medicine Hospital as the direction,and draws up a set of four dimensions,12 secondary indicators and 50 tertiary indicators through questionnaire surveys of front-line medical staff,logistics managers and industry experts inside and outside the hospital.The performance evaluation index system consisted of four dimensions,12 secondary indicators and 50 tertiary indicators.The weight of each indicator was calculated by using hierarchical analysis,and the indicators were logically checked.Finally,the hospital data from 2018 to 2022 were substituted,and the following conclusions were obtained:(1)although some of the business indicators of the hospital showed an increasing trend,there was still a certain gap between the overall view and the provincial and municipal standards,and there might be a situation of sacrificing some indicator values for a few excellent data;(2)the diagnosis and treatment did not highlight the characteristics of traditional Chinese medicine,and there was still a dependence on the income from drugs and consumables.This is not in line with the new medical reform’s idea of "reducing the cost of patient care";(3)financial indicators such as asset and liability ratio are high,and the hospital may have blind expansion;(4)the staffing of clinical departments is unreasonable,and there is a lack of TCM talents,and there is no good talent training mechanism,which will easily lead to the consequences of a shortage of young and yellow.(5)The allocation of resources tends to favor the departments with good benefits and lacks support for weak disciplines in TCM hospitals,such as pediatrics,and does not achieve balanced development.This paper combines the results of the case study to make recommendations to provide ideas and experiences for the performance evaluation of public TCM hospitals in China.The research in this paper is divided into five chapters:The first chapter is an introduction.It presented the background and significance of the study,described the research ideas,contents and methods,and discussed the expected contributions and shortcomings.The second chapter is a literature review.It defined the concepts of "new medical reform background" and "public TCM hospitals",and reviewed the current situation of hospital performance evaluation,index design methods and implementation effects at domestic and abroad,and presented the shortcomings of existing studies.Chapter three is the theoretical analysis section.In the first section,the theoretical basis of performance evaluation is explained in terms of goal consistency theory,performance management theory,and incentive theory;in the second section,the requirements and impacts of the new medical reform on the performance evaluation of public TCM hospitals in China are analyzed;in the third section,the principles,index system composition,and performance evaluation methods are analyzed in order to build a performance evaluation system for public TCM hospitals based on the background of the new medical reform.Chapter 4 is a case study.Section 1 introduces the basic situation and the 14 th Five-Year Plan of Chengdu X Traditional Chinese Medicine Hospital;Section 2analyzes the selection of the three-level indicators in the performance evaluation system;Section 3 shows the design idea and survey results of the performance evaluation questionnaire,and determines the weight of each indicator using the hierarchical analysis method;Section 4 evaluates some important indicators at the hospital level.In the fourth section,at the hospital level,some important indicators are evaluated by the method of longitudinal comparison;at the department level,the data of representative clinical departments are collected and evaluated by the performance evaluation model based on the weighting of indicators by the hierarchical analysis method,and finally,the performance evaluation results are combined with the corresponding management system for performance allocation,equipment allocation and further study,in order to achieve the effect of guidance and incentive and to realize the optimization after performance evaluation.Section5 is a summary of the case study section.The fifth chapter is the conclusion and optimization suggestion section.The first section evaluates the design and case study of the performance evaluation system of public TCM hospitals in this paper.The second section puts forward feasible suggestions based on the evaluation results to make the performance evaluation system fully effective.The suggestions include: changing the concept of development and finding its own positioning;deepening the integration of industry and finance and scientific and comprehensive evaluation;and strengthening the supporting guarantee and promoting the application of results in three aspects.The main contributions of this paper are:(1)From the research perspective,this paper focuses on the performance evaluation optimization of public TCM hospitals in the context of the new medical reform.According to the relevant literature,there are not enough studies on performance evaluation of public TCM hospitals by experts and scholars in China,and many indicators are outdated and the research conclusions and recommendations have little reference value in the context of the continuous enrichment of the new medical reform.This paper combined with the latest policy ideas of the new medical reform to conduct relevant research and analysis on the performance evaluation of public TCM hospitals,which has a certain degree of novelty.(2)In terms of the research object,it mainly concentrated on tertiary public TCM hospitals.Most of the existing related studies have selected public hospitals as the object,but the definition of public hospitals is broadly defined,and there are differences between public TCM hospitals and public Western medical hospitals,which makes the study less relevant.Public TCM hospitals have a weak foundation and slow development within China’s medical and health system,and taking them as the research object of this paper responds to the requirements of the new medical reform for the development of TCM career,and has a certain feasibility value for the reform and innovation of this type of hospitals.(3)As for research methods,the Performance Appraisal Indexes of Tertiary Public TCM Hospitals is used as the basic framework to construct a new index system using hierarchical analysis,and X TCM Hospital in Chengdu City is adopted as an example for analysis to verify the scientificity and rationality of the index system.In the design of the indexes,national monitoring indexes were mainly used,and more operational indexes were selected to ensure that they could represent the important ideas of the new medical reform and provide a comprehensive performance evaluation of the hospital.The corresponding weights of the three-level indicators in the four dimensions were also determined by distributing questionnaires to the clinical medical and logistic managers of the hospital and experts outside the hospital,which enhanced the scientific quality of the evaluation. |
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