| Objective(s):By analyzing the data of the four dimensions of medical quality,operational efficiency,sustainable development,and satisfaction evaluation of the performance appraisal results of eight tertiary class A general governmental hospitals in Kunming from 2019-2021,we objectively analyze the current situation and changing trends of the four dimensions of the performance appraisal results of tertiary class A general governmental hospitals from 2019-2021.To understand whether the performance appraisal index system can reflect the disparity between the tertiary level A general governmental hospitals of different affiliations(provincial and municipal).To explore the factors influencing the performance appraisal results of the tertiary Class A general governmental hospitals in Kunming and make corresponding suggestions,so as to provide useful reference and reference for the high-quality development of other general governmental hospitals at all levels in Yunnan Province.Methods:Based on the Performance Appraisal Operation Manual for Three-tier governmental Hospitals(2022 version)determined by the National Health and Health Commission,the performance appraisal indicators and result data of relevant hospitals were obtained through the national performance appraisal platform,and a combination of qualitative and quantitative research was adopted,in which the qualitative research was mainly based on the literature research method to understand the progress and status of performance appraisal research at home and abroad,the expert consultation method was used to determine the performance appraisal indicator system and the orientation of monitoring indicators,and understanding the actual situation,problems and solution initiatives of the four dimensions of performance appraisal in relevant hospitals by interviewing the leaders in charge of performance appraisal work.For the quantitative study,the measurement data conformed to normal distribution,and the mean±standard deviation was used to analyze whether there was a gap between the performance appraisal results of different affiliated tertiary-level comprehensive governmental hospitals in Kunming using independent sample t-test.The TOPSIS comprehensive evaluation method was used to comprehensively evaluate the results of the four dimensions of the performance appraisal of the eight tertiary class A general governmental hospitals in Kunming area.Results: 1.Medical quality: From the comprehensive evaluation ranking of medical quality of each hospital in 2019-2021: in 2019,the ranking from excellent to poor is H4(C=0.629),H1(C=0.482),H5(C=0.473),H2(C=0.390),H8(C=0.386),H7(C=0.356),H3(C=0.353),H6(C=0.269);in 2020,the ranking from excellent to poor is H4(C=0.576),H1(C=0.451),H5(C=0.451),and H6(C=0.269).),H6(C=0.269);in 2020,the ranking from best to worst is H4(C=0.576),H1(C=0.451),H5(C=0.410),H3(C=0.404),H2(C=0.395),H7(C=0.364),H8(C=0.308),H6(C=0.282);in 2021 The ranking from best to worst is H4(C=0.600),H5(C=0.498),H2(C=0.419),H1(C=0.414),H3(C=0.377),H7(C=0.314),H6(C=0.305),H8(C=0.302).2019-2020 the combined H2,H3,H6,H7 The evaluation C-value increased,the increase was concentrated between 0.01-0.05,and the level of quality of care increased.2020-2021 the combined evaluation C-value of H2,H4,H5,and H6 increased,the increase was concentrated between 0.02-0.09,and the level of quality of care increased.2.Operational efficiency: From the ranking of the comprehensive evaluation of the operational efficiency of each hospital in 2019-2021: H3(C=0.653),H5(C=0.621),H1(C=0.555),H2(C=0.553),H8(C=0.526),H4(C=0.452),H6(C=0.441),H7(C=0.325)in 2019,and H3(C=0.588),H2(C=0.581),and H8(C=0.325)in 2020,in order of ranking from best to worst.),H7(C=0.325);in 2020,the ranking from best to worst is H3(C=0.588),H2(C=0.581),H8(C=0.515),H7(C=0.506),H5(C=0.459),H4(C=0.440),H6(C=0.432),H1(C=0.406);in 2021 The ranking from best to worst is H3(C=0.681),H2(C=0.572),H7(C=0.524),H5(C=0.653),H4(C=0.498),H1(C=0.479),H8(C=0.471),and H6(C=0.443).2019-2020 are affected by the new coronary pneumonia outbreak,H1,H3,H4,H5,H6,H8,the comprehensive evaluation C value decreases,the decrease value is concentrated between 0.01-0.16,the level of operational efficiency decreases.2020-2021 H1,H3,H4,H5,H6,H7,the comprehensive evaluation C value increases,the increase value is concentrated between 0.01-0.09,the level of operational efficiency increases.3.Sustainable development: From the ranking of the hospitals’ comprehensive evaluation of sustainable development in 2019-2021: H1(C=0.474),H7(C=0.457),H3(C=0.417),H4(C=0.397),H5(C=0.340),H2(C=0.257),H6(C=0.248),H8(C=0.229)in 2019,and H1(C=0.736),H3(C=0.372),H5(C=0.372)in 2020.),H8(C=0.229);in 2020,the ranking from best to worst is H1(C=0.736),H3(C=0.372),H5(C=0.345),H4(C=0.338),H8(C=0.316),H7(C=0.306),H6(C=0.300),H2(C=0.290);in 2021 The ranking from best to worst is H1(C=0.781),H3(C=0.378),H5(C=0.373),H4(C=0.348),H7(C=0.310),H6(C=0.303),H2(C=0.290),H8(C=0.278).2019-2020,H1,H2,H5,H6,H8 The comprehensive evaluation C-value of H1,H2,H3,H4,H5,H6,H7 increases,the increase in value is concentrated between0.01-0.26,and the level of sustainable development increases.2020-2021,the comprehensive evaluation C-value of H1,H2,H3,H4,H5,H6,H7 increases,the increase in value is concentrated between 0.00-0.05,and the level of sustainable development increases.4.Satisfaction evaluation: From the comprehensive satisfaction evaluation ranking of each hospital in 2019-2021: in 2019,the ranking from excellent to poor is H6(C=0.798),H1(C=0.667),H8(C=0.624),H2(C=0.601),H3(C=0.508),H5(C=0.319),H7(C= 0.233),H4(C=0.035);in 2020 the ranking from best to worst is H8(C=0.861),H2(C=0.568),H1(C=0.494),H5(C=0.482),H4(C=0.478),H3(C=0.467),H6(C=0.297),H7(C=0.196);In 2021,the ranking from best to worst is H1(C=0.953),H8(C=0.730),H4(C=0.679),H3(C=0.528),H6(C=0.447),H2(C=0.415),H7(C=0.250),H5(C=0.186).2019-2020,the overall ratings of H1,H2,H3,H6,and H7 have decreasing comprehensive evaluation C-values,decreasing values are concentrated between 0.03-0.50,and satisfaction evaluation levels decrease.2020-2021,H1,H3,H4,H6,and H7 have increasing comprehensive evaluation C-values,increasing values are concentrated between 0.05-0.46,and satisfaction evaluation levels increase.5.Overall trend of performance appraisal: From the overall performance appraisal comprehensive evaluation ranking of each hospital in 2019-2021: H1(C=0.498),H4(C=0.463),H3(C=0.445),H5(C=0.423),H7(C=0.417),H2(C=0.388),H8(C = 0.362),H6(C = 0.336);in 2020 the ranking from best to worst is H1(C = 0.520),H4(C = 0.453),H3(C = 0.446),H2(C = 0.405),H7(C = 0.401),H5(C = 0.385),H8(C = 0.363),H6(C = 0.330);The ranking from best to worst in 2021 is H1(C=0.567),H4(C=0.480),H3(C=0.429),H5(C=0.422),H2(C=0.404),H7(C=0.402),H6(C=0.358),H8(C=0.337).2019-2020,H1,H2,H3,and H8 had an increase in the C value of comprehensive evaluation,the increase was concentrated between 0.00-0.02,and the overall performance assessment level increased.2020-2021,H1,H4,H5,H6,and H7 had an increase in the C value of comprehensive evaluation,the increase was concentrated between 0.02-0.05,and the overall performance assessment level increased.6.Through the comparative analysis of the performance assessment indexes of five provincial and three municipal tertiary governmental hospitals in Kunming,medical quality: the proportion of day surgery to elective surgery in provincial tertiary hospitals was 9.53% higher than that in municipal tertiary hospitals(t=-0.559,P<0.05),the proportion of day surgery to elective surgery in provincial tertiary hospitals was3.38%(t=-0.559,P<0.05),the(t=-2.470,P<0.05),low risk mortality rate of 0.01% in provincial tertiary hospitals was lower than that of 0.02% in municipal tertiary hospitals(t=-2.957,P<0.05);operational efficiency: the income and expenditure balance rate of 5.06% in provincial tertiary hospitals was higher than that in municipal tertiary hospitals.(t=2.775,P<0.05);sustainable development: the medical to nursing ratio of provincial tertiary hospitals was 0.74 higher than that of municipal tertiary hospitals,which was 0.63(t=2.760,P<0.05),and the proportion of critical care physicians in provincial tertiary hospitals was 2.56 higher than that of municipal tertiary hospitals,which was 1.36(t=2.630,P<0.05).Conclusion(s): 1.2019-2021,the level of medical quality in the performance assessment of the tertiary level A comprehensive governmental hospitals in Kunming area has risen less,and there is still more room for development.The functional positioning of tertiary hospitals is clear,and some hospitals have low medical quality and safety,lack of awareness of rational drug use among medical staff,lack of an overall plan to regulate the use of antibacterial drugs and lack of a clear and detailed service process.2.2019-2021 the level of operational efficiency of the performance appraisal of the tertiary class A general governmental hospitals in Kunming area is gradually improved,the efficient utilization of resources is higher,the structure of income and expenditure is more reasonable,in 2020 due to the impact of the new crown pneumonia epidemic,the hospital has the problem of unsatisfactory control of medical costs,but in 2021 the overall trend is up.3.2019-2021 the level of sustained development of the performance assessment of the three-level A comprehensive governmental hospital in Kunming area further deepened,the hospital focused on balancing the relationship between the proportion of personnel with various titles,optimizing the structure of personnel,paying attention to the construction of disciplines,and increasing the investment in research funding for health technicians.4.2019-2021 The level of satisfaction evaluation of performance appraisal of the Grade 3 A comprehensive governmental hospital in Kunming area continues to improve,the hospital implements humane management,broadens promotion channels,establishes a long-term mechanism for talent training,and encourages medical personnel to upgrade their on-the-job qualifications.By optimizing the appointment service process and releasing the numbers a week in advance,the convenience of patient consultation is improved.Establish a reasonable charging system and make all charges during hospitalization transparent so that patients can enjoy the right to know.5.2019-2021 The performance appraisal level of the Grade 3 A comprehensive governmental hospitals in Kunming area shows an overall improvement,with some indicators showing a clear trend toward improvement,and the role of the performance appraisal baton is gradually emerging.Through the assessment for three consecutive years from 2019-2021,although the impact of the new crown pneumonia epidemic is greater in 2020,the overall performance level of most Grade A comprehensive governmental hospitals in 2021 is on an upward trend.6.The performance appraisal results can reflect the disparity in medical quality,operational efficiency and sustainable development of the tertiary class A general governmental hospitals of different affiliations,and the provincial tertiary class A general governmental hospitals are higher than the municipal tertiary class A general governmental hospitals.Suggestion(s):This paper analyzes the current situation of the performance appraisal results of eight tertiary governmental hospitals in Kunming,analyzes the causes of the problems in the performance appraisal of tertiary governmental hospitals,and puts forward relevant suggestions and optimization strategies to promote the active implementation of the functional positioning of other comprehensive governmental hospitals at all levels in Yunnan Province,improve medical treatment technology and service levels,and promote the high-quality development of governmental hospitals.In the area of medical quality In terms of medical quality:optimize resource allocation,guide patients to rational triage;standardize diagnosis and treatment behavior,and promote rational drug use.In terms of operational efficiency: optimize revenue structure and strengthen cost control.In terms of sustainable development: pay attention to the construction of talent team and promote sustainable development;strengthen discipline construction and focus on internal development.Satisfaction evaluation: pay attention to patients’ medical experience and improve the satisfaction of medical and nursing staff and patients. |
PDF Full Text Request