ABSTRACT
Objective:To understand the commonalities and characteristics of provincial-level performance appraisal plan of tertiary public hospitals, and to provide reference for improving and promoting their performances.Methods:The provincial plans introduced from January 31, 2019 to March 31, 2020 matched with the performance appraisal of the national tertiary public hospitals were retrieved through portal websites of the provincial people′s government and health commission, and 19 programs supplemented with local indicators on the basis of the National assessment index were selected as the research objects. The key information such as release time, issuing authority, evaluation object, implementation subject and index system of the plans were extracted, and content analysis method was used to analyze the characteristics and commonalities.Results:Ten out of 19 plans were released during June to July of 2019, and 12 plans were issued by the general office of the provincial people′s government, and the main body of assessment was the provincial-level health commission. Two first-level indicators of Party building and social benefits were added. The supplement of second-level indicators mainly focused on mandatory tasks, quality and safety, primary-level organization construction, service process and moral culture construction. A total of 241 third-level indicators were added, of which qualitative indicators accounted for 65.15%(157 indicators). The top five provinces with the most supplementary indicators were Guizhou, Jilin, Heilongjiang, Liaoning and Zhejiang. Seven provincial-level regions of Shanghai, Ningxia, Guangxi, Qinghai, Guizhou, Anhui and Yunnan clarified the grading standards and methods for performance appraisal results.Conclusions:The supplementary indicators of provincial-level performance appraisal plans for tertiary public hospitals focus on social benefits, Party building, and quality of medical care. The proportion of qualitative indicators is high, the classification of assessment objects is not clear enough, the characteristics of localized supplementary indicators are obvious, and the grading and result of performance appraisal index need to be optimized.
ABSTRACT
Objective:To analyze the output efficiency of medical services in clinical departments, so as to provide a breakthrough point for rational allocation of resources and improvement of service efficiency.Methods:The classic BCC model of data envelopment analysis(DEA) was used to evaluate the medical service efficiency of 44 clinical departments in a hospital, and the comprehensive efficiency, pure technical efficiency, scale efficiency and scale benefits were analyzed. The input indicators were the number of medical staff, medical costs and the number of beds at the end of the period. The output indicators were diagnosis-related group(DRG) indicators, including the number of DRG groups, total weight, case mix index, cost consumption index, time consumption index and mortality rate of low-risk group.Results:The average values of comprehensive efficiency, pure technical efficiency and scale efficiency of the whole hospital in 2018 were 0.897, 0.920 and 0.975 respectively. DEA was relatively effective in 16 departments(36%), weakly effective in 7 departments(16%), and ineffective in 21 departments(48%). In the case of constant output, the redundancy rates of the actual beds, medical staff and medical business expenditure of non DEA effective departments were 17.3%, 20.3% and 17.1% respectively; under the same input, the output of non DEA effective departments was insufficient.Conclusions:The comprehensive efficiency of medical services in this hospital is ideal, but the proportion of non DEA effective departments is relatively high. It is suggested to improve the efficiency of medical services by optimizing resource input, strengthening discipline construction, and strengthening cost control.