我国正式开放医疗市场,全面放开社会资本办医,促使了民营医院的蓬勃发展。时至 今日,民营医院在全国医疗机构中已占半壁江山。随着医疗体制改革的深入发展,我国的 医疗市场竞争日趋激烈。如何在激烈的市场竞争获得一席之位这一问题摆在每位民营医院 经营者面前。民营医院在规模、技术水平等因素处于劣势的情况下,想要获得竞争优势, 只有在医院人力资源管理与经营管理方面下工夫。绩效考评医院人力资源管理与经营管理 的核也环节,也是困扰民营医院管理的一个问题。如何科学的对医生的绩效进行科学与准 确的考评,从而促进医院的战略目标的实现,提高医院的管理水平与能力,最大限度激发 医生的工作积极性,提升医院的综合实力,是民营医院管理者的重要的任务,也成为当前 急待解决的突出问题。 医师费制度(化ysicianFee,PF)由台湾医院管理大师张锦文于20世纪70年代末 借鉴美国医师付费制度在台湾马偕医院首次提出。其核屯、思想是根据医师的劳动付出作为 绩效按不同比例或一定金额提成给医师。这种制度设计使医师收入因素由医师服务量及服 务项目的价格所决定。本文M民营医院为例,尝试将医师诊疗费制度这一方法运用于医生 的绩效考评,探索建立一个科学、客观、系统、实用的绩效考评方案。 本文首先回顾了绩效考评的相关理论,阐述了绩效、绩效考评、医师诊疗费制度等的 相关概念及绩效考评常用的方法,介绍了国内外医生绩效考评研究现状。其次。本文介绍 了M民营医院医生绩效考评的基本情况,其内容包括M民营医院简介、组织结构、医生人 员现状和绩效考评的现状,并奸对绩效考评满意度调查情况指出M民营医院医生绩效考评 存在问题及其原因。通过分析M民营医院绩效问题的分析,本文认为M民营医院要实现医 院的跨越式发展、提档升级、创建H级综合型医院的战略目标,设计一个符合M民营医院 当前形势的绩效考评优化方案至关重要。第H部分,即文章的核也部分,阐述了M民营医 院医生绩效考评方案优化设计目的与原则,认为优化方案应W医师费制度为绩效考评优化 方案的核也,综合平衡计分卡法、关键绩效指标法等多种绩效考评理论为指导理论,并提 出心文医生工作量核算为基础的医师费制度为核也,W王作质量与效率考核为重也,综合评 价为手段,患者满意为导向,并综合运用科学的绩效考评理论与方法的总体思路,特别指 出应将医院和医生视为平等的合伙关系、医生专屯、于医疗工作而不应背负医院经营的风 险、増加医生的切身感等作为绩效考评新思路。优化方案的创新点在于通过医师费制 I度的设计将考核科室的经济指标转变为考核医生的工作数量。M民营医院医生绩效考评优 化方案的主体可W分为二个具体部分。第一部分是考核医生工作数量为主的医师费制度的 设计,包括医巧费制度的提成原则、提成比例、提成比例设定的弹性策略、专科医师费重 新分配制度、医师费积分重分配等内容。第二部分是考核医生工作质量、工作效率、患者 满意度及学习成长方面为主科室综合目标考巧及医生绩效综合考评的设计。优化方案将科 室综合目标考评与专科医师费分配相结合,医生绩效综合考评与专科内医师费积分重分配 相结合,从而在考核医生工作数量与考核工作质量之间找到一个平衡。在优化方案的实施 方面,本文介绍了优化方案的考评主体、考评周期、实施流程、绩效沟通、绩效考评结果 的表现形式及应用。最后,本文提出实施优化方案的保障措施,认为优化方案应得到医院 核也管理层的支持,要在全院营造绩效导向的医院文化氛围,要健全绩效考评组织机构与 管理制度,加强全员绩效考评的培训,提高绩效信息收集过程的信息化,建立绩效考评的 申述机制。同时,文章还分析了优化方案的预期效果、在实际操作过程中可能出现的问题 及解决办法。 通过对M民营医院医生绩效考评方案的优化设计,本文为民营医院提供了一个具有相 对参考价值的绩效考评方案,并为民营医院的医生的绩效考评开巧了一条新思路。 关链词:绩效考评;医师费制度;绩效考评优化方案 IITheResearchofPhysicianPerfor前anceAppraisalOptimizationProgram ofMHospitalBasedon化ephysicianFeeSys1:em Abstract Chinaformallyopenstheme出calmarket,扣11expandthemark幻化socialcapital, promptingtheboomingofprivatehospitals.Today,privatehospitalsaccountedforhalfofthe medicalinstitutionsin化ecountry.Withthefiirtherdevelopmentofheahhcarei＊eform,Chilians healthcaremarkethaswi也essedgrowingcompetitio打.Thequestionofhowtoget过化化inthe fiercemarketcompetitionislaidbeforeeveryprivatehospitaloperator.DespUeitsdisadvantage i打size,skilllevelandotherfactors,theprivatehospitalcanonlyresort化itsadvantageinhuman resourcemanagementandbusinessmanagement,inordertogainacompetitiveadvantage. Performanceappraisalonthehospitalhumanresourcemanagementandbusinessmanagement willalsobekeyfactor泌wellasanissuetrouWingprivatehospitalmanagement.How化make泣 scientificandaccurateevaluationontheperformanceofdoctors,helping化achieve化estrategic goalsofthehospital,soas化maximizeandinspiredoctoK,enthusiasmandincreasetheoverall strengthofthehospital,istheimportanttaskfacingprivatehospitalmanagers,hasbecomethe urgentproblenisthatcriesout1:obesolved. Physicianfeesystem(PhysicianFee,FF),firstintroduced化TaiwanMackayMemorial HospitalmanagementbyZhangJinwenthroughlearningfromAmericanPhysicianfeesystemin thelate1970s.The〇〇巧ide过is化payasaperformanceindifferentproportionsor泣certain amountofcommission化physiciansbasedonthephysician’swork.Thissystemdesignallows thephysicianincomefactorwhichisdeterminedbythequalityofphysicianservicesandpriceof serviceprojects.Th的epaperstakesMPrivateHospitalasanexample,try化employphysician clinicfeesystemforthedoctor＊sperformanceevaluation,explorestheestablishmentofa scientific,objective,systematicandpracticalperformanceevaluationprogram. Thispaperfirstlyreviewstherelevanttheoriesonperformanceevaluation,describesthe conceptsofperformance,performanceevalxiation,physicianfeesystemandothermethodsused forperformanceappraisal,andd的cribestheliteratureoftheperformanceevaluationstudyfrom homeandabroad. Second.Thispaperintroducesthebasicsituationofdoctors＊performanceevaluationatM privatehospital,whichincludesthestatusquoofMprivatehospitalpro巧le,organizational structure,personnelstatusandphysicianperformanceevaluation,andpointedouttheproblems withitsPerformanceEvaluationbasedo打investigatio打resultonsatisfactionofdoctors＊ IIIperformanceevaluation.ThroughfurtheranalysisofprivatehospitalsM'sperformanceproblems, webelievetiiatitiscrucialfbrtheprivatehospitalMtodesignanoptimumperformance appraisalproposallinewithitscurrentsituation,soastoachieveleapfrogdevelopmentofthe hospital,upgradingitselftobeat;opcomprehensivehospital. In也etiiirdpart,thatis化ecorepartof化earticle,Idescribetheoptimi之ationpurposesand principlesofdesignonM’sPerformanceEvaluationofdoctors,withphysicianfeesys化mbeing 化ekeytooptimizedevaluatio打scheme,byemployi打gbalancedscorecardmethod,key performance山出〇过1;〇巧and0化erperformanceevaluationmethodas化eguiding化eory,proposes doctorsworkloadbasedphysicianfeesystemasthecore,emphasizingthequalityandefficiency assessment,usescomprehensiveevaluationasameans,whilefbcusingonpatient satisfaction-orientedindicators,andseetoit化athospitalsanddoctorsbetreatedasequal part打ers.soastomakethemedicaldoctorsCO打centrateontheirworkwithoutbeari打gtheriskof hospitaloperations,achievingtheaimofincreasi打gdoctors'personalsenseIIi打thenew performanceevaluationsys化m.Theoptimizedperformanceevaluationscheme0打Mhospi化1 canbedividedin化twosped打csections.Thefirstpartismainlythephysicianfeesyst;emwitfi primaryfocusondoctor’sworkload,includi打g化eprincipleofcommission,commission percentage,flex化lestrategyofcommission,commissionpercentagesetby化eredistrib山ion sys化mspecialist托es,physicianfeesandsointegralredistribution.Thesecondpartisthe assessmentofphysicianqualityofwork,efficiency,patientsatisfaction,andleami打呂abUity aspects,whichis化edesignedfbrassessing化eoverallobjectiveofmainsectionsof化ehospital aswellitsphysicians.Theoptimizedevaluationschemeintegrates1;heoverallgoalofdifferent sectionsandspeciali巧disl;rib山ioncosts,combinescomprehe打siveevaluatio打oftheperformance ofphysiciansandspecialistfeesintegralredistribution,inorder化findabalancebetweenthe quantityandqualityofdoctors'work. In化eimplementationof化eoptimizedproposal,化epaperdescribes化eevaluationbody, evaluationcycle,比eimplementationprocess,化eperformancecommunication,formsand applicationofperformanceevaluatio打results.Finally,thispaperpresentst;hesafeguarding measuresfbrimplementingtheoptimizedscheme,claims也at化ehospitalshouldoptimizeits corehospitalmanagementsupport,createaperformance-orientedculUireofthehospital, improveorganizatio打alperformanceappraisalandmanagementsysl;em,strengthe打thetraining offullperformanceevaluation,toimprovel:heinformationizationoftheinformationcollection process,establish化ecomp