【作者】 何莎莎；

【导师】 冯占春；

【作者基本信息】 华中科技大学 ， 社会医学与卫生事业管理， 2009， 硕士

【摘要】 目的:本研究以“绩效”概念的共词分析结果为基础,结合公立医院的实际,从组织层面确定公立医院绩效的内涵。通过比较分析研究国内外医院绩效评价现状及非营利性组织评估,遵循卫生系统绩效评价的思想,构建我国公立医院组织绩效评价的理论研究路径。探讨公立医院组织绩效内涵对绩效评价的启示。为更好的开展绩效评价与改进提供理论基础。方法:运用公共管理学、政策分析理论、社会学等理论和方法,对公立医院组织绩效的内涵、绩效评价的理论与现状进行了分析。主要方法包括:⑴词频分析法;⑵共词分析法;⑶卫生统计学方法;⑷头脑风暴法。结果:(1)绩效是一个概念较为抽象、边界相对宽泛的中性词。绩效内涵包含社会学、经济学和管理学三个维度以及40个概念要素。(2)公立医院组织绩效的定义为:医院在既有资源条件下,在积极履行社会责任与基本职能的过程中,在讲求内部管理与外部效应的基础上,获得的产出最大化。它包括社会效益、经济效益及管理的效率与效能。(3)公立医院绩效内容与范围的界定应遵循医院工作的逻辑顺序:即资源→活动→产出→结果。资源是指为开展活动所需的资源消耗;活动是指公立医院职能履行的过程和医院经营管理活动;产出是指医院活动所产生的所有输出和提供的服务;而结果则是指这些输出对公众健康所产生的影响,主要表现为接受治疗者健康状况的改善程度。(4)我国公立医院组织绩效评价的理论路径由5个基本环节构成,即评价目标、内容、方法、指标与标准以及绩效评价报告。其中绩效评价内容主要包括社会效益、经济效益和管理效益,要能全方位反映医院整体工作状况。(5)我国公立医院组织绩效内涵对绩效评价的启示:从价值导向来看,公立医院应做到“以人为本”,公立医院绩效评价应体现公益性及非营利性;从评价内容来看,公立医院绩效应包含经济效益、社会效益和管理的效率与效能;从评价主体来看,公立医院绩效评价主体应呈现多元化;从评价方法来看,目前在公立医院绩效评价中应用较多的为平衡记分卡法。讨论与建议:(1)明确公立医院社会责任,加强医院社会效益考评;(2)正确认识经济效益与社会效益的内涵及其辩证关系;(3)建立医院绩效评价制度,完善绩效评价系统;(4)注重绩效评价反馈,推动医院绩效管理全面建设;(5)加强公立医院内涵建设,逐步实现公立医院“公益性”回归。更多还原

【Abstract】 Objective:Based on the Co-term analysis of performance,combined with the practice and characteristics of public hospital,the study defined the connotation of organizational performance of public hospital in our country.By comparing the analysis on the status quo of performance evaluation of hospital and non-profit organization,followed the thinking of performance evaluation of the health system,we conceived the theoretical route of performance evaluation in the public hospital. In order to provide theoretical base for better performance evaluation and improvement.Methods: Through theoretical analysis and professional consulting, the performance connotation and status quo of performance evaluation were analyzed by applying the theories and methods of public management, public policy analysis and sociology, etc. The main methods include word frequency analysis, Co-term analysis, biostatistics and brain storming.Results:Firstly,Performance is an abstract concept which has border broad. The connotation of performance included the dimensions of economics,sociology and management. It also included 40 elements of the concept.Secondly,Organizational performance of public hospital in our country is defined as:under the conditions of the existing resources,in the process of actively fulfill social responsibilities and basic functions;form the basis of internal management and external effects,hospital acquired the output which is maximum. It included social benefits, economic benefits,managerial efficiency and efficacy.Thirdly,the content and scope of public hospital performance should follow the logical order of the task,that is, resources→activities→outputs→results. Resources is defined as activities required by the resource consumption;activities refers to functions performed process and managerial activities;output refers to the removal generated by the hospital activities and the services they provided;the result is the impact to public health of the outputs,mainly to improve the health status of people who received treatment.Fourthly,the theoretical path of organizational performance evaluation of public hospitals composed five basic aspects,that is,objectives,contents,methods,indicators,standards and performance evaluation report. Performance evaluation which includes social,economic and managerial efficiency,it is necessary to reflect the overall working conditions of public hospital.Finally,the enlightenment of organizational performance connotation for performance evaluation included 4 points:Judging from the value-oriented,public hospitals should be“people-oriented”and its performance should be reflected in public and non-profit;From the evaluation contents , it included social benefits, economic benefits, managerial efficiency and efficacy;From the subject of the evaluation,performance evaluation of public hospitals should be diversified;Judging from the evaluation method,the current performance evaluation method used more in public hospitals application is Balanced Scorecard Method.Discussion and Suggestions:(1) Cleared social responsibility of public hospitals and strengthen the social effectiveness evaluation;(2) Correctly understand the connotation of economic and social benefits and the dialectical relationship between them;(3) Established hospital performance evaluation institution, improved the performance appraisal system;(4) Emphasized performance evaluation feedback, promoted the performance management comprehensive construction of public hospital;(5) To strengthen the meaning construction of public hospital, progressive realized the regress of "public welfare" of public hospital.更多还原