【作者】 朱晶佳；

【导师】 万莹；

【作者基本信息】 江西财经大学 ， 行政管理， 2009， 硕士

【摘要】 改革开放以来,随着我国经济建设取得的巨大成就,国家在医疗卫生领域的投入不断增加,但仍然不能满足人民群众日益增长的卫生服务需求,在医疗卫生领域也出现了一些新问题,如医药费用过快增长、人口老龄化以及医疗服务效率不高等等。在这样的背景下,社区卫生服务作为解决以上问题的方式被提出来。社区卫生服务(CHS)是满足城市居民基本卫生服务需求的最佳方式,在提供便捷、连续、综合、协调、价廉的卫生服务方面具有很大的优势,在提高卫生服务公平性和服务效率、控制卫生费用增长方面起到了卓有成效的作用。在党和政府的大力推动下,社区卫生服务在我国得到了长足的发展,现已迈入了改革创新、加快发展的新阶段。并成为我国城镇医疗体制改革的重要内容,使得城市卫生服务能力得到了进一步的加强。但社区卫生服务在发展的过程中,它暴露出来了一系列的问题,包括公益性目标的偏离、服务供给效率不高以及服务重点的偏离等等。而绩效管理作为一种先进的管理工具,在提高工作效率、明确工作目标等方面具有卓越的功效,在社区卫生服务机构中建立绩效管理机制对于提高社区卫生服务的供给效率、促进社区卫生服务的发展等具有重要的意义。为此,国内一些学者对社区卫生服务的绩效管理进行了研究,也有一些机构有了社区卫生服务绩效管理的实践,但总体而言,这些研究和实践大都集中于绩效考核与评价等方面,绩效预算、绩效控制、绩效监督以及绩效反馈等方面都很少涉及到。有鉴于此,本文提出社区卫生服务绩效管理的研究,对社区卫生服务绩效管理在我国的发展现状进行了分析,对一些社区卫生服务机构采用绩效管理的实践进行了介绍,提出社区卫生服务绩效管理所面临的问题,包括筹资渠道单一,绩效预算体系尚未建立;绩效评价存在着诸如评价模式单一、指标设置不科学等问题;绩效反馈机制尚未建立;政府引导作用的缺失等。为此,需要对社区卫生服务绩效管理进行进一步的研究。本文对国外社区卫生服务运行管理模式进行了梳理,对国外社区卫生服务管理模式的特点进行了分析,并提出了国外模式对于社区卫生服务绩效管理的借鉴。在这样的基础之上,本文提出了加强社区卫生服务绩效管理的对策,包括建立社区卫生服务的政府绩效预算管理;完善社区卫生服务绩效评价与考核机制;完善社区卫生服务绩效信息流通机制;完善社区卫生服务绩效管理的监督机制;转变政府职能,发挥政府的引导作用等等。更多还原

【Abstract】 Since the reform and opening up, as China’s great achievements in economic construction, our Country’s input in the field of health care increases, but it still can not meet people’s growing demand for health services. In the health field there were also some new problems, such as excessive growth of medical costs, an aging population as well as efficiency of medical services is not high and so on. In this context, community health services as a way to solve the above problems have been raised. Community Health Services (CHS) is the best way to meet the needs of urban residents for basic health services. It has a great advantage in providing convenient, continuous, comprehensive, coordinated and affordable health services, and has played a productive role in improving the health service equity and efficiency in service delivery as well as control the growth of health expenditure. Under the vigorous promotion of the party and the government’s, community health services in our country has been developed rapidly, has marched into a new stage of reform and innovation. It has become a major content of China’s urban medical reform, making urban health service capacity strengthened. However, during the development process, community health services exposed a range of issues, including deviations from public interest objectives, the service supply efficiency is not high, and service focus deviation, etc... As an advanced management tool, the performance management has excellent efficacy in improving work efficiency, clear work objectives and other aspects. Establishing performance management mechanism in community health service agencies has great significance for improving the efficiency of the supply of community health services, promotion of community health services development. To this end, some domestic scholars of community health service have studied performance management. There are also a number of community health service agencies which have a performance management practices. Overall, however, most of these studies and practice focused on performance assessment and evaluation. In such areas as performance budgeting, performance control, performance monitoring and performance feedback and so on are rarely involved.In view of this, this paper presents the research on performance management of community health services. It analyzed the development of performance management in China, introduced a number of community health services organizations which adopted performance management practices , proposed problems in performance management community health service , including the financing of a single channel, performance budgeting system has not been established; performance evaluation models exist, such as evaluation of a single, target setting and unscientific and so on; performance feedback mechanism has not yet established; the lack of the role of government guidance and so on. To this end, we need further study for performance management of community health service. This paper analyzed the management model and characteristics of foreign community health service and proposed learning of foreign model for China’s community health services performance management. In this basis, this paper proposes strategies to strengthen the performance management of community health service , including establishment of Government Performance and budget management in community health services; improving community health service performance evaluation and assessment mechanisms; improving the performance information flow mechanism of community health services; improving the oversight mechanisms in performance management of community health service ; transformation of government functions and development of the government’s guiding role and so on.更多还原