【摘要】：縣級(jí)公立醫(yī)院績(jī)效評(píng)價(jià)是縣級(jí)公立醫(yī)院管理重要組成部分。目前,我國(guó)尚未形成從政府和社會(huì)視角評(píng)價(jià)縣級(jí)公立醫(yī)院的統(tǒng)一規(guī)范評(píng)價(jià)體系,制約縣級(jí)公立醫(yī)院發(fā)展。因此,從政府和社會(huì)角度出發(fā),構(gòu)建一套完整的評(píng)價(jià)縣級(jí)公立醫(yī)院指標(biāo)體系,整體評(píng)價(jià)縣級(jí)公立醫(yī)院具有促進(jìn)縣級(jí)公立醫(yī)院發(fā)展的重要作用。縣級(jí)公立醫(yī)院績(jī)效評(píng)價(jià)指標(biāo)體系對(duì)縣級(jí)公立醫(yī)院業(yè)績(jī)、綜合運(yùn)營(yíng)、發(fā)展?fàn)顩r等方面進(jìn)行有效衡量和準(zhǔn)確輸出,提升縣級(jí)醫(yī)院綜合管理能力,促進(jìn)縣級(jí)公立醫(yī)院形成核心競(jìng)爭(zhēng)力,并形成長(zhǎng)效競(jìng)爭(zhēng)優(yōu)勢(shì),對(duì)于促進(jìn)我國(guó)醫(yī)藥衛(wèi)生體制的改革,完善公立醫(yī)院的法人治理結(jié)構(gòu),建立有效的激勵(lì)約束機(jī)制,提高縣級(jí)公立醫(yī)院的競(jìng)爭(zhēng)力具有重要的理論與現(xiàn)實(shí)意義。本課題從保障縣級(jí)公立醫(yī)院公益性、激發(fā)縣級(jí)公立醫(yī)院積極性、促進(jìn)縣級(jí)公立醫(yī)院可持續(xù)性三個(gè)視角進(jìn)行切入,從政府和社會(huì)的角度出發(fā),以縣級(jí)公立醫(yī)院績(jī)效評(píng)價(jià)體系的設(shè)計(jì)為研究對(duì)象,探討評(píng)價(jià)縣級(jí)公立醫(yī)院標(biāo)準(zhǔn)。首先,通過閱讀相關(guān)文獻(xiàn)和深入咨詢從事醫(yī)院管理與衛(wèi)生政策研究領(lǐng)域的專家初步擬定縣級(jí)公立醫(yī)院績(jī)效評(píng)價(jià)指標(biāo)體系;其次,對(duì)咨詢問卷進(jìn)行可靠性檢驗(yàn);再次,運(yùn)用德爾菲法對(duì)指標(biāo)進(jìn)行篩選;最后,運(yùn)用層次分析法對(duì)各項(xiàng)指標(biāo)設(shè)置權(quán)重,形成縣級(jí)公立醫(yī)院績(jī)效評(píng)價(jià)指標(biāo)體系。本課題最終構(gòu)建了縣級(jí)公立醫(yī)院績(jī)效評(píng)價(jià)模型以及縣級(jí)公立醫(yī)院績(jī)效評(píng)價(jià)指標(biāo)體系,該指標(biāo)體系包括社會(huì)效益、醫(yī)療質(zhì)量與服務(wù)、醫(yī)院運(yùn)營(yíng)管理、可持續(xù)發(fā)展四項(xiàng)一級(jí)指標(biāo);14項(xiàng)二級(jí)指標(biāo)和48項(xiàng)三級(jí)指標(biāo),對(duì)每項(xiàng)指標(biāo)進(jìn)行權(quán)重設(shè)置,檢驗(yàn)結(jié)果具有一致性。咨詢問卷信度和效度高,可靠性好。三輪問卷回收率均在90%以上,咨詢結(jié)果可靠性強(qiáng)。指標(biāo)協(xié)調(diào)系數(shù)具有顯著性,咨詢專家建議協(xié)調(diào)性、可靠性、代表性好。本研究在新型醫(yī)療體制改革的背景下,從政府和社會(huì)角度出發(fā),構(gòu)建縣級(jí)公立醫(yī)院績(jī)效評(píng)價(jià)模型,形成了縣級(jí)公立醫(yī)院績(jī)效評(píng)價(jià)縣級(jí)公立醫(yī)院績(jī)效評(píng)價(jià)指標(biāo)體系,該指標(biāo)體系從社會(huì)效益維度、醫(yī)療質(zhì)量與服務(wù)維度、醫(yī)院運(yùn)營(yíng)管理維度、可持續(xù)發(fā)展維度出發(fā)科學(xué)評(píng)價(jià)縣級(jí)公立醫(yī)院,為縣級(jí)公立醫(yī)院發(fā)展指明方向,促進(jìn)縣級(jí)公立醫(yī)院發(fā)展。
[Abstract]:Performance evaluation of county-level public hospitals is an important part of county-level public hospital management. At present, China has not yet formed a unified and standardized evaluation system for evaluating county-level public hospitals from the angle of government and society, which restricts the development of county-level public hospitals. Therefore, from the point of view of government and society, it is important to construct a complete evaluation index system of county-level public hospitals, and to evaluate the county-level public hospitals as a whole to promote the development of county-level public hospitals. The performance evaluation index system of county-level public hospitals can effectively measure and output the performance, comprehensive operation and development status of county-level public hospitals, promote the comprehensive management ability of county-level hospitals, and promote the core competitiveness of county-level public hospitals. It is of great theoretical and practical significance to promote the reform of Chinese medical and health system, to perfect the corporate governance structure of public hospitals, to establish an effective incentive and restraint mechanism and to improve the competitiveness of county-level public hospitals. From three angles of view of ensuring the public welfare of county-level public hospitals, arousing the enthusiasm of county-level public hospitals, and promoting the sustainability of county-level public hospitals, the subject proceeds from the angle of government and society. Based on the design of performance evaluation system of county-level public hospitals, this paper discusses the evaluation standards of county-level public hospitals. First of all, through reading relevant literature and consulting experts engaged in hospital management and health policy research field preliminary development of the county level public hospital performance evaluation index system; secondly, the reliability of the consultation questionnaire test; again, Using Delphi method to screen the indicators; finally, use the Analytic hierarchy process to set up the weight of each index to form the performance evaluation index system of county public hospitals. Finally, the paper constructs the performance evaluation model of county-level public hospitals and the performance evaluation index system of county-level public hospitals. The index system includes social benefits, medical quality and service, hospital operation and management. There are 14 second-class indexes and 48 third-level indexes for sustainable development. The weight of each index is set up and the result is consistent. The reliability and validity of the questionnaire were high and the reliability was good. The recovery rate of three rounds of questionnaires was above 90%, and the result of consultation was reliable. The index coordination coefficient is significant, consultation experts suggest coordination, reliability, good representativeness. Under the background of the new medical system reform, this paper constructs the performance evaluation model of county-level public hospitals from the angle of government and society, and forms the performance evaluation index system of county-level public hospitals. The index system scientifically evaluates county-level public hospitals from social benefit dimension, medical quality and service dimension, hospital operation and management dimension, sustainable development dimension, points out the direction for the development of county-level public hospitals, and promotes the development of county-level public hospitals.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R197.3

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