Article(id=1240730056012648860, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202411408, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1732118400000, receivedDateStr=2024-11-21, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773742697003, onlineDateStr=2026-03-17, pubDate=1745510400000, pubDateStr=2025-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773742697003, onlineIssueDateStr=2026-03-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773742697003, creator=13701087609, updateTime=1773742697003, updator=13701087609, issue=Issue{id=1240730050669113883, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='8', pageStart='1345', pageEnd='1536', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773742695728, creator=13701087609, updateTime=1773742807836, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240730520988995837, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240730520988995838, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240730050669113883, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1418, endPage=1421, ext={EN=ArticleExt(id=1240730056293667242, articleId=1240730056012648860, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Research on the construction of public hospital operation management evaluation index system based on balanced scorecard, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To construct the evaluation index system of public hospital operation management to provide a reference tool for administrative departments and public hospitals to grasp the public hospital operation management situation.

Methods

Based on the balanced scorecard theory, the evaluation index system of public hospital operation management was initially constructed through literature analysis, the final evaluation index system was determined by Delphi method, and the index weight was calculated by AHP method.

Results

The response rate of expert consultation for the secondround was 100%, the authority coefficient was 0.840 and the coordination coefficients of the importance, feasibility and relevance of the indicators were 0.210, 0.181 and 0.196, respectively (P<0.001). The final evaluation index system consisted of 4 first-level indicators, 16 second-level indicators and 39 third-level indicators. The top 3 indicators of combined weight were inpatient satisfaction(0.0979), outpatient satisfaction(0.0682) and the proportion of medical service income(0.0494).

Conclusion

The public hospital operation management evaluation index system constructed by this research had high scientific, rational and practical guiding significance and was an effective tool to analyze and evaluate the operation management of public hospitals.

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目的

构建公立医院运营管理评价指标体系,为行政部门和公立医院掌握运营管理情况提供参考工具。

方法

基于平衡计分卡理论,通过文献分析法初步构建公立医院运营管理评价指标体系,采用德尔菲法确定最终评价指标体系,运用层次分析法计算指标权重。

结果

第二轮专家咨询问卷回收率100%,权威系数0.840,指标重要性、可行性、相关性的协调系数分别为0.210、0.181、0.196(P<0.001),最终评价指标体系包括一级指标4个、二级指标16个、三级指标39个,组合权重排名前3位的指标分别为住院患者满意度(0.097 9)、门诊患者满意度(0.068 2)和医疗服务性收入占比(0.049 4)。

结论

构建的公立医院运营管理评价指标体系具有较高的科学性、合理性和一定的实践指导意义,是分析评价公立医院运营管理情况的有效工具。

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邓林密,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=9kqo6+vnUhs9s5tK/NFF5Q==, magXml=4PUDKgXjSqGydcnw1EI7TQ==, pdfUrl=null, pdf=Df9RekyZoN9aCUSXQud9/g==, pdfFileSize=584646, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=4nseQtiieDoMpHC0FAJsEg==, mapNumber=null, authorCompany=null, fund=null, authors=

张成(1992—),男,硕士,助理研究员,研究方向:卫生健康政策评价

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(In Chinese), articleTitle=Thoughts on evaluation index system for High-Quality economic operation of public hospitals, refAbstract=null)], funds=[Fund(id=1241070726350950400, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, awardId=21PJ123, language=CN, fundingSource=四川省卫生健康委员会医学科技项目(21PJ123), fundOrder=null, country=null), Fund(id=1241070726439030790, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, awardId=2022JDKY0015, language=CN, fundingSource=四川省省级科研院所基本科研项目(2022JDKY0015), fundOrder=null, country=null), Fund(id=1241070727948980238, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, awardId=2024030, language=CN, fundingSource=成都市医学科研课题项目(2024030), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241070721313592065, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, xref=1., ext=[AuthorCompanyExt(id=1241070721321980675, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, companyId=1241070721313592065, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Sichuan Health Development Research Center, Chengdu, Sichuan 610042, China), AuthorCompanyExt(id=1241070721326174980, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, companyId=1241070721313592065, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川省卫生健康发展研究中心,成都 610042)]), AuthorCompany(id=1241070721389089544, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, xref=2., ext=[AuthorCompanyExt(id=1241070721397478153, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, companyId=1241070721389089544, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.川北医学院)]), AuthorCompany(id=1241070721468781325, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, xref=3., ext=[AuthorCompanyExt(id=1241070721477169934, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, companyId=1241070721468781325, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.成都市第二人民医院)]), AuthorCompany(id=1241070721556861713, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, xref=4., ext=[AuthorCompanyExt(id=1241070721565250322, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, companyId=1241070721556861713, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.成都市郫都区人民医院)]), AuthorCompany(id=1241070721674302230, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, xref=5., ext=[AuthorCompanyExt(id=1241070721682690839, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, companyId=1241070721674302230, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=5.桂林医科大学)])], figs=[ArticleFig(id=1241070725562422217, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, language=EN, label=Table 1, caption=

Expert authority coefficient

, figureFileSmall=null, figureFileBig=null, tableContent=
轮数熟悉程度Cs判断依据Ca权威系数Cr
第一轮0.7970.8980.847
第二轮0.7870.8930.840
), ArticleFig(id=1241070725797303249, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, language=CN, label=表1, caption=

专家权威系数情况

, figureFileSmall=null, figureFileBig=null, tableContent=
轮数熟悉程度Cs判断依据Ca权威系数Cr
第一轮0.7970.8980.847
第二轮0.7870.8930.840
), ArticleFig(id=1241070725902160857, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, language=EN, label=Table 2, caption=

Expert coordination coefficient

, figureFileSmall=null, figureFileBig=null, tableContent=
指标性质第一轮第二轮
协调系数χ2P协调系数χ2P
重要性0.198160.52P<0.0010.210170.45P<0.001
可行性0.15789.24P<0.0010.181146.37P<0.001
相关性0.134108.20P<0.0010.196158.78P<0.001
), ArticleFig(id=1241070725977658338, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, language=CN, label=表2, caption=

专家协调系数情况

, figureFileSmall=null, figureFileBig=null, tableContent=
指标性质第一轮第二轮
协调系数χ2P协调系数χ2P
重要性0.198160.52P<0.0010.210170.45P<0.001
可行性0.15789.24P<0.0010.181146.37P<0.001
相关性0.134108.20P<0.0010.196158.78P<0.001
), ArticleFig(id=1241070726061544424, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, language=EN, label=Table 3, caption=

Indicators and weights of public hospital operation management evaluation system

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一级指标权重二级指标权重三级指标权重组合权重
经济运行0.14创收能力0.23每职工平均医疗收入0.320.010 3
每床平均医疗收入0.290.009 3
百元固定资产医疗收入(不含药品收入)0.400.012 9
发展能力0.54总资产增长率0.180.014 0
固定资产增长率0.260.020 0
医疗盈余率0.550.042 4
偿债能力0.23流动比率0.240.007 8
速动比率0.370.012 1
资产负债率0.390.012 7
就医体验及评价0.30解决患者“看病贵”0.19门诊次均费用增幅0.480.026 9
住院次均费用增幅0.520.029 7
解决患者“看病难”0.25门诊患者预约后平均等待时间0.160.012 2
择期手术患者术前平均等待时间0.220.016 5
临床路径入径率和出径率0.250.018 6
出院患者随访率0.150.011 4
日间手术占择期手术的比例0.210.015 9
患者评价0.56门诊患者满意度0.410.068 2
住院患者满意度0.590.097 9
运营核心0.25质量安全0.38抗菌药物使用强度0.110.010 1
室间质评合格率0.170.016 0
单病种质量管理0.150.014 4
低风险组病例死亡率0.250.024 0
手术患者并发症发生率0.320.030 6
服务效率0.21每职工平均诊疗人次0.180.009 4
每职工平均住院床日0.190.010 3
平均住院日0.350.018 5
医疗设备使用率0.280.015 0
技术水平0.41CMI0.180.019 0
RW≥2比例0.230.024 0
出院患者手术占比0.170.018 0
出院患者三四级手术占比0.410.042 2
员工学习与机构成长0.31员工执业安全感0.23医疗纠纷人民调解率0.330.023 1
专职保安员与医务人员比例0.670.047 0
员工执业获得感0.27医疗服务性收入占比0.600.049 4
人员支出占比0.400.032 7
员工执业归属感0.24人才培养经费投入占比0.580.043 4
每百名卫生技术人员科研项目经费0.420.031 2
医疗机构成长潜力0.27新技术(新项目)收入占比0.540.044 6
重点专科专病收入占比0.460.038 2
), ArticleFig(id=1241070726162207728, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240730056012648860, language=CN, label=表3, caption=

公立医院运营管理评价指标及权重

, figureFileSmall=null, figureFileBig=null, tableContent=
一级指标权重二级指标权重三级指标权重组合权重
经济运行0.14创收能力0.23每职工平均医疗收入0.320.010 3
每床平均医疗收入0.290.009 3
百元固定资产医疗收入(不含药品收入)0.400.012 9
发展能力0.54总资产增长率0.180.014 0
固定资产增长率0.260.020 0
医疗盈余率0.550.042 4
偿债能力0.23流动比率0.240.007 8
速动比率0.370.012 1
资产负债率0.390.012 7
就医体验及评价0.30解决患者“看病贵”0.19门诊次均费用增幅0.480.026 9
住院次均费用增幅0.520.029 7
解决患者“看病难”0.25门诊患者预约后平均等待时间0.160.012 2
择期手术患者术前平均等待时间0.220.016 5
临床路径入径率和出径率0.250.018 6
出院患者随访率0.150.011 4
日间手术占择期手术的比例0.210.015 9
患者评价0.56门诊患者满意度0.410.068 2
住院患者满意度0.590.097 9
运营核心0.25质量安全0.38抗菌药物使用强度0.110.010 1
室间质评合格率0.170.016 0
单病种质量管理0.150.014 4
低风险组病例死亡率0.250.024 0
手术患者并发症发生率0.320.030 6
服务效率0.21每职工平均诊疗人次0.180.009 4
每职工平均住院床日0.190.010 3
平均住院日0.350.018 5
医疗设备使用率0.280.015 0
技术水平0.41CMI0.180.019 0
RW≥2比例0.230.024 0
出院患者手术占比0.170.018 0
出院患者三四级手术占比0.410.042 2
员工学习与机构成长0.31员工执业安全感0.23医疗纠纷人民调解率0.330.023 1
专职保安员与医务人员比例0.670.047 0
员工执业获得感0.27医疗服务性收入占比0.600.049 4
人员支出占比0.400.032 7
员工执业归属感0.24人才培养经费投入占比0.580.043 4
每百名卫生技术人员科研项目经费0.420.031 2
医疗机构成长潜力0.27新技术(新项目)收入占比0.540.044 6
重点专科专病收入占比0.460.038 2
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基于平衡计分卡的公立医院运营管理评价指标体系构建研究
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张成 1 , 潘秋予 2 , 宋磊 3 , 张礼杰 4 , 邓林密 5
现代预防医学 | 卫生政策与管理 2025,52(8): 1418-1421
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现代预防医学 | 卫生政策与管理 2025, 52(8): 1418-1421
基于平衡计分卡的公立医院运营管理评价指标体系构建研究
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张成1, 潘秋予2, 宋磊3, 张礼杰4, 邓林密5
作者信息
  • 1.四川省卫生健康发展研究中心,成都 610042
  • 2.川北医学院
  • 3.成都市第二人民医院
  • 4.成都市郫都区人民医院
  • 5.桂林医科大学
  • 张成(1992—),男,硕士,助理研究员,研究方向:卫生健康政策评价

通讯作者:

邓林密,E-mail:
Research on the construction of public hospital operation management evaluation index system based on balanced scorecard
Cheng ZHANG1, Qiu-yu PAN2, Lei SONG3, Li-jie ZHANG4, Lin-mi DENG5
Affiliations
  • Sichuan Health Development Research Center, Chengdu, Sichuan 610042, China
出版时间: 2025-04-25 doi: 10.20043/j.cnki.MPM.202411408
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目的

构建公立医院运营管理评价指标体系,为行政部门和公立医院掌握运营管理情况提供参考工具。

方法

基于平衡计分卡理论,通过文献分析法初步构建公立医院运营管理评价指标体系,采用德尔菲法确定最终评价指标体系,运用层次分析法计算指标权重。

结果

第二轮专家咨询问卷回收率100%,权威系数0.840,指标重要性、可行性、相关性的协调系数分别为0.210、0.181、0.196(P<0.001),最终评价指标体系包括一级指标4个、二级指标16个、三级指标39个,组合权重排名前3位的指标分别为住院患者满意度(0.097 9)、门诊患者满意度(0.068 2)和医疗服务性收入占比(0.049 4)。

结论

构建的公立医院运营管理评价指标体系具有较高的科学性、合理性和一定的实践指导意义,是分析评价公立医院运营管理情况的有效工具。

平衡计分卡  /  公立医院  /  运营管理  /  评价体系
Objective

To construct the evaluation index system of public hospital operation management to provide a reference tool for administrative departments and public hospitals to grasp the public hospital operation management situation.

Methods

Based on the balanced scorecard theory, the evaluation index system of public hospital operation management was initially constructed through literature analysis, the final evaluation index system was determined by Delphi method, and the index weight was calculated by AHP method.

Results

The response rate of expert consultation for the secondround was 100%, the authority coefficient was 0.840 and the coordination coefficients of the importance, feasibility and relevance of the indicators were 0.210, 0.181 and 0.196, respectively (P<0.001). The final evaluation index system consisted of 4 first-level indicators, 16 second-level indicators and 39 third-level indicators. The top 3 indicators of combined weight were inpatient satisfaction(0.0979), outpatient satisfaction(0.0682) and the proportion of medical service income(0.0494).

Conclusion

The public hospital operation management evaluation index system constructed by this research had high scientific, rational and practical guiding significance and was an effective tool to analyze and evaluate the operation management of public hospitals.

Balanced scorecard theory  /  Public hospitals  /  Operation management  /  Evaluation system
张成, 潘秋予, 宋磊, 张礼杰, 邓林密. 基于平衡计分卡的公立医院运营管理评价指标体系构建研究. 现代预防医学, 2025 , 52 (8) : 1418 -1421 . DOI: 10.20043/j.cnki.MPM.202411408
Cheng ZHANG, Qiu-yu PAN, Lei SONG, Li-jie ZHANG, Lin-mi DENG. Research on the construction of public hospital operation management evaluation index system based on balanced scorecard[J]. Modern Preventive Medicine, 2025 , 52 (8) : 1418 -1421 . DOI: 10.20043/j.cnki.MPM.202411408
2020年,国家卫生健康委印发《关于加强公立医院运营管理的指导意见》,明确要“动态掌握和评价运营管理工作进展及实施效果”。而一套有效的运营管理评价工具能帮助公立医院管理者有效应对外部“三医”协同发展治理等政策要求和内部经济运行压力,动态掌握运营管理实际情况,从而为加强顶层设计,明确提升路径,实现落实外部政策和内涵式发展“双赢”。当前,关于公立医院运营管理评价工具开发的研究较少,已有的研究在评价内容上主要以经济财务指标反映公立医院运营管理情况,重财务轻业务[1];评价方法主要以描述性分析[2]、对比分析[3-4]和综合评价运营效率为主[5-6],方法单一且各指标相互孤立;指标设置缺乏动态监测,偏向事后考核、年度比较,重结果轻过程[7]。平衡计分卡作为广泛应用的绩效管理工具,具有兼顾组织内外,平衡业务与财务、过程与结果、短期与长期等特点[8],能够弥补现有研究的不足。因此,本文基于平衡计分卡理论,旨在建立一套平衡业务和财务、结构和过程等的公立医院运营管理评价工具,为提升公立医院运营管理水平提供参考。
本文选取的公立医院运营管理评价指标来源主要包括:(1)从政府网站收集与公立医院运营管理相关的外部政策文件,包括医保支付方式改革,公立医院等级评审、绩效考核及高质量发展评价等,了解当前公立医院运营管理相关的政策要求,提取运营管理相关评价指标;(2)从中国知网、万方、PubMed等国内外数据库中以“运营管理”“经济运行”“运营评价”等为关键词,检索相关研究文献,对运营管理相关评价指标进行归纳整合。
平衡计分卡是从财务、顾客、内部经营流程、学习与成长四个角度,将组织战略逐层分解为具体且相互平衡的绩效考核指标体系并对指标实现状况进行考核,从而加强组织战略执行力的绩效管理工具。本文基于平衡计分卡建立的公立医院运营管理评价指标体系,能够综合衡量公立医院举办者、管理者、患者、员工等相关利益方。
首先,基于政策文件及文献梳理,初步建立公立医院运营管理评价指标体系,采取德尔菲法,邀请长期在公立医院从事医务、运营、医保、财务等方面的管理者以及研究者,开展两轮问卷咨询,并根据被访者反馈意见对评价指标体系进行调整。然后,采用层次分析法,建立层次模型,构造判断矩阵,邀请上述被访者根据指标相对重要性两两比较打分,计算各级指标权重。
将数据录入Excel 2016,计算专家权威系数Cr。采用SPSS 22.0计算专家协调系数Kendall-W、χ2P,检验水准P<0.05。采用SPSSPRO计算评价指标体系每个层次和每个指标的权重值。
根据平衡计分卡中财务、顾客、内部经营流程、学习与成长四个维度的评价框架,基于政策文件和学术文献[9-13],初步构建公立医院运营管理三级评价指标体系,其中一级指标包括经济运行、就医体验及评价、运营核心、员工学习与机构成长共4项;二级指标分别包括反映公立医院创收、发展和偿债能力,患者“看病难”“看病贵”等,运营核心中质量安全、服务效率、技术水平以及员工执业目标与机构成长潜力共13项;三级指标充分考虑指标的代表性、可行性、相关性,共筛选反映不同层级指标38项。
按照德尔菲法“建立指标体系的咨询专家人数应控制在15~50名”原则,本文从公立医院、科研院校邀请长期从事医务、运营、医保、财务等方面的专家共15名,平均工作年限11年,其中硕士及以上学历11人(73%),中高级职称13人(87%)。
(1)专家积极系数。第1轮专家咨询发放问卷17份,回收有效问卷15份,回收率88%;第2轮专家咨询面向第1轮返回有效问卷的15位专家,回收有效问卷15份,回收率100%,专家参与积极性较高。
(2)专家权威系数。首先请每个专家对评价指标的熟悉程度Cs和判断依据Ca分别按照Likert 5级和Likert 3级评分,再计算全部专家CsCa的平均值,最终得到权威系数CrCr=(Cs+Ca)/2,Cr越大代表专家权威性越高,通常将Cr≥0.70作为专家权威系数较高的标准。本文两轮专家咨询权威性均较好,见表1
(3)专家协调系数。首先请每个专家对评价指标的重要性、可行性、相关性分别按照Likert 5级评分,再通过非参数检验计算得到评价指标的重要性、可行性、相关性的Kendall-W。Kendall-W反映专家协调系数,取值0~1之间,Kendall-W越大表示协调程度越好。本文两轮专家咨询各协调系数均有所提高,一致性较好,且差异具有统计学意义(P<0.001),见表2
(4)专家咨询结果。按照指标得分>3.50分、变异系数<0.25作为指标保留标准。第一轮专家咨询所有三级指标均符合保留标准,但根据专家意见对个别指标定义进行修改,如将“抽查10万元以上医疗设备使用率”修改为“医疗设备使用率”等;新增体现解决患者“看病难”的“日间手术占择期手术的比例”指标;考虑到患者的术后并发症是非计划二次手术的重要原因,因此未采纳专家新增“非计划重返手术室再手术率”指标建议等。第二轮专家咨询未对指标进行修改。经两轮专家咨询,最终形成公立医院运营管理评价指标体系,其中一级指标4个、二级指标16个、三级指标39个,见表3
首先,邀请专家采用1~9相对尺度对各级指标相对重要性两两比较打分,各指标最终得分为全部专家打分平均值;然后,采用和积法进行一级指标权重计算和一致性检验,结果显示一致性比值CR=0.013<0.1,说明一级指标判断矩阵的一致性是可以接受的,指标权重有效。按照相同方法和步骤分别计算二级、三级指标权重,二级、三级指标一致性比值均满足CR<0.1要求,各级指标权重值见表3
在理论支撑上,将平衡计分卡中财务、患者、内部运营流程、学习与成长四个维度分别拆解对应公立医院举办者、管理者、患者、员工等相关利益群体,并逐层分解为具体且相互平衡的指标体系,确保不同层级指标相互衔接。在构建方法上,严格遵循德尔菲法和层次分析法构建指标体系的步骤,80%以上咨询专家来自于大型三甲公立医院中医务、运营、财务、医保等部门管理人员,具有丰富的管理实践经验,两轮专家咨询中的权威系数和协调系数均达到相关标准要求。在指标设置上,结合当前公立医院相关政策考核要求如改善就医体验、医疗质量安全改进目标等,参考现有文献中高频使用指标以及咨询专家实践管理经验,在评价指标选取上充分体现便捷性、代表性和可行性,既包括经济运行指标、也涵盖医疗服务指标,既监测过程、也体现结果,有效发挥平衡计分卡在平衡财务与业务指标、过程与结果指标等方面的优势。
本文基于平衡计分卡建立的公立医院运营管理评价体系涉及医院经济运行、医疗质量、运营效率、技术水平、患者就医体验以及员工学习与成长等受到公立医院举办者、管理者、患者及员工关注的多个方面。从结果来看,一级指标中员工学习与机构成长(0.31)、就医体验及评价(0.30),二级指标中患者评价(0.56)、发展能力(0.54)、技术水平(0.41)以及三级指标中组合权重排名前3位的住院患者满意度(0.097 9)、门诊患者满意度(0.068 2)和医疗服务性收入占比(0.049 4)对公立医院运营管理影响较大。综合来看,公立医院应把“以患者为中心”放在运营管理优先发展的战略地位,解决好群众“看病难”“看病贵”等重点影响患者就医体验和满意度评价的问题,持续改善医疗服务,促进患者就医体验和满意度提升,以此培养稳定忠诚的就医群体,确保公立医院获得可持续经营收入,同时也减少了患者医疗纠纷,确保员工执业安全感。而且,可持续经营收入一方面为落实薪酬待遇提供可能,确保员工执业获得感,另一方面也为提升员工重点专科及特色专病诊疗技术水平而引进所需的医疗设施设备、新技术等提供经济支撑,既确保员工执业归属感,又促进公立医院高质量发展,还为患者提供了精准高效的价值医疗服务,患者就医需求的满足意味着满意度持续提升,最终形成公立医院良性运营管理闭环,较好体现运营管理过程中各环节的系统性和各相关利益群体的协同性。
早在2020年,国家卫生健康委就明确要开展公立医院运营管理相关评价工作,但尚未建立一套科学合理、重点突出、便捷操作的评价工具,部分学者主要通过财务年报指标数据反映公立医院经济运行情况;公立医院绩效考核反映精细化管理的运营效率维度仅选用部分经济指标,缺乏一定的整体性[14]。本文基于平衡计分卡理论,通过德尔菲法和层次分析法系统建立的公立医院运营管理评价指标体系具有一定的实践指导意义。具体来说,行政管理部门可结合最新的政策改革要求,针对不同级别(省市县)、不同类型(综合、专科)公立医院的发展战略、业务重心,持续优化评价指标体系的指标权重、评价内容及标准等,逐步扩大指标体系的应用范围,为横向评价公立医院运营管理水平,促进运营管理能力提升提供支撑。公立医院则应建立院科两级的运营管理组织体系,将运营战略目标细分和拆解到相关的临床、医技等科室,动态监测科室运营管理实施效果,横向纵向考核比较并加强结果运用。同时,还要注重多指标关联性分析,通过不同指标组合分析为运营管理提供思路,例如若固定资产增长率高于同级别医院,但百元固定资产医疗收入(不含药品收入)反而不高,这提醒医院管理者固定资产使用效率不高,不能继续依靠“买设备盖房子”来扩大营业收入,而应推动管理模式从粗放式向精细化转变等。
  • 四川省卫生健康委员会医学科技项目(21PJ123)
  • 四川省省级科研院所基本科研项目(2022JDKY0015)
  • 成都市医学科研课题项目(2024030)
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2025年第52卷第8期
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doi: 10.20043/j.cnki.MPM.202411408
  • 接收时间:2024-11-21
  • 首发时间:2026-03-17
  • 出版时间:2025-04-25
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  • 收稿日期:2024-11-21
基金
四川省卫生健康委员会医学科技项目(21PJ123)
四川省省级科研院所基本科研项目(2022JDKY0015)
成都市医学科研课题项目(2024030)
作者信息
    1.四川省卫生健康发展研究中心,成都 610042
    2.川北医学院
    3.成都市第二人民医院
    4.成都市郫都区人民医院
    5.桂林医科大学

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2种不同金属材料的力学参数

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红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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