摘要目的 了解我国公立医院在运营中应用以资源为基础的相对价值比率( RBRVS)相关绩效评价方法的初步情况.方法 对全国最早借助第三方公司实行RBRVS相关绩效评价方法1年以上的12所大型三级甲等公立医院进行调查,总结其RBRVS绩效评价的设计重点,包括考核层面、核算方式、方案设计、点数设置及成本计入的选择等.采用描述性统计学方法分析相关数据.结果从RBRVS绩效考核层面来看,受访医院中大部分的考核层级还不够细化,其中, 8所医院绩效考核只到科室级,3 所医院考核到诊疗组,只有1 所医院考核到个人.受访医院中,8 所以上医院应用RBRVS绩效评价提高了效率及员工积极性,近半数医院表示该方法有助于提升服务难度、降低成本、提高医疗质量.结论 公立医院选择与第三方合作进行RBRVS相关绩效改革具有一定优势.我国引入RBRVS绩效评价需要根据公立医院具体情况与管理目标进行本土化过程设计.

abstractsObjective To learn the initial application of RBRVS related performance appraisal at public hospitals in China. Methods 12 tertiary public hospitals which took the lead to introduce RBRVS models, via third-party cooperation, in medical stuff performance assessment over one year were surveyed. The study summarized their design emphases of RBRVS performance appraisal, covering such aspects as appraisal level, accounting method, conceptual design, points setup and items charged as cost. Descriptive statistics was used to analyze the data so acquired. Results As shown in the performance appraisal level, most hospitals were found with defects in refining levels, as eight hospitals only appraise down to the department level, three to diagnostic group level, and only one hospital to individuals. Of these hospitals, over eight hospitals used RBRVS to elevate the efficiency and inventiveness of employees, while half of these hospitals reported the method can improve service, reduce cost and enhance quality of care. Conclusions Public hospitals enjoy advantages via third-party cooperation RVRBS method in RVRBS-related reforms. Introduction of this method calls for localization design based specifics and management goals of public hospitals.