平衡利益相关者的利益:对中国公立医院绩效评估实施的平衡得分卡视角
Shufang Yao1, Shaozhuang Ma2, Lishuo Shi3
1Guangzhou Asclepius Healthcare Accreditation Institute (GAHA), Guangzhou, China.
概括
中国国家公立医院评估改善了战略和满意度,但面临挑战. 关键的利益相关者利益,特别是卫生当局和公众,并没有被评估指标完全解决.
科学领域:
- 医疗服务管理 医疗服务管理
- 公共卫生政策 公共卫生政策
- 医院绩效测量方法 医院绩效测量方法
背景情况:
- 中国在2019年引入了第三级公共医院的国家绩效评估.
- 关于其具体评估指标和实施结果的研究有限.
- 了解系统对利益相关者利益和医院运营的影响至关重要.
研究的目的:
- 评估中国国家评估体系中关键利益相关方利益的平衡.
- 检查国家评估对公共医院运营的积极影响和挑战.
- 为改善医院在类似环境中的绩效评估系统提供见解.
主要方法:
- 利用了利益相关者理论和平衡得分卡框架.
- 进行了两轮的德尔菲咨询,分别有46名和29名专家.
- 分析了档案评估数据 (2018-2020年) 并与医院利益相关者进行了41次半结构面试.
- 采用肯德尔一致系数和主题分析来解释数据.
主要成果:
- 评估指标主要涵盖患者,高管和医疗保健工作者,但不包括卫生当局和公众.
- 该系统采用均衡的得分卡方法,强调以患者为中心和内部流程.
- 积极影响包括明确的战略,优先考虑的公共角色,提高质量/安全/效率和提高满意度.
- 挑战包括资源限制,指标与患者需求/医生实践之间的错位,以及标准化与当地环境紧张关系.
结论:
- 国家评估对中国公立医院产生了积极的影响,但在利益相关者代表性方面存在局限性.
- 解决已识别的挑战对于优化评估系统的有效性和公平性至关重要.
- 结果为决策者和医院管理人员提供了关于绩效评估设计和实施的实际影响.
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