rbrvs价值评价体系在上海二级甲等医院绩效分配方面的实践

r rb br rv vs s 价价值值评评价价体体系系在在上上海海 市市二二级级甲甲等等医医院院绩绩效效分分配配方方面面 的的实实践践 总总 8 8 页页 -CAL-FENGHAI.-YICAI-Company One1 -CAL-本页仅作为文档封面，使用请直接删除 RBRVS 价值评价体系在上海市二级甲等医院绩效分配方面的实践 摘要 目前，随着国家卫生部对医院公益性要求的确立和强化，收支结余法已不再适应公益性 改革的要求。2012 年 12 月，申康医院发展中心下发了关于市级医院深化内部绩效考核和 分配制度改革的指导意见（试行）。2014 年，市级医院全面实施改革。经过几年的实践， 已经取得了一定成效。在药品费零加成的背景下，为了能够在医疗、服务、管理等方面实现 突破、朝着精细化管理和创新驱动型发展的方向不断迈进，作为二级甲等综合性医院的上海 市******已着手开展以 RBRVS 价值评价体系为基础的绩效改革工作。本文将以该院的绩效改 革为切入点，介绍 RBRVS 价值评价体系的分配原则与分配方法，阐述该院依据全国医疗服 务价格项目规范（2012 年版）、上海市医疗机构医疗服务项目和价格汇编（2014 年） 设计符合本院实际情况的、具有强操作性的、能够体现 RBRVS 价值评价体系的绩效改革方案 的实际工作流程,并提出在设计过程中的思考与体会。从源头上对医院注入活力、深层激发医 疗工作者的工作热情、全方位提升医疗水平和服务质量、彰显社会效益、经济效益等宏伟蓝 图的构建都需要撬动绩效改革的杠杆作用得以实现，绩效改革可谓是一切改革的序幕。目 前，在二级公立医院中实行 RBRVS 价值评价体系的医院屈指可数，随着国家对公立医院的要 求和医院自身不断发展的需要，势必有越来越多的医院将会加入到绩效改革的队伍中。相信 该院在这方面的探索和实践也将对同级医院有一定的借鉴作用。 Nowadays, with the social responsibilities of the public hospitals proposed and emphasized by the National Health and Family Planning Commission, Balance of payments in bonus distribution is no longer adapted. December 2012, Shen Kang，the hospital development center， issued the guiding opinions on deepening the internal perance re and distribution of municipal hospitals trial. In 2014, the municipal hospital carried out the re . After several years, some achievements have been achieved.Under the policy of “ zero addiition in the price of drugs “, Shanghai Pudong New Area Peoples Hospital has embarked on a perance innovation based on the RBRVS value in order to achieve a breakthrough in the aspect of medical, service, management, to realize the target of the delicacy management and innovation-driven development . The paper will focus on the hospital perance re, introduce the principle of distribution and allocation s of RBRVS value uation system, state the design flow which can meet the actual situation of the hospital with have strong operability and reflect the the re program of RBRVS value uation system based on the “national price of medical services specifications“ 2012 Editionand “the Shanghai City medical service item and price compilation“ 2014 edition, share the thinking in the design process. Perance Re plays a key role in injecting vitality to the hospital, stimulating deep work enthusiasm of all medical workers, enhancing all-round medical level and service quality, highlighting the social benefits and economic benefits .At present, RBRVS value uation system is used uncommon in two A hospitals .However,with the requirements of the nation towards public hospital and hospitals own development, there will be an increase in two A hospitals in the perance re . I believe that the hospitals practice will be the reference to the hospital at the same level. 关键词 RBRVS；绩效改革；分配原则；工作流程；思考和体会 1 研究背景 2 1.1 医院情况 ****** 1.2 医院开展绩效改革原因 从国家对公立医院的发展要求层面看，国务院办公厅关于建立现代医院管理制度的指 导意见（国办发【2017】67 号文）明确指出“要认真落实习近平总书记提出的两个允许 （允许医疗卫生机构突破现行事业单位工资调控水平，允许医疗服务收入扣除成本并按现行 规定提取基金后主要用于人员奖励），稳步提高