At present, Beijing has formulated a series of performance management policies for community health service centers, most of which focus on assessment and have not yet formed a performance management system. At the same time, there are still many problems in performance management considering the actual work of the centers. On the basis of the original internal performance appraisal system, this study improved the performance management in view of the existing problems, formed a set of performance management system applicable to the district community health service center, provided a reference for the community health service centers to establish a scientific performance management system in the future, and promoted the development of community health service work.

To explore the effect of performance management in community health service center.

In 2019, this group conducted a baseline survey on the current status of performance management in terms of center position setting, assessment indicators and weights, performance feedback and improvement in 18 community health service centers in Tongzhou District, Beijing. The Delphi expert consultation method was used to determine the evaluation indicators of the implementation effect of performance management, and the Internal Performance Management Manual of Community Health Service Centers (hereinafter referred to as the Manual), which contains 6 first-level indicators (number of services, service utilization, service quality, medical staff performance evaluation, patient satisfaction, and target management) and 34 second-level indicators, was finally determined. 2021, the evaluation of the application effect of the Manual was carried out (number of services, service utilization, service quality, medical staff performance evaluation, patient satisfaction, and target management) .

The service quantity, service utilization and service quality of key work in 2020 were improved compared with those of the previous year, except for the family doctor contract rate and the real physical examination rate of the elderly, which were slightly lower than the regional average level, other indicators were higher than the regional level; performance management evaluation: Medical staff believed that the salary and workload were relatively matched and very matched increased by 29.8%; the cognition of center development goals, department development goals and individual work priorities increased by 15.6%, 13.2% and 2.6% respectively; the assessment indicators were in line with the actual work increased by 20.6%; reasonableness of index weight value and the secondary performance distribution of departments and stations increased by 19.4% and 8.3% respectively; the incentive that is strong increased by 18.3%; the performance improvement effect increased by 18.1% significantly; the overall satisfaction with performance management increased by 11.8%. Resident satisfaction: satisfaction with chronic disease management, children's health management, medical staff's technical level, and medical treatment results improved to varying degrees. Year-end assessment of district level: except for 1 center whose ranking remained unchanged, the rest of the centers were all improved. Salary: annual per capita incomes of on-the-job workers, doctors, nurses, and preventive and public health personnel increased by 5.2%, 7.6%, 8.4%, and 10.4% respectively, which was forty seven, eighty seven, forty four and thirty nine thousand higher than that of the whole region.

After the demonstration of community health service centers with different economic development levels, the application effect of the performance management system is remarkable, which improves the quantity and quality level of key work in the community, enhances the enthusiasm and service ability of medical staff, and then improves the satisfaction of patients, and it has certain promotion value. However, the number of centers that apply performance management system is limited and the time is short, so it is necessary to expand the application scope and continue to track the application situation in the future.

北京市制定了一系列社区卫生服务中心绩效管理方面的政策，多数社区卫生服务中心以考核为主，并未形成绩效管理体系。本研究在原有内部绩效考核体系的基础上，针对存在的问题完善绩效管理，形成一套适用于全区社区卫生服务中心的绩效管理体系。

探讨绩效管理体系在社区卫生服务中心的内部实施效果。

2019年本课题组对北京市通州区18所社区卫生服务中心的中心岗位设置、考核指标与权重、绩效反馈与改进等方面绩效管理现状进行基线调查。通过德尔菲专家咨询法确定绩效管理实施效果的评价指标，最终确定包含6个一级指标（服务数量、服务利用、服务质量、医务人员绩效评价、患者满意度和目标管理）、34个二级指标的《社区卫生服务中心内部绩效管理手册》（以下简称手册）。2021年对手册应用效果进行评价（服务数量、服务利用、服务质量、医务人员绩效评价、患者满意度和目标管理）。

2020年重点工作的服务数量、服务利用和服务质量较上年度提高，除家庭医生签约率和老年人体检真实率略低于全区平均水平，其余指标均高于全区水平；医务人员绩效评价：医务人员认为工资与工作量比较匹配和非常匹配上升了29.8%；对中心发展目标、科室发展目标和个人本职工作重点的认知分别上升了15.6%、13.2%和2.6%；考核指标符合实际工作上升了20.6%；指标权重值和科室、占二次绩效分配合理分别上升了19.4%和8.3%；认为激励性较强增加了18.3%；绩效改进效果明显增加了18.1%；绩效管理总体满意度上升了11.8%。患者满意度：对慢性病管理、儿童健康管理、医务人员技术水平和就诊结果方面的满意度均有不同程度的提高。区级年终考核：除1中心排名未变，其余中心均名次提高。工资薪酬：在岗职工、医生、护士和预防保健人员年人均收入分别增长了5.2%、7.6%、8.4%和10.4%，较全区人均收入分别提高了4.7、8.7、4.4、3.9万元。

经过不同经济发展水平的社区卫生服务中心论证，该绩效管理体系应用效果显著，提高了社区重点工作数量和质量水平，增强了医务人员积极性和服务能力，进而提升了患者的满意度，具有一定的推广价值。但应用绩效管理体系的中心数量有限，时间偏短，在今后需要扩大应用范围，继续追踪应用情况。