Implementation Progress in Performance Appraisal for the Staff of Community Health Institutions in China after New Health Reform

doi:10.12114/j.issn.1007-9572.2018.28.003

Abstract

Abstract: A performance appraisal system is to motivate providers to effectively promote the transformation of service model，improve quality and efficiency of healthcare and sustain strong performance，as well as to motivate the enthusiasm of medical staff.This article introduced several performance appraisal systems for the staff in Chinese community health institutions after the new health reform.We also discussed their strengths and limitations.As "health gatekeepers"，community health institutions need to upgrade the performance appraisal system to define job functions clearly，choose key performance indicators wisely，provide impactful incentives to key performers，use performance data to improve care，and improve the efficiency of appraisal process with new information technology "Internet+".

Key words: Community health institutions, Community health workers, Performance appraisal

摘要： 完善的绩效考核不仅能充分激发医务人员的积极性，同时也能有效促进社区卫生服务机构的服务模式转变、完善服务功能、提高服务质量和效率。本文介绍了新医改以来我国社区卫生服务机构人员绩效考核的典型做法，并总结其中的经验与不足。为进一步完善社区卫生服务机构人员绩效考核，建议在设计绩效考核体系时，合理划分不同性质工作岗位、合理选取考核指标、构建科学动态的绩效评价指标体系、加强考核结果利用、加强绩效反馈改进，充分利用“互联网+”助推绩效考核，最终发挥社区卫生服务机构健康“守门人”的作用。

关键词: 社区卫生服务机构, 社区卫生工作者, 绩效考核

YUAN Linlin,SHAO Yuchen,REN Lemeng, et al. Implementation Progress in Performance Appraisal for the Staff of Community Health Institutions in China after New Health Reform　[J]. Chinese General Practice, 2018, 21(28): 3417-3422. DOI: 10.12114/j.issn.1007-9572.2018.28.003.
袁林林,邵雨辰,任乐濛等. 新医改以来我国社区卫生服务机构人员绩效考核实施进展[J]. 中国全科医学, 2018, 21(28): 3417-3422. DOI: 10.12114/j.issn.1007-9572.2018.28.003.

References

［1］中共中央　国务院关于深化医药卫生体制改革的意见［Z］．2009.3421
［2］李倩，卢祖洵，金建强.荷兰全科医生的职责［J］．中国社会医学杂志，2003，20（3）：97-100．DOI：10.3969/j.issn.1673-5625.2003.03.001.3421
LI Q，LU Z X，JIN J Q.The duties of a Dutch general practitioner［J］．Chinese Journal of Social Medicine，2003，20（3）：97-100．DOI：10.3969/j.issn.1673-5625.2003.03.001.3421
［3］邓娟娟.社区卫生服务中心员工绩效考核指标体系的研究和应用［D］．上海：东华大学，2011.3421
DENG J J.Research and application of performance evaluation indicators system for employees in community health service centers［D］．Shanghai：Donghua University，2011.3421
［4］鲍勇.基于家庭医生制度的绩效评价指标和体系研究［J］．中华全科医学，2015，12（1）：1-3．DOI：10.16766/j.cnki.issn.1674-4152.2014.01.001.3421
BAO Y.The latest research on performance evaluation index and system based on family physician system［J］．Chinese Journal of General Practice，2015，12（1）：1-3．DOI：10.16766/j.cnki.issn.1674-4152.2014.01.001.3421
［5］常利洁.北京市南苑社区卫生服务中心岗位绩效管理研究［D］．北京：中国地质大学，2015.3421
CHANG L J.Research on performance appraisal of post：Beijing Fengtai District Nanyuan Community Health Service Center as an example［D］．Beijing：China University of Geosciences，2015.3421
［6］姚岚，龚勋，张亮，等．社区卫生服务中心个人绩效考核方案初探［J］．中国卫生经济，2007，26（12）：13-15．DOI：10.3969/j.issn.1003-0743.2007.12.005.3421
YAO L，GONG X，ZHANG L，et al．Discuss personal performance appraise in the community health service center［J］．Chinese Health Economics，2007，26（12）：13-15．DOI：10.3969/j.issn.1003-0743.2007.12.005.3421
［7］刘继霞，欧阳伟，肖立新，等．基于服务当量值的社区卫生服务岗位绩效管理的实践探索与评价［J］．中国全科医学，2017，20（22）：2689-2702．DOI：10.3969/j.issn.1007-9572.2017.22.004.3422
LIU J X，OUYANG W，XIAO L X，et al．Practice implementation and effect assessment of performance management community health service-related positions based equivalent value of sevices［J］．Chinese General Practice，2017，20（22）：2689-2702．DOI：10.3969/j.issn.1007-9572.2017.22.004.3422
［8］朱月伟，章菱，周俊杰，等．社区卫生“有效工时”绩效考核的实践与探索［J］．中国卫生经济，2010，29（2）：48-50．DOI：10.3969/j.issn.1003-0743.2010.02.015.3422
ZHU Y W，ZHANG L，ZHOU J J，et al．The practice and exploration of performance appraisal in community health "effective working hours"［J］．Chinese Health Economics，2010，29（2）：48-50．DOI：10.3969/j.issn.1003-0743.2010.02.015.3422
［9］徐蕾，赵琦，朱敏杰，等．家庭医生绩效考核指标体系的构建研究［J］．中国全科医学，2015，19（25）：3028-3032．DOI：10.3969/j.issn.1007-9572.2016.25.006.3422
XU L，ZHAO Q，ZHU M J，et al．Construction of performance appraisal indicator system of family doctors［J］．Chinese General Practice，2015，19（25）：3028-3032．DOI：10.3969/j.issn.1007-9572.2016.25.006.3422
［10］张平，赵德余.中国特色健康保障之路的探索：长宁社区卫生服务发展模式的演进历程与经验［M］．上海：上海人民出版社，2011：10.3422
ZHANG P，ZHAO D Y.Exploration of the road to health protection with Chinese characteristics：the evolution and experience of the development model of Changning community health service［M］．Shanghai：Shanghai People's Publishing House，2011：10.3422
［11］张计委，张军，陆海姝，等．全科服务团队分级绩效考核指标体系构建及应用效果分析［J］．中国卫生资源，2012，15（5）：371-373．DOI：10.3969/j.issn.1007-953X.2012.05.006.3422
ZHANG J W，ZHANG J，LU H S，et al．Construction and effect of classified performance measurement indicator system for general practitioner service team［J］．Chinese Health Resources，2012，15（5）：371-373．DOI：10.3969/j.issn.1007-953X.2012.05.006.3422
［12］程敏，田军.社区卫生服务中心员工绩效考核方法研究［J］．中国全科医学，2012，15（31）：3581-3585．DOI：10.3969/j.issn.1007-9572.2012.31.006.3422
CHENG M，TIAN J.Performance evaluation of community health service center［J］．Chinese General Practice，2012，15（31）：3581-3585．DOI：10.3969/j.issn.1007-9572.2012.31.006.3422
［13］韩琤琤，冯亿，刘向红，等．德胜社区卫生服务中心实行绩效考核与分配制度对社区卫生机构激励的效果分析［J］．中国全科医学，2009，12（1）：71-74．DOI：10.3969/j.issn.1007-9572.2009.01.031.3422
HAN Z Z，FENG Y，LIU X H，et al．Analysis of the effect of performance appraisal and distribution system on the incentives of community health institutions in Desheng Community Health Service Center［J］．Chinese General Practice，2009，12（1）：71-74．DOI：10.3969/j.issn.1007-9572.2009.01.031.3422
［14］钟宁，吴克明，刘德安，等．全科团队社区卫生服务质量评价体系研究及应用［J］．中国卫生质量管理，2010，17（2）：73-75．DOI：10.3969/j.issn.1006-7515.2010.02.025.3422
ZHONG N，WU K M，LIU D A，et al．Research and application of quality evaluation system of community health service in general team［J］．China Health Quality Management，2010，17（2）：73-75．DOI：10.3969/j.issn.1006-7515.2010.02.025.3422
［15］杜晖，曹文芳，朱红英.以标化工作量为基础的绩效考核评价体系对社区卫生综合改革的推动作用［J］．智慧健康，2017，3（4）：27-30．DOI：10.19335/j.cnki.2096-1219.2017.04.07.3422
DU H，CAO W F，ZHU H Y.The promoting effect of the performance assessment system based on standardized workload on the comprehensive reform of community health［J］．Smart Health，2017，3（4）：27-30．DOI：10.19335/j.cnki.2096-1219.2017.04.07.3422
［16］陆新建，侯进，蔡利强.基于标化工作量的家庭医生岗位绩效考核初探［J］．中国全科医学，2017，20（s2）：214-215.3422
LU X J，HOU J，CAI L Q.Primary investigation of performance appraisal about family doctor based on standardized workload［J］．Chinese General Practice，2017，20（s2）：214-215.3422
［17］杨肖光，代涛，王芳.我国基层医疗卫生机构实施绩效工资的政策分析［J］．中国卫生政策研究，2013，6（5）：15-20．DOI：10.3969/j.issn.1674-2982.2013.05.003.3422
YANG X G，DAI T，WANG F.Analysis of the policy of implementing performance salary in China's basic medical and health institutions［J］．China Health Policy Research，2013，6（5）：15-20．DOI：10.3969/j.issn.1674-2982.2013.05.003.3422
［18］闫昕，雷行云，李娟，等．国外社区卫生服务绩效管理和信息技术应用的现状研究［J］．中国全科医学，2015，18（1）：27-30．DOI：10.3969/j.issn.1007-9572.2015.01.008.3422
YAN X，LEI X Y，LI J，et al．The present situation of performance management of community health services abroad and the application of information technology［J］．Chinese General Practice，2015，18（1）：27-30．DOI：10.3969/j.issn.1007-9572.2015.01.008.3422
［19］彭迎春，苏宁，陈琦，等．基于工作分析的社区卫生服务机构岗位绩效考核构想［J］．中华医院管理杂志，2009，25（2）：110-113．DOI：10.3760/cma.j.issn.1000-6672.2009.02.013.3422
PENG Y C，SU N，CHEN Q，et al．Proposal for a job-analysis based perfornmnce appraisal for posts in community healthcare organizations［J］．Chinese Hospital Management Magazine，2009，25（2）：110-113．DOI：10.3760/cma.j.issn.1000-6672.2009.02.013.3422
［20］龚勋，姚岚，陈启鸿，等．社区卫生服务中心个人绩效考核现状分析［J］．中国卫生事业管理，2008，25（1）：35-37．DOI：10.3969/j.issn.1004-4663.2008.01.016.3422
GONG X，YAO L，CHEN Q H，et al．Situation of individual performance assessment in community health service center［J］．China Health Care Management，2008，25（1）：35-37．DOI：10.3969/j.issn.1004-4663.2008.01.016.3422
［21］高伟婧.什刹海社区卫生中心员工绩效考核研究［J］．中国医疗设备，2017，32（s1）：147.3429
GAO W J.Research on performance evaluation of Shichahai Community Health Center［J］．Chinese Medical Equipment，2017，32（s1）：147.3429
［22］周紫霄.卫生行政管理人员360度绩效考核的应用探析［J］．国际医药卫生导报，2004，10（14）：247-248．DOI：10.3760/cma.j.issn.1007-1245.2004.14.154.3429
ZHOU Z X.Analysis on the application of 360 degree performance evaluation of health administrative personnel［J］．International Medicine and Health Report，2004，10（14）：247-248．DOI：10.3760/cma.j.issn.1007-1245.2004.14.154. 3429
［23］方鹏骞，李璐.基于胜任力评价的社区卫生服务机构管理人员绩效考核体系探讨［J］．中国卫生质量管理，2012，19（4）：92-94．DOI：10.3969/j.issn.1006-7515.2012.04.032.3429
FANG P Q，LI L.Discussion on performance appraisal system of management personnel of community health service institutions based on competency evaluation［J］．China Health Quality Management，2012，19（4）：92-94．DOI：10.3969/j.issn.1006-7515.2012.04.032.3429
［24］BATES R A，HOLTON E F.Computerized performance monitoring：a review of human resource issues［J］．Human Resource Management Review，1995，5（4）：267-288．DOI：10.1016/1053-4822（95）90010-1.3429
［25］吴姝德.基于绩效考核的全科医生团队薪酬激励机制研究［D］．武汉：华中科技大学，2016.3429
WU S D.Research on the salary incentive mechanism of general practitioners team based on performance appraisal［D］．Wuhan：Huazhong University of Science and Technology，2016.3429
［26］侯春玲，陈静静，田英，等．绩效考核及分配制度在社区卫生服务机构的实践研究［J］．中国全科医学，2014，17（25）：2945-2947．DOI：10.3969/j.issn.1007-9572.2014.25.010.3429
HOU C L，CHEN J J，TIAN Y，et al．Practice research on performance appraisal and distribution system in community health service organizations［J］．Chinese General Practice，2014，17（25）：2945-2947．DOI：10.3969/j.issn.1007-9572.2014.25.010.3429
［27］张文娟.新医改形势下基层公立医院员工激励问题研究：以河北省Y市医院为例［D］．北京：北京师范大学，2010.3429
ZHANG W J.Research on the incentive of employees in grass-roots public hospitals under the new medical reform：a case study of Y hospital in Hebei Province［D］．Beijing：Beijing Normal University，2010.3429

[1]	LI Ziqi, HE Ping, YUAN Beibei, ZHANG Wei, XU Hanyi, WEI Qianchen, MENG Qingyue, XU Jin. Index System Construction and Application Case Analysis for County Health System Development Focusing on Primary Care [J]. Chinese General Practice, 2023, 26(25): 3147-3152.
[2]	YAN Hao, CHEN Sisi, NIE Hanlin, HUANG Zhengwei, HU Hanxu, ZHAO Weihan, YANG Yong, SHI Xuefeng. Preferences for the Use of Appropriate TCM Techniques among Primary Health Workers: a Discrete-choice Experiment-based Study [J]. Chinese General Practice, 2023, 26(16): 1958-1964.
[3]	LI Xinyan, HAN Youli. Effects and Implications of Introducing Competition Mechanisms in the Delivery of Contracted Family Doctor Services [J]. Chinese General Practice, 2023, 26(04): 447-452,459.
[4]	JI Yan，SUN Yange，YAN Chunze，DING Lan，DING Jing. Further Clinical Training for In-service Medical Workers in a Community Health Center of Beijing　 [J]. Chinese General Practice, 2021, 24(4): 490-495.
[5]	CHEN Xinyue，YOU Lili，WANG Huanqian，LIAN Jun，YANG Li，LIU Meicen，LIAO Zirui，ZHAO Jinhong，YANG Linghe，FAN Zixuan，YANG Siqi，LIU Yuanli. Job Satisfaction and Influencing Factors among Essential Public Health Practitioners in Primary Care　 [J]. Chinese General Practice, 2021, 24(28): 3597-3601.
[6]	QIN Jiangmei，WANG Fang，LIN Chunmei，ZHANG Yanchun，ZHANG Lifang. Recent Developments in Performance Assessment Policies and Practices in Primary Healthcare in China　 [J]. Chinese General Practice, 2021, 24(16): 1989-1994.
[7]	ZHENG Chanjiao，CHEN Baoxin，HUANG Zhijie，SHEN Huanyu，OU Weilin，ZHANG Dongying，WANG Jiaji，ZHOU Zhiheng. Job Satisfaction and Influencing Factors in the First Batch of Community Health Workers Delivered Pilot Family Doctor Services in Guangdong Province　 [J]. Chinese General Practice, 2020, 23(8): 964-968.
[8]	HE Lin，TIAN Hui，WANG Lan. Current Status of Core Competencies of Health Management among Community Health Workers and Its Influencing Factors　 [J]. Chinese General Practice, 2020, 23(34): 4320-4325.
[9]	LIU Pingyang，WANG Haitang，DU Zhaohui. Recent Developments in General Practitioners' Competence Evaluation　 [J]. Chinese General Practice, 2020, 23(25): 3220-3225.
[10]	MA Guofang，WANG Xiaona，WANG Xin. Development prediction and operation research of "2+X"-type family doctor team in Xinjiang's urban community health organizations [J]. Chinese General Practice, 2020, 23(19): 2412-2416.
[11]	HU Wenshuang，ZHANG Ning，FENG Guosheng. Evaluation of Chronic Disease Patients on Community Health Services and Its Influence on the Selection of Medical Institutions under the Medical Treatment Alliance　 [J]. Chinese General Practice, 2020, 23(16): 1982-1988.
[12]	ZHANG Haina，WANG Meirong，CHEN Xiaolei，XU Xiaojingyuan，LI Jing，WANG Huali，DU Juan. The Content Construction of Dementia Management in Community Based on Delphi Method　 [J]. Chinese General Practice, 2020, 23(16): 2072-2079.
[13]	ZHANG Xiaoyan，ZHANG Xiaona，YANG Shiyu. Knowledge Mapping Analysis of Research Fields about Family Doctors　 [J]. Chinese General Practice, 2019, 22(27): 3395-3400.
[14]	LIU Caiyin，HE Tingting，WANG Quan. Responses to the Supportive Policies for the Implementation of Contracted Family Doctor Services and Job Satisfaction in Primary Healthcare Workers　 [J]. Chinese General Practice, 2019, 22(10): 1160-1164.
[15]	LU Huimin，HUANG Qi，YANG Dandan，MIAO Chunxia，GAO Xiuyin. Family Doctor Team Burnout and Influencing Factors：a Survey　 [J]. Chinese General Practice, 2019, 22(10): 1223-1228.