Abstract: Using common performance assessment theories and methods，we systematically reviewed the performance assessment policies in primary healthcare published between 2009 and 2020，and summarized typical local practices，experiences as well as problems during the period in China. In this period，the policies on performance assessment in primary healthcare are consistent in essence but have been improved successively，such as the Guiding Opinions on the Implementation of Performance Assessment in Healthcare（No. 98〔2010〕of Department of Personnel of the Ministry of Health），Guiding Opinions on Strengthening the Performance Assessment in Public Healthcare Institutions（No. 94〔2015〕of Department of Personnel of the Ministry of Health），and Guiding Opinions on Strengthening the Performance Assessment in Primary Healthcare（Trial Version）（No. 9〔2020〕 of Department of Primary Health of the National Health Commission），the latter one strengthens the applicability of the assessment，and focuses more on economic operation and informatization. Considering the local innovative practices，typical experiences and problems，we put forward four recommendations on the basis of review of available evidence and our own experience of participating in the drafting of these policies：（1）Modifying the performance assessment system for primary healthcare at the regional level to be a version with clear normal reference value for each indicator and detailed scoring methods.（2）The normal reference values for indicators and scoring methods should be simulated with historical data，and modified continuously.（3）Determining the indicators assessed at the regional level，enhancing the tiered assessment，and highlighting the application of performance assessment results.（4）Using technologies to directly grasp quantitative data from the information platform to reduce the burden of assessing performance of primary healthcare institutions. We expect these recommendations will assist local primary healthcare institutions in implementing and improving performance assessment.

Key words: Primary medical and health institutions, Performance appraisal, Performance management, Pay for performance, Health policy

摘要： 本文在对绩效考核理论与方法进行梳理和总结的基础上，系统梳理了全国2009—2020年出台的基层医疗卫生机构绩效考核政策进展，以及各地典型做法、经验及存在的问题。从政策进展看，《关于卫生事业单位实施绩效考核的指导意见》（卫人发〔2010〕98号）、《关于加强公立医疗卫生机构绩效评价的指导意见》（国卫人发〔2015〕94号）、《关于加强基层医疗卫生机构绩效考核的指导意见（试行）》（国卫办基层发〔2020〕9号）3个不同时期文件的基层医疗卫生机构绩效考核内容一脉相承，指标体系逐步完善；《关于加强基层医疗卫生机构绩效考核的指导意见（试行）》强化了指标可操作性，关注经济运行和信息化。根据参与文件起草经验，以及各地创新做法、典型经验及存在问题，提出4个方面的建议：（1）在省级层面完善指标体系，明确各指标标准值并细化评分方法；（2）指标值和评分方法要利用历史数据模拟，并且持续完善和优化；（3）确定省级监测指标，加强分级考核，重视绩效考核结果应用；（4）依靠信息化平台和信息化技术，量化指标直接抓取，为基层减负。希望上述建议能为各地基层医疗卫生机构绩效考核实施和完善提供借鉴。

关键词: 基层医疗卫生机构, 绩效考核, 绩效管理, 绩效工资, 卫生政策