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                                《天津市人民政府辦公廳關于印發天津市三級公立醫院績效考核工作實施方案的通知》政策解讀
                                來源:市衛生健康委 發布時間:2019-06-21 17:24


                                  日前,我市印發《天津市人民政府辦公廳關于印發天津市三級公立醫院績效考核工作實施方案的通知》(津政辦函〔2019〕46號,以下簡稱《實施方案》),有關情況解讀如下:

                                  一、背景依據

                                  公立醫院是本市醫療服務體系的主體,是人民群眾看病就醫的主要場所,是實現醫療服務高質量發展的主力軍。黨的十八大以來,市委市政府堅決貫徹落實以習近平同志為核心的黨中央的決策部署,牢固樹立以人民為中心的發展理念,把衛生健康事業作為重大民計民生問題,對人民群眾看病就醫工作高度重視,特別是注重激勵公立醫院發揮引領我市醫學發展和保障患者基本就醫權利的雙重作用。因此,對本市三級公立醫院實行績效考核,對激勵公立醫院落實功能定位和可持續發展起到十分重要作用,也是公立醫院改革和現代醫院管理制度的重要內容,是檢驗公立醫院改革發展成效的重要標尺,更是貫徹落實黨中央、國務院決策部署、狠抓落實的重要手段,對進一步深化本市公立醫院綜合改革、加快完善本市分級診療制度和現代醫院管理制度具有重要意義。

                                  二、目標任務

                                  通過績效考核,推動本市三級公立醫院在發展方式上由規模擴張型轉向質量效益型,在管理模式上由粗放的行政化管理轉向全方位的績效管理,促進收入分配更科學、更公平,實現效率提高和質量提升,促進深化醫藥衛生體制改革和公立醫院綜合改革政策落地見效。2019年,按照國家要求進一步完善本市三級公立醫院績效考核工作,使指標體系更加精細,考核辦法更加科學,結果運用更具引導性。到2020年,建立較為完善的三級公立醫院績效考核體系,促進三級公立醫院功能定位進一步落實,內部管理更加規范,醫療服務整體效率有效提升。

                                  三、主要內容

                                  此次報審的《實施方案》提出了實施三級公立醫院績效工作的“五個明確”:

                                  一是明確績效考核指標體系。市衛生健康委在《國務院辦公廳關于加強三級公立醫院績效考核工作的意見》(國辦發〔2019〕4號)提出的4個一級指標、14個二級指標、55個三級指標的基礎上,結合本市實際進行延展,形成比較符合本市實際的績效考核指標體系。本市三級公立醫院績效考核指標體系分為量化考核指標、加分指標和減分指標3部分組成。其中,量化指標主要從黨的建設、醫療質量、運營效率、持續發展、滿意度評價、行風建設、醫保執行情況7個維度進行考核,包含7個一級指標、22個二級指標、63個三級指標;為了提高指標體系對公立醫院公益屬性的導向性,鼓勵公立醫院落實功能定位,積極投入政府指令任務和社會公益事業。加分指標包括設立健康扶貧支援合作、應急救治與大型活動保障工作情況、落實藥品和耗材采購使用政策、開展按疾病診斷相關分組(DRGs)試點、公立醫院智慧醫院建設、臨床科學用血和無償獻血工作等。減分指標包括重大違法違規事件或重大事件并造成重要影響的指標。

                                  二是明確績效考核工作程序。按照《國務院辦公廳關于加強三級公立醫院績效考核工作的意見》(國辦發〔2019〕4號)要求,結合本市實際情況,將考核程序和方法包括醫院自查自評、市級統籌考核和黨的建設考核。在2019年9月底前,完成對2018年醫院績效情況的分析評估,將2018年病案首頁信息、年度財務報表和其他績效考核指標相關數據上傳至國家和本市三級公立醫院績效考核信息系統。根據績效考核指標和自評結果,醫院調整完善內部績效考核和薪酬分配方案,實現外部績效考核引導內部績效考核,推動醫院科學管理。2020年起,每年2月底前完成上述工作。市衛生健康委承擔全市三級公立醫院的績效考核工作,及時將總結評估報告報送國家衛生健康委。

                                  三是明確建立協調推進機制。市衛生健康委負責開展三級公立醫院績效考核工作,并牽頭組織、發展改革、財政、教育、人社、醫保等部門建立協調推進機制,研究三級公立醫院績效考核推進工作,解決考核中遇到的問題。把績效考核作為推進深化醫改的重要抓手,促進有關醫改政策落地見效。

                                  四是明確績效考核基礎工作。由國家統一疾病分類編碼、手術操作編碼和醫學名詞術語集,全市加強應用,通過提高病案首頁質量、加強滿意度調查工作,完善績效考核信息系統,確保績效考核關鍵數據的真實、客觀。

                                  五是明確績效考核結果運用。將績效考核結果作為醫院發展規劃、財政資金投入、績效工資總量核定、醫保政策調整、醫院等級評審和評價、醫學中心和區域醫療中心建設以及其他各項評優評先工作的重要依據;同時,將績效考核結果作為重大項目立項、選拔任用公立醫院黨組織書記、院長和領導班子成員的重要參考。

                                  四、涉及范圍

                                  《實施方案》適用于全市三級公立醫院績效考核工作。具體考核指標的權重分值和評分標準、三級公立中醫醫院績效考核指標由市衛生健康委會同市有關部門另行制定。

                                     

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