综合医院基于医疗工作和管理的绩效考核与薪酬分配研究

综合医院基于医疗工作和管理的绩效考核与薪酬分配研究宇应涛培养类别非全日制学位类型专业学位一级学科(专业类)公共卫生硕士二级学科(专业)公共卫生（MPH）研究方向医院管理指导教师董晓建教授培养单位军事预防医学院第四军医大学TheFourthMilitaryMedicalUniversity分类号UDC密级硕士学位论文二O一三年五月独独创创性性声声明明秉承学校严谨的学风与优良的科学道德，本人声明所呈交的论文是我个人在导师指导下进行的研究工作及取得的研究成果。尽我所知，除了文中特别加以标注和致谢的地方外，论文中不包含其他人已经发表或撰写过的研究成果，不包含本人或他人已申请学位或其他用途使用过的成果。与我一同工作的同志对本研究所做的任何贡献均已在论文中作了明确的说明并表示了致谢。申请学位论文与资料若有不实之处，本人承担一切相关责任。论文作者签名：日期：保保护护知知识识产产权权声声明明本人完全了解第四军医大学有关保护知识产权的规定，即：研究生在校攻读学位期间论文工作的知识产权单位为第四军医大学。本人保证毕业离校后，发表论文等使用本论文工作成果时第一署名单位仍然为第四军医大学。学校可以公布论文的全部或部分内容（含电子版，保密内容除外），可以采用影印，缩印或其他复制手段保存论文；学校有权允许论文被查阅和借阅，并在校园网上提供论文内容的浏览和下载服务。同意学校将论文加入《中国优秀博硕士学位论文全文数据库》和编入《中国知识资源总库》等，并可浏览和下载，同时享受《中国优秀博硕士学位论文全文数据库出版章程》规定的相关权益。论文作者签名：导师签名：日期：第四军医大学硕士学位论文目录缩略语表······························································································································1中文摘要······························································································································2英文摘要······························································································································5前言······························································································································9文献回顾····························································································································12正文····························································································································231材料·························································································································231.1医院信息系统数据结构················································································231.2医院编制表····································································································231.3医院等级评审考核条目················································································231.4全国医疗服务价格项目规范········································································242方法·························································································································243结果·························································································································293.1年度绩效工资考核指标及办法····································································293.2日常（月度）绩效工资考核指标及办法····················································314讨论·························································································································364.1医院定岗定编存在的问题············································································364.2不同类别人员绩效工资差异程度掌握难····················································364.3医院信息系统存在偏医疗轻管理问题························································364.4绩效考核精细化难以做到考核到个人························································37小结····························································································································38参考文献····························································································································40个人简历和研究成果········································································································42致谢····························································································································43附件····························································································································44第四军医大学硕士学位论文-1-缩略语表缩略语英文全称中文全称PMperformancemanagement绩效管理HRMHumanResourceManagement人力资源管理HISHospitalInformationSystem医院信息系统TQMtotalqualitymanagement全面质量管理HRPHospitalResourcePlanning医院资源计划MSPIMedicalServicePriceItem医疗服务价格项目BSCTheBalancedScorecard平衡计分卡KPIKeyPerformanceIndication关键业绩指标第四军医大学硕士学位论文-2-综合医院基于医疗工作与管理的绩效考核与薪酬分配研究硕士研究生：宇应涛导师：董晓建教授第四军医大学训练部医学教育研究室，西安710032中文摘要关键词：综合医院；医疗工作与管理；绩效考核；薪酬分配；研究综合医院运行模式具有复杂性，决定了医院薪酬分配是一项复杂的系统工程。科学合理的薪酬分配办法能调动广大医务人员积极性，鼓励积极诊治病人，提高医疗质量，改善服务水平，提高医疗效率，节约运行成本，不断开展新技术新业务。对社会而言，综合医院的薪酬分配体系关系到医院的发展，关系到医院承担的社会责任履行程度。随着国家新医改政策的不断深入，综合医院必将成为国家医改政策涉及的领域。近年来，随着我国医疗保障体制改革的不断深入，广大人民群众对医疗保健的需求日益增长，医院诊疗数量不断攀升，促进了医院快速发展，在这种形势下，医院如何加强自身管理，建立科学合理的薪酬分配体系，提高医务人员积极性，提高管理水平以适应新形势需要，已经成为医院管理者必须面对的课题。在这种背景下，近年来许多学者在此方面做了大量细致卓有成效的工作，产生了一些先进的理论和方法，为我国医院薪酬分配指明了方向，在众多的薪酬分第四军医大学硕士学位论文-3-配理论体系中，基于绩效管理的薪酬分配得到广大医务工作者和医院管理者的广泛认可。由于医院运行的复杂性，医院信息化水平的制约等因素，这些绩效管理理论难以在医院实际开展，目前大多处于理论研究阶段。本为研究的目的是：针对综合医院绩效薪酬实施困难的问题，依托医院信息系统，建立一套完备的绩效薪酬分配体系，为我国综合医院薪酬分配提供参考模式，促进医院科学发展，更好地履行社会责任。本研究的方法是提取医院信息系统底层数据结构表，了解医院信息系统可以达到的数据层级和范围，以此为基础，结合医院绩效管理理论体系，构建综合医院各类科室、各类岗位的薪酬分配办法。本研究取得的主要成果有：1．收集整理了不同医院信息系统近千张数据结构表，对这些数据结构表进行互相对比、整理、合并、去重，得到医院信息系统公共数据集，为绩效薪酬方案推广普及奠定基础。2．对综合医院科室分类进行科学划分，在当前临床和医技科室两大类基础上更进一步深化，把医院科室划分为手术科室、非手术科室、手术关联科室、门诊治疗处置型科室、医技科室、保障科室、机关等七大类，不同类别科室绩效薪酬分配办法完全不同。3．针对不同类型科室和部门，构建不同的绩效考核与薪酬分配方案，非手术科室重点突出治疗、手术科室重点突出手术、医技科室重点突出服务保障能力，并体现劳动强度和技术含量、风险程度等因素。4．建立了科室二次分配框架，在此框架下，各科室结合本科室各个岗位特点，制定考核到个人的绩效薪酬分配办法，在全院范围消除吃大锅饭问题，建立起医院面向科室、科室面向个人的绩效薪酬分配体系。5．建立起基于上述绩效薪酬分配信息化系统设计方案，为医院和科室二次分配采用信息化手段奠定基础，使绩效薪酬分配办法透明、阳光、及时、方便。第四军医