Research On The Evaluation Of Medical Performance Of Clinical Departments Mainly Basing On Workload And The Quality Of Work

ObjectivesAcorrding to the Health Ministry《the hospital management evaluation guide》,three-level hospital accreditation standards and program of hospital management year activity, we selected some important, representative and available indications which can reflect medical performance in clinical departments of the three-level hosiptal, and we want to build a comprehensive performance evaluation system for clinial departments, with the application of systematic and integrated methods,mathematical statistical methods and scientific metrology methods.The aim of our studies is to break away from the accounting practice of paying for pyhsician in public hospitals which only based on the balance of financial revenue and expenditure and to explore a new method of clinical departmens performance appraisal based on workload and the quality of work. Throughing our studies we want to provide a useful reference for the distribution system reform of public hospitals, and to improve the quality and efficiency, and to fully reflect the value of medical technology services through the evaluation of doctors'performance of clinical depatments.MethodsIn this study, our research objects are 23 clinical departments of a medical university's affliated hospital. The data used in our revaluation were from the hospital information center reports, human resources statistical reports, consolidated financial statements and the medical records of patients discharged from hospital clinical departments in 5th month of 2009.We mainly applied literature method and a variety of statistical methods in this study.Literature method:to understand the progress of this subject at home and abroad, we have examined a large nubmer of english ang chinese literature,through which medical performance evaluation indications were selected.Statistical methods:in this paper, the comprehensive analysis of generalized distance method were applied to determine the weight of different level of care levels and different surgical levels, which were used to calculate the value of the various departmens'care levels and surgical levels. And we used the principal component analysis combined TOPSIS method to evaluate the performance of 12 surgical departments and 11 non-surgical departments.ResultsIn accordance with the principles of the sentivity, importance, representativeness, availability ect, we have constructed a appraisal index system of clinical departmens' medical performance, and we have evaluated the medical performance of clinical departments with the application of the principal component analysis and TOSIS method. Specific results are as follows:l.The evaluation results of non-surgical departments'medical performanceIndicators involved in this study were as follows:①the first-level indicators:social and economic benefit, total amount of medical work, average workload, work efficiency and the quality of medical work.②the second-level indicators:the rate of decline the average hospitalization costs of medicare patients, drug proportion of total revenue, the rate of decline of the average of previous 3 months'drug proportion of tptal revenue, input-output ratio, care-level integrated value, number of out-patients, the number of rescue critically ill patients, the number of admitted patients,the number of discharged patients, the number days of actual occupation of beds, per capita outpatients, per capita number of long-tem doctor's advice issued, per capita number of temporary doctor's advice issued, per captia consultation visits, per capita number of critically ill patients to rescue, per capita the number of admitted patients, per capita the number of discharged patients, per capita responsible for the number of hospital bed days, per sickbed care-level integrated value, the average turnover rate of hospital beds, the actual of bed utilization, the average length of stay, the rate of improved and cured, the rate of admission diagnosis and diacharged diagnosis consistent, diagnosis rate of hospitalization on the 3rd, success rate of rescue critically ill patients.The final assessment results of TOPSIS method:Comprehensive performance scores of non-surgical departments (C scores)The correlation analysis of the final evaluation results of TOPSIS and sections' monthly the balance of financial revenue and expenditure results:The correlation analysis of the TOPSIS and the balance of financial revenue and Expenditure2.The evaluation results of surgical departments' medical performanceIndicators involved in this study were as follows:①the first-level indicators: social and economic benefit, total amount of medical work, average workload, work efficiency and the quality of medical work.②he second-level indicators:the rate of decline the average hospitalization costs of medicare patients, drug proportion of total revenue, the rate of decline of the average of previous 3 months'drug proportion of tptal revenue, input-output ratio, care-level integrated value, per hour surgery-level integrated value, number of out-patients, length of surgery time, the number of rescue critically ill patients, the number of admitted patients,the number of discharged patients, the number days of actual occupation of beds, per capita outpatients, per capita number of long-tem doctor's advice issued, per capita number of temporary doctor's advice issued, per captia consultation visits, per capita number of critically ill patients to rescue, per capita surgery-level integrated value, per capita the length of surgery time, per capita the number of admitted patients, per capita the number of discharged patients, per capita responsible for the number of hospital bed days, per sickbed care-level integrated value, per sickbed surgical-level intergrated value, the average turnover rate of hospital beds, the actual of bed utilization, the average length of stay, the rate of improved and cured, the rate of admission diagnosis and diacharged diagnosis consistent, diagnosis rate of hospitalization on the 3rd, diagnosis rate before and after surgery consistent,success rate of rescue critically ill patients.The final assessment results of TOPSIS method:Comprehensive performance scores of surgical departments (C scores)The correlation analysis of the final evaluation resultsof TOPSIS and sections' monthly the balance of financial revenue and expenditure results:The correlation analysis of the TOPSIS and the balance of financial revenue and ExpenditureConclusions1.we established a comprehensive evaluation index system for non-surgical departments and surgical departments which can evaluate their medical performance separately. This evaluation system was different from previous studies',covering doctors'workload,departments'benefit,medical quality and work efficiency ect.2.Our assessment results was more scientific and rational, with using the combination of principal component analysis and TOPSIS menthod.3.There was a correlation between the evaluation results of this study and the balance of financial revenue and expenditure, which making research results having the pratical value and feasibility..