Study Of Performance Appraisal In Shanghai Tertiary Hospitals

Owing to the improvement in living standards and rapid advance in medical technologies in recent years, the urgent demand for health and healthcare from the public has been contradicted with the affordability of limited financial resources delivered by the government. This, coupled with uneven regional planning and distribution of the health resources, a faster pace of aging population and more chronic conditions in the spectrum of diseases, have led to an intense complaint of'inaccessible medical care and unaffordable medical bills'. As a result, the current national healthcare reform aims to improve the quality, reduce the cost but maintain the accessibility and equality. The quality and efficiency of hospital services have, therefore, become the focus of the health system. Under such circumstances, a better performance of public hospitals has become a practical requirement and fast track to the improvement of medical service capabilities and elevation of levels of the public health. Consequently, it's of great, imminent significance to study the objective priorities, mode framework and weight design in the process of performance appraisal of public hospitals.This paper begins with definitions of relevant core concepts and introduction of theories on the performance appraisal of public hospitals. This follows with a summarization of the merits and limitations on performance appraisal schemes in 23 tertiary hospitals since the year of 2006. These schemes are collected by the Shanghai Shenkang Hospital Development Center, a pilot institution of 'separated hospital management from hospital operation'. The paper addresses the problems in the present appraisal effect, methods and feedback, reveals the link between these flaws and the imperfect existing health system and management operation of public hospitals, and investigates their underlying causes. After that, the paper comes up with suggestions for improvement of the performance appraisal. These suggestions include: to increase the government investment in healthcare to secure the social welfare of public hospitals; carry out the 'Huge Ministry System' reform to lessen the obstacles resulting from barriers between multiple departments, policies from different departments and departmental or regional interest drive; supplement appraisal indexes that can reflect the process and rationality in medical treatment; and facilitate the 'customer orientation' in the appraisal system by referring to the new WHO ideas in healthcare, introduce'responsive'indexes and thus achieve the 'people-oriented' goal. Finally, the paper concludes that the performance appraisal system of tertiary hospitals should fully reflect special features of the medical profession and cover three categories of indexes, namely medical service quality, cost control and financial management, highlighting the safe, accessible and acceptable outcomes through reasonable, appropriate and correct process. This people-oriented, hierarchical, open and government-guided index system will not only be accepted, but also be relied and trusted by the public.In summary, this paper intends to further perfect and popularize the mode of performance appraisal for public hospitals, thus to optimize the use of medical resources for a substantial elevation of medical treatment quality and full guarantee of the public health.