Study On Performance Evaluation Of Public Hospital Based On RBRVS

An important goal of the comprehensive reform of China's medical and health system is to make public hospitals be of the nature of public welfare.To achieve this reform goal,four ministries and commissions,including Ministry of Human Resources and Social Security,issued the "Guiding Opinions on Carrying out the Pilot Work of Salary System Reform in Public Hospitals”in 2017,aiming to establish a performance evaluation system that highlights the nature of public welfare in public hospitals and a salary system that conforms to the laws of the health industry.This paper studies the establishment of hospital performance evaluation system based on Resource-based Relative Value Scale(abbreviated RBRVS)in a hospital in Tianjin,preliminarily evaluates the application effect and further discusses the constraints and countermeasures faced by the large-scale promotion of RBRVS.This paper employs statistical analysis method to compare and analyze the changes in business indicators,operating costs,employee benefits,patient burden and other aspects of a hospital in Tianjin from 2015 to 2018 before and after the application of RBRVS-based hospital performance appraisal system.Outpatient visits have increased by 0.42%,discharge visits by 5.88%,operation visits by 22.76%and medical business income by 5.21%annually.The cost of medical services grew by an average of 2.72%a year,the expenditure on wages and benefits grew by an average of 21.24%,the annual average of drug income decreased by 22.607 million yuan,the proportion of drug income in medical services decreased by an average of 4.56 percentage points,the average annual average of drug expenses for outpatients decreased by 7.62%,and the average annual average of drug expenses for inpatients decreased by 10.33%.The results showed that the main medical service indexes of the hospital kept increasing,the operating costs were well controlled,the wages and benefits of the staff were greatly improved,the proportion of drug expenses and drug income decreased significantly,the rapid growth of the burden of patients' medical expenses was curbed,the original intention of applying the performance evaluation system based on RBRVS was realized,and it was consistent with the goal of the comprehensive reform of the national medical and health system.Although the actual situation of public hospitals across the country is different,the application of RBRVS-based performance indicator system in a hospital in Tianjin still has certain reference significance.Although there are still some difficulties in promoting the performance appraisal system based on RBRVS,such as lack of guidance at the national level,limited financial input,lagging adjustment of medical service prices,and restriction of applicable objects,it is believed that with the continuous deepening of the comprehensive reform of the medical and health system,through the establishment of the financial input policy,medical service prices and medical security system under the overall management at the national level,RBRVS will be more widely applied in the performance management of public hospitals in China,and will also help to establish the hospital salary system in line with the characteristics of the health industry currently required by the state.