【正文】 所以有專(zhuān)家提出，開(kāi)展基于方法集的組合評(píng)價(jià)方法（26）來(lái)作為綜合的評(píng)價(jià)體系。主要是三方面功能：一是鑒定科室的醫(yī)師績(jī)效，定量區(qū)分其績(jī)效水平．選拔出優(yōu)秀的科室人才 ；二是利用實(shí)際績(jī)效的評(píng)價(jià)對(duì)被評(píng)價(jià)對(duì)象的行為加以控制，引導(dǎo)其向目標(biāo)靠近 ；三是管理部門(mén)能及時(shí)動(dòng)態(tài)地掌握情況，既可以清楚地看到本單位人才整體優(yōu)勢(shì)與特色，又可以看到問(wèn)題與劣勢(shì)，并找出產(chǎn)生問(wèn)題的原因，及時(shí)加以解決，為決策提供科學(xué)的依據(jù)（20）。In China, transition has been pleted from planning economy to market economy, but reform on social institutions is still relatively lagging behind, where the current health care system was born under the planning economy. As a reasonable system, performance management is having much attention from hospital managers on different levels in China, which is mostly discussed in three layers, . hospital, faculty and its managers, and individual employees. My searching the database of technological periodicals written in Chinese indicates that there are 567 papers on hospital performance published from 1989 to February 2008, 129 relating to “performance assessment”, 122 satisfying the key word of search for hospital performance and only 26 papers on establishment of performance assessment and appraisal system. As early as 1993, Hu Lin, Yu Shuang and etc. with Fourth Military Medical University based in Xi’an built a “hospital prehensive benefit appraisal system”, whose index is divided into two groups as per input and output, including 6 aspects: personnel, equipment, supplies, funds, social benefits and economic benefits（8）。 management mode（3）, which gets connected longterm equipment and service choice, middlelevel decision support and munity hospital performance which has taken structural confinement into consideration. While helping further understand decision over strategic operation management, the abovementioned study determines some causeeffect relations and their action on hospital performance in the course of decision on operation. Furthermore, this study also finds out a key strategic decision helping improve performance of munity hospital in the changing environment of medical service. Among them, the “balance score card” is the latest and most effective mode for performance management, which is attracting a number of scholars and management workers. 對(duì)于醫(yī)院績(jī)效評(píng)價(jià)研究，國(guó)外醫(yī)院績(jī)效評(píng)價(jià)研究也包括三個(gè)層面。醫(yī)院在進(jìn)行績(jī)效評(píng)估與績(jī)效管理時(shí)，應(yīng)采取揚(yáng)棄的態(tài)度，充分借鑒企業(yè)的做法與經(jīng)驗(yàn)，并注重結(jié)合本行業(yè)的實(shí)際，實(shí)事求是地進(jìn)行績(jī)效評(píng)估與績(jī)效管理。My employer, Wuxi Fourth People’s Hospital (WFPH), is one of the first lot of grade 3 prehensive hospitals certified by Ministry of Health of the People’s Republic of China, which integrates health service, training, research, illness prevention and health care. It simultaneously serves as Wuxi Cancer Hospital and Fourth Hospital Attached to Suzhou University. Meanwhile, this hospital also houses Clinical Cancer amp。無(wú)錫市針對(duì)國(guó)際國(guó)內(nèi)形勢(shì)變化，在沒(méi)有任何經(jīng)驗(yàn)可借鑒的情況下，在國(guó)內(nèi)率先進(jìn)行了“政事分開(kāi)，管辦分離”運(yùn)行機(jī)制的改革。民營(yíng)醫(yī)院大量崛起，其中有些甚至收購(gòu)了多家公立醫(yī)院；外資醫(yī)院或機(jī)構(gòu)正在大舉入侵，其憑借獨(dú)特的技術(shù)和服務(wù)優(yōu)勢(shì)占得了不小的市場(chǎng)份額；隨處可見(jiàn)的私人診所和藥店也如雨后春筍般出現(xiàn)。醫(yī)院開(kāi)放床位1050張，腫瘤床位占總開(kāi)放床位的50%以上。As an important way to manage hospitals, performance assessment can impartially and objectively embody realization of management by objectives. Born in mid1950s, management by objectives is a set of management systems formed on the basis of the reasonable management and behavior science theory founded by Frederick Winslow Taylor, which is expected to arouse people’s enthusiasm to involve personally in making the objective. In order to continuously renovate and improve management, it is necessary to establish a reasonable assessment system which focuses on actual performance. Only in this way can appraisal be made fully, equally, objectively and impartially. This is the base point to realize such management. 績(jī)效管理已在發(fā)達(dá)國(guó)家，特別是國(guó)際成功企業(yè)中被廣泛采用，美國(guó)及歐洲一些國(guó)家的醫(yī)院，在各個(gè)層次都成功實(shí)施了績(jī)效管理。其中，“平衡計(jì)分卡”作為績(jī)效管理的一種最新、最有效的管理模式，吸引了眾多的學(xué)者和管理實(shí)踐者。盡管企業(yè)領(lǐng)域績(jī)效管理的方法已發(fā)展得比較成熟，但在國(guó)內(nèi)醫(yī)療衛(wèi)生領(lǐng)域中比較通用和權(quán)威的績(jī)效考核指標(biāo)還有待更深入的探索。呂東環(huán)（18）則用認(rèn)為系統(tǒng)的方法、原理，評(píng)定、測(cè)量工作人員在職務(wù)上的工作行為和工作效果，檢查和評(píng)定工作人員對(duì)職位所規(guī)定的職責(zé)的履行程度。由于不同級(jí)別的醫(yī)院情況不同，績(jī)效考核辦法也不同，目前大家都處于摸索階段。從當(dāng)前公立醫(yī)院資源配置和管理的實(shí)際狀況來(lái)看，很多醫(yī)院也已經(jīng)開(kāi)始進(jìn)行提高經(jīng)濟(jì)效益、進(jìn)行成本核算、拉開(kāi)職工收入差距等方面的嘗試。 Reflection on Establishment of Performance Assessment on Hospital Managers（17）, motivation is made for promoting personal management ability, operating ability, overall coordinating ability and other qualities in management, guided by the hospital management value. A performance assessment system for director of clinical faculty is established to ensure that the post as director of clinical faculty enables a modern hospital to meet the requirements on standardized reasonable management。 D ratio (the ratio of Types C and D cases to the total cases), personal average medical expense, patients’ satisfaction degree（10）。另有一些對(duì)中層管理人員工作和能力評(píng)價(jià)的研究，并嘗試開(kāi)發(fā)了綜合性的能力與工作評(píng)價(jià)工具（6），而員工評(píng)價(jià)目前比較盛行的是同級(jí)評(píng)價(jià) （7）。 hospitals, however, basically serve to heal the wounded and rescue the dying and take into account cost accounting only under the premise seeking for social results. A hospital shall handle performance appraisal and management by applying the applicable practice of an enterprise to its own line according to the fact. Right now it still cries out for a mature and practicable assessment system to approach how to roll a more reasonable assessment system and a dynamic mechanism with virtuous petition into hospital appraisal and parison and how to assess each talent’s performance with help of reasonable and impartial performance index in different units of a department. This is the subject calling for an immediate solution offered by hospital managers. 有關(guān)衛(wèi)生組織績(jī)效測(cè)量的研究正在開(kāi)展，績(jī)效測(cè)量標(biāo)準(zhǔn)的研究是鑒于衛(wèi)生保健機(jī)構(gòu)沒(méi)有一個(gè)標(biāo)準(zhǔn)的績(jī)效測(cè)量系統(tǒng)，美國(guó)俄亥俄州大學(xué)的一項(xiàng)研究(1)在回顧有關(guān)醫(yī)療組織績(jī)效文獻(xiàn)的基礎(chǔ)上，提出了衛(wèi)生保健機(jī)構(gòu)績(jī)效測(cè)量的總體框架。 times e for emergency or as outpatient in a year, of which there are 28,000 discharged patient 在醫(yī)管中心成立后，將前幾年進(jìn)行的以經(jīng)濟(jì)指標(biāo)考核為主的 “托管制”改革進(jìn)一步深化為注重對(duì)社會(huì)效益和工作業(yè)績(jī)綜合考核的“醫(yī)療服務(wù)、資產(chǎn)經(jīng)營(yíng)委托管理法人代表任期目標(biāo)責(zé)任制”改革，把解決醫(yī)院建設(shè)和運(yùn)行目標(biāo)作為重點(diǎn)，探索所有權(quán)和經(jīng)營(yíng)權(quán)分離的模式，達(dá)到既盡顯公益性特征、又增強(qiáng)醫(yī)院活力的目的。由于目標(biāo)管理事先有比較明確的目標(biāo)作為標(biāo)準(zhǔn)和動(dòng)力，人們隨時(shí)進(jìn)行自我管理，并努力完成既定的工作目標(biāo)。 the Hospital Management Center (HMC) separated from the Bureau of Health is a responsible entity of the government to “run hospitals” and “manage assets”. “Running hospital” calls for providing quality medical products on a municipal level which can meet demand from different walks of life by optimizing arrangement of resources and f