I 摘要 医院的可持续发展离不开医院绩效管理体系的合理构建和良好运行，医院绩 效管理水平是构成医院核心竞争力的关键因素，反映医院具体的管理思想和管理 文化。目前国内大多数医院是按照收支结余的方法来计提科室绩效的，这种方法 意味着科室只有存在结余才会存在绩效，是一种极度不公平的分配方法。一方面， 科室收入与国内的收费定价系统挂钩，而该系统没有考虑不同专业间社会效益与 经济效益的差别，并且存在同一执行项目不同收费价格的情况，这无疑会给各科 室绩效带来很大的偏差；另一方面，支出完全由各科室承担相当于医院成本控制 的责任全部落在了职工身上，这也是一种不合理的体现。一些医院意识到这一点 而实行绩效考核，使得医院的绩效管理有了很大的提升，但是仍不能从根本上解 决公平分配的问题。因此，各公立医院亟需寻找一套公平合理可行的绩效考核方 案来促进医院长期稳定的发展。 本文通过对医院前期的调研，了解了医院现行的绩效工资分配现状以及存在 的问题，在原绩效方案的基础上研究了一套较为公平合理的绩效考核新方案。新 方案实行“医护分开”、“多劳多得、优劳优得”、“两级分配”的核算原则， 通过引进CPT-RBRVS结算定价体系，统计各科室主要绩效指标执行点数；然后通 过描述性和相关性分析选择其他可量化的绩效指标床日数和出院人次；再根据确 定的指标变量构成的面板数据分别对医院手术和非手术科室建立混合回归模型、 变截距回归模型和变系数回归模型，并通过F检验确定对医院的手术科室建立变系 数模型，对医院的非手术科室建立变截距模型；最后考虑到医院的一致性和医院 职工的接受情况决定分别对医院的手术科室和非手术科室建立变截距回归模型。 本文研究的结果是医院各科室的绩效水平主要与各科室的执行点数、床日数 和出院人次有关。科室可以通过增加科室工作量，提高科室床位使用率，缩短病 人治愈周期来增加科室的绩效工资。 关键词：医院绩效；CPT-RBRVS；面板数据；实证分析；相关性；影响因素重庆大学硕士学位报告 英文摘要 II ABSTRACT The sustainable development of hospital cannot leave the reasonable construction and good operation of the hospital performance management system, the performance management level of hospital reflects its specific management thinking and management culture. At present, most of the public hospitals in China still use balance method to calculate the performance salary of department, it means that the department will have performance when the income of department is greater than spending, and which is extremely unfair. On the one hand, the department income is associated with domestic toll pricing system, but the system don’t consider the different between social benefit and economic benefit, and exist different charging items with same perform in domestic toll pricing system, which will bring great deviation; On the other hand, departments must bear all spending of department, it means the responsibility of hospital cost control completely fell upon the workers, which is also unfair. Some hospitals aware of this and implement performance appraisal, which makes the performance management of the hospital has a lot of improvement, but still cannot solve the problem of distributive justice fundamentally. Therefore, the public hospitals need to find a fair and reasonable performance evaluation scheme to promote long-term and stable development of the hospital. This article according to the early investigation, understand the hospital's performance wage distribution situation and existing problems at present, based on it, research a new performance appraisal scheme, which is more fair and reasonable. New scheme implement the accounting principles of “The performance of doctor and nurse separate accounting”, “More work more gain, good work good gain” and “Two levels of distribution”. It introduced CPT-RBRVS clearing pricing system to statistical the main performance indicators of perform points of department. And then choose other quantifiable performance indicators of using bed day and number of discharged patients by descriptive and correlation analysis. And then according to the panel data form by the index variables to set up constant coefficient of panel data model, variable intercept panel data model and variable coefficient panel data model. And through F test, determine to set up the variable coefficient model to surgery department of hospitals and to set up variable intercept model to non-surgical departments of hospitals. Finally considering the consistency and the acception situation of hospital’s staff, decide to set up variable intercept regression model to the surgery and non-surgical departments of重庆大学硕士学位报告 英文摘要 III hospital respectively. The results of this study is the performance of hospital’s each department is mainly related to the indicator variables of perform points, using bed day and number of discharged patients. Department can increase the department performance salary by increase work load, improve bed utilization rate and shorten patient cure period of department. Key words: Hospital Performance, CPT - RBRVS System, Panel Data, Empirical Analysis, Correlation, Affecting Factors重庆大学硕士学位报告 目 录 IV 目 录 中文摘要..........................................................................................................................................I 英文摘要........................................................................................................................................II 1 绪 论......................................................................................................................................1 1.1 问题的提出及研究意义 ....................................................................................................... 1 1.1.1 问题的提出 ................................................................................................................. 1 1.1.2 研究的意义 ................................................................................................................. 1 1.2 国内外研究现状 ................................................................................................................... 2 1.2.1 国外研究现状 ............................................................................................................. 2 1.2.2 国内研究现状 ............................................................................................................. 3 1.3 本文研究目的和研究内容 ................................................................................................... 3 1.3.1 本文研究的目的 ......................................................................................................... 3 1.3.2 本文研究的主要内容 ................................................................................................. 4 2 面板数据回归......................................................................................................................5 2.1 面板数据回归模型的一般形式 ........................................................................................... 5 2.2 面板数据回归模型的形式 ................................................................................................... 5 2.2.1 混合回归模型 ............................................................................................................. 5 2.2.2 变截距模型 ................................................................................................................. 6 2.2.3 变系数模型 ................................................................................................................. 6 2.2.4 模型形式的确定 ......................................................................................................... 6 2.3 面板数据回归模型的影响形式 ........................................................................................... 8 2.3.1模型影响形式............................................................................................................... 8 2.3.2 模型影响形式的确定 ................................................................................................. 8 3 医院绩效分配新方案简介 .........................................................................................10 3.1 CPT-RBRVS体系...............................................................................