State Council Issues Guidelines on Performance Evaluation of Tier-3 Public Hospitals, Highlighting Information Systems as Key Component
On January 30, VCBeat learned from the official government website that to further deepen the reform of public hospitals and promote the establishment of a modern hospital management system, the State Council has approved new guidelines on strengthening the performance appraisal of tertiary public hospitals, as outlined in Document No. 4 [2019] issued by the General Office of the State Council.
The “Opinions” set forth the primary indicator system for performance evaluation of tertiary public hospitals:
(1)Medical Quality.Providing high-quality medical services is the core mission of tertiary public hospitals. Hospital medical quality and safety are assessed through indicators such as medical quality control, rational drug use, and homogenization of examinations and tests. Medical quality and safety for key diseases and critical technologies are evaluated using representative single-disease quality control indicators. The effectiveness of improvements in medical services is assessed through metrics including appointment-based diagnosis and treatment, outpatient and emergency services, and patient waiting times.
(II)Operational Efficiency.Operational efficiency reflects the level of refined management in hospitals and is key to achieving scientific hospital management. The efficiency of medical resource utilization is assessed through human resource staffing ratios and personnel workload indicators. Hospital economic operation management is evaluated using economic management indicators. Indicators assessing the structure of revenue and expenditure indirectly reflect the government’s fulfillment of its responsibilities in running healthcare institutions and the rationality of the hospital’s medical income structure, thereby promoting the goals of achieving a balance between revenue and expenditure with a slight surplus, and effectively reflecting the technical and labor value of medical staff. Changes in the average cost per outpatient visit and per inpatient stay are used to measure the hospital’s proactive efforts to control unreasonable cost growth.
(III)Sustainable Development.Workforce development and teaching and research capabilities reflect a hospital’s capacity for sustained growth, serving as key indicators of innovation-driven development and the continuous, healthy operation of tertiary public hospitals. Specifically, the stability of medical personnel is assessed through workforce structure metrics; the hospital’s capacity to support innovation is evaluated via metrics on the clinical translation of research outcomes; its role in leading development and ensuring sustained operations is measured by technology application metrics; and its creditworthiness construction is appraised through comprehensive public credit evaluation ratings.
(IV)Satisfaction Rating.Hospital satisfaction comprises two components: patient satisfaction and healthcare worker satisfaction. Patient satisfaction is a key indicator of the social benefits provided by tertiary public hospitals, while enhancing healthcare worker satisfaction is essential for ensuring the delivery of high-quality medical services. By evaluating satisfaction among outpatient, inpatient, and healthcare worker populations, hospitals can assess patients’ sense of gain and healthcare workers’ motivation.
Moreover, informatization has become a critical support system for performance evaluation:
(I) Improve the quality of medical record front sheets.Tertiary public hospitals shall strengthen hospital information construction centered on electronic medical records, standardize the completion of medical record front pages in accordance with national uniform regulations, and enhance the standardized and regulated management of clinical data.All regions shall strengthen quality control of the medical record face sheet and enhance the management of uploaded data quality, ensuring that assessment data are objective and authentic.
(II) Unified Coding and Terminology Sets.By the end of March 2019, the National Health Commission implemented a nationally unified system for disease classification codes, surgical procedure codes, and medical terminology.The National Administration of Traditional Chinese Medicine issued the "National Unified Classification and Codes for TCM Diseases and Syndromes" and the "Glossary of TCM Terminology."By the end of August 2019, all regions shall organize tertiary public hospitals to complete the coding and terminology conversion of electronic medical records, and fully implement the nationally unified disease classification codes, surgical procedure codes, and medical nomenclature.。
(3) Improve the patient satisfaction survey platform. The State shall establish a satisfaction management system for public hospitals, and continuously improve the construction, development, and management of public hospitals based on the results of satisfaction surveys. By the end of March 2019, all tertiary public hospitals nationwide shall be included in the satisfaction survey platform of the National Health Commission. Local authorities shall utilize the satisfaction survey platform of the National Health Commission and incorporate the survey results into the performance evaluation of tertiary public hospitals.
(4) Establish an assessment information system. By the end of March 2019, the National Health Commission shall establish a national performance assessment information system for tertiary public hospitals.By the end of June 2019, all provinces shall establish provincial performance appraisal information systems that are interconnected with the National Performance Appraisal Information System for Tertiary Public Hospitals., with a primary focus on data-based assessment and supplementary on-site verification as necessary, leveraging the "Internet + Assessment" approach to collect objective performance data for conducting performance evaluations of tertiary public hospitals.
Furthermore, the “Opinions” also provide clear assessment indicators:
Below is the original text of the “Opinions”: