目的：探讨团队绩效考核方案在社区卫生服务中心中的实施效果。方法于2013年10月—2014年9月，以成都市武侯区晋阳社区卫生服务中心的6个全科服务团队为研究对象，采用随机数字表法将其平均分为对照组和试验组。对照组采用个人绩效考核方案，试验组采用团队绩效考核方案，开展时间均为12个月。结束后，比较并分析两组的工作量、工作质量、年人均绩效及满意度。结果(1)2014年试验组门诊数低于对照组，而健康管理、新建基本健康档案及慢性病管理等公共卫生服务的工作量均高于对照组。(2)2013年和2014年，两组基本医疗服务工作质量得分和公共卫生服务工作质量得分比较，差异均无统计学意义(P>0．05)。2014年两组基本医疗服务工作质量得分与2013年比较，差异均有统计学意义(P<0．05)。试验组公共卫生服务工作质量得分与2013年比较，差异有统计学意义( P<0．05)；而对照组公共卫生服务工作质量得分与2013年比较，差异无统计学意义( P>0．05)。(3)2013年两组医生年人均绩效和护士年人均绩效比较，差异无统计学意义( P>0．05)。2014年两组医生年人均绩效比较，差异无统计学意义(P>0．05)；而护士年人均绩效比较，差异有统计学意义(P<0．05)。2014年对照组医生年人均绩效和护士年人均绩效与2013年比较，差异均无统计学意义( P>0．05)；而试验组医生年人均绩效和护士年人均绩效与2013年比较，差异均有统计学意义(P<0．05)。(4)两组医务人员对收入、绩效考核方式激励性、团队协作的满意度比较，差异有统计学意义(P <0．05)；而对绩效分配合理性的满意度比较，差异无统计学意义(P >0．05)。两组就诊患者对诊疗计划的解释、医生服务态度、总体的满意度比较，差异有统计学意义(P<0．05)；而对倾听及解答疑问、医生诊疗水平、护士护理水平、护士服务态度的满意度比较，差异无统计学意义( P>0．05)。结论与个人绩效考核方案相比，团队绩效考核方案能更好地提高社区医务人员的工作量和工作质量，尤其是公共卫生服务；可以提高社区医务人员的绩效水平，激励性较好；医务人员和就诊患者的满意度均较高。%Objective To investigate the effect of team performance appraisal program for community health service centers. Methods From October 2013 to September 2014, we enrolled 6 general practice service teams of Jinyang Community Health Service Center in Wuhou District of Chengdu. Using random number table method, the teams were averagely divided into control group and trial group. The control group was managed with individual performance appraisal program, and the trial group was managed with team performance appraisal program. The intervention time was 12 months for both groups. After the intervention was completed, comparison was made between the two groups in work volume, work quality and annual per capita performance and satisfaction degree. Results (1) In 2014, the trial group was lower in the number of outpatients and was higher in the work volume of health management, newly established basic health records, chronic disease management and other public health services. (2) In 2013 and 2014, the two groups were significantly different (P>0. 05) in the score of basic medical medical service quality and the score of public health service. The scores of basic medical service of the two groups in 2014 were significantly different from those in 2013 (P<0. 05); the score of public health service in 2014 was significantly different from those in 2013 (P<0. 05); while the score of public health service in 2014 was not significantly different (P>0. 05) from those in 2013. (3) In 2013, the two groups were not significantly different (P >0. 05) in the annual per capita performance of doctors and that of nurses. In 2014, the two groups were not significantly different in the annual per capita performance of doctors (P>0. 05), but were significantly different in the annual per capita of nurses (P<0. 05) . The annual per capita performance of doctors and that of nurses of control group in 2014 were not significantly different from those in 2013 ( P>0. 05 ); while the annual per capita performance of doctors and that of nurses of trial group in 2014 were significantly different from those in 2013 ( P<0. 05 ) . ( 4 ) The two groups were significantly different ( P <0. 05 ) in the satisfaction degree toward income, the motivation of performance evaluation method and team cooperation; while the two groups were not significantly different in the satisfaction degree toward the rationality of performance allocation (P>0. 05) . The two groups were significantly different (P<0. 05) in patients′ satisfaction degree toward the explanation of treatment program, the service attitude of doctors, and overall satisfaction degree; while the two groups were not significantly different ( P >0. 05 ) in patients′ satisfaction degree toward listening and answering questions, doctors′ level of nursing, nurses′ level of nursing and the service attitude of nurses. Conclusion Compared with individual performance appraisal program, team performance appraisal program can better improve work volume and work quality, especially for public health services; it can also better improve the performance level of community medical staff, has better motivation and brings higher satisfaction degree among medical staff and patients.
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