On February 6, 2024, the National Health Commission and other departments issued the "Notice on Printing and Distributing the National Monitoring and Analysis of the Performance Appraisal of the National ** Public Hospitals in 2022" (hereinafter referred to as the "Notice"). According to the notice, the informatization support capacity of public hospitals continues to increaseIn 2022, the national average level of electronic medical record system application level will reach level 4. 
A total of 2,817** public hospitals across the country participated in the 2022 annual performance appraisal, including 2,112 Western medicine hospitals (1,521 general hospitals, 591 specialized hospitals) and 705 traditional Chinese medicine hospitals (see Figure 1). Compared with 2021, 128 new hospitals have been added, and 17 hospitals have withdrawn from the assessment due to mergers, downgrades, cancellation, etc.
Figure 1 The situation of hospitals participating in the performance appraisal of ** public hospitals in 2022
The capacity of medical services continues to increase
In 2022, the case mix index (CMI value) of discharged patients in public hospitals in the country increased slightly compared with 2021; The proportion of discharged patients undergoing fourth-level surgery and minimally invasive surgery has increased compared with 2021, and the ability of public hospitals to solve difficult and complex diseases has steadily improved.
In 2022, the proportion of ** public hospitals that carry out day surgery is 795%, an increase of 3 compared with 20210 percentage points; Day surgery accounted for 14 elective surgeries2%, an increase of 17 percentage points. The scope of ambulatory medical services has been continuously expanded, and the supply capacity of ambulatory medical services has been effectively improved.
The level of quality and safety continues to improve
Compared with 2021, the complication rate and incision-like surgical site infection rate of surgical patients in ** public hospitals in the country decreased by 0 in 2022, respectively02 and 004 percentage points, the incidence of medical safety adverse events decreased.
In 2022, the level of drug rationality in the country's leading public hospitals will be further improved. The rationality of the clinical application of antimicrobial drugs has been enhanced, and the intensity of antimicrobial use has been continuously better than the national requirement of 40ddds (33.)8DDDS), and there is still a downward trend, and the proportion of hospitals with antimicrobial use intensity that meets the specified requirements continues to increase.
In 2022, 975% of the ** public hospitals participated in the inter-laboratory quality evaluation organized by the National Clinical Laboratory Center, and the median participation rate of the national inter-laboratory quality evaluation project was 955%, and the median pass rate was 980%, an increase of 2 compared with 20212 and 07 percentage points.
The ability of informatization support continues to be enhanced
In 2022, the informatization support capacity of the country's leading public hospitals will continue to increase, among which the participation rate of the application level of the electronic medical record system will reach 990%，The national average level of application of the electronic medical record system has reached level 4, individual hospitals have reached level 8. In line with this, in 2022, the average outpatient appointment rate was 611%, an increase of 05 percentage points, and the average appointment wait time fell further.
2018-2022** Grading and evaluation of the application level of electronic medical record system in public hospitals.
In addition, in 2022, 776% of the first public hospitals have set up a chief accountant to participate in the decision-making of major financial and economic matters of the hospital and supervise the implementation of the situation, give full play to professional advantages in the analysis and decision-making of important economic matters of the hospital, and play a role in promoting the quality and efficiency of medical services and improving the efficiency of hospital economic management. Compared with 2021, the proportion of medical service revenue in public hospitals in 2022 will increase by 07 percentage points, ** The resource allocation of public hospitals has gradually shifted from focusing on material elements to paying more attention to talent and technical elements.
Patient satisfaction has increased steadily
The "patient-centered" service model has continued to improve, and patient satisfaction has increased steadily. In 2022, the satisfaction rate of outpatients and inpatients in the country's ** public hospitals was 888 points, 928 points, an increase of 1 compared with 20219 points and 10 points. Outpatient satisfaction has been comprehensively improved in six dimensions: experience, doctor communication, communication, environment and identification, privacy, and medical staff response. The satisfaction of inpatients was greatly improved in the dimensions of admission and discharge procedures and information, pain management, and drug communication.
Highlight the problem and work requirements
The notice pointed out that although the medical service capacity and patient satisfaction of public hospitals have been improved, there are still some outstanding problems. For example, the distribution of medical resources has shifted from insufficient total to insufficient structure, high-quality medical resources in Beijing, Shanghai, Zhejiang and other regions are still relatively concentrated, the medical service level of public hospitals in the central and western regions and non-provincial capital cities is relatively weak, and the comprehensive strength of the medical service level of public hospitals in North China and East China is still significantly higher than that of other regions. Judging from the monitoring data, the phenomenon of "cross-provincial and remote medical treatment" in the country's leading public hospitals still exists.
In terms of patients' medical experience, the process problems of long queuing and payment time and "turning back and running" upstairs and downstairs still exist. Some hospitals are not timely in responding to patients' new expectations for pain management, elderly care, and first-class services, and age-appropriate and barrier-free modifications are still not in place.
The notice puts forward three aspects of work requirements:
(1) Thoroughly summarize the experience and practices of the past five years, and continue to optimize and deepen the performance appraisal work. The first is to scientifically make full use of the performance appraisal results, continue to deepen the cohesion of external policies in the reform of medical insurance payment methods and the reform of the salary distribution system, and improve policy cohesion and system integration. The second is to combine the actual situation found in the performance appraisal, find the existing gaps and excavate the typical ones, guide the best public hospitals to continuously optimize the internal management and service processes of the hospital, promote the effective allocation and use of resources, and improve the efficiency and operation efficiency of medical services. The third is to actively summarize the work experience of public hospital performance appraisal based on objective data, conduct in-depth analysis of the data resources accumulated in performance appraisal, and provide data support for scientific decision-making, precise governance and efficient services in the field of health care.
2) Based on the requirements of the new development stage, continue to promote the construction of a new pattern of high-quality development of public hospitals. All localities and relevant departments shall take into account the distribution of the population, age structure and aging development trend, the characteristics of the disease spectrum, and the flow of medical treatment within their jurisdiction, to improve the comprehensive service capacity of disease diagnosis and treatment in public hospitals, and promote the implementation of functional positioning in public hospitals. We will continue to make efforts in the construction of high-level public hospital networks, the construction of key clinical specialty groups, the construction of high-quality talent teams, and the construction of "three-in-one" smart hospitals；Improve the construction of medical quality management and control system, improve medical quality, promote the transformation of public hospitals from "disease-centered" to "patient-centered", continuously improve the medical service process, and improve patients' medical experience; Improve the modern hospital management system, improve the standardization level of hospital management, improve the ability of clinical scientific research, and achieve high-level scientific and technological self-reliance and self-reliance.
(3) Further promote the expansion of high-quality medical resources and the balanced distribution of regions. Adhere to the guidance of the construction of "double centers", actively play the leading role of industry and radiation, realize the translational output of high-quality medical resources, and promote regional separation; With the "Millions and Millions" project of key clinical specialties as the starting point, we will continue to promote the capacity building of clinical specialties, improve the comprehensive service capacity of difficult and critically ill patients in public hospitals, and guide the separation of acute and slow; With the support of "informatization" and "medical alliance", we will expand the channels for the expansion of high-quality medical resources and build a hierarchical diagnosis and treatment pattern, based on the top and bottom separated. Continuously improve the equity and accessibility of basic medical and health services, narrow the differences in resource allocation, service capacity and health level between urban and rural areas, regions and populations, and better meet the demand for medical services.