Application of Resource-based Relative Value Scale evaluation system in nursing performance distribution reform in China_West China Medical Journal

Authors：

YAN Jiaqing ^1,2 ,  ZHANG Hongbo ³

1. Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China;
2. School of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai 201318, P. R. China;
3. Department of Nursing, Chongming Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 202150, P. R. China;

Corresponding?author：

ZHANG Hongbo, Email: zhanghongbo72@163.com

Keywords：

Resource-based Relative Value Scale; nursing; performance distribution reform

DOI：

10.7507/1002-0179.202405229

Video：

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Abstract Full text Figures/Tables Video References Cited by

As the medical industry continuously raises its demands for efficiency and quality, hospital performance management has gradually become the focus of reform. The Resource-based Relative Value Scale (RBRVS) evaluation system, as an effective performance evaluation tool, has been adopted and implemented by numerous hospitals both domestically and internationally. Based on the analysis of the current status of performance reform using RBRVS in hospitals at home and abroad, this article comprehensively introduces the origin, development, and basic principles of RBRVS. Furthermore, it provides an evaluation of the difficulties encountered in the practical application of this system and suggests optimization measures.

Citation： YAN Jiaqing, ZHANG Hongbo. Application of Resource-based Relative Value Scale evaluation system in nursing performance distribution reform in China. West China Medical Journal, 2024, 39(6): 943-948. doi: 10.7507/1002-0179.202405229 Copy

1.	?zer ?, U?urluo?lu ?, Sungur C, et al. The relationship between authentic leadership, performance and intention to quit the job of nurses. Hosp Top, 2019, 97(3): 73-79.
2.	張天瑾. EL 二甲綜合醫院績效管理優化研究. 沈陽: 沈陽工業大學, 2023.
3.	Rapin J, Pellet J, Mabire C, et al. How does nursing-sensitive indicator feedback with nursing or interprofessional teams work and shape nursing performance improvement systems? A rapid realist review. Syst Rev, 2022, 11(1): 1-177.
4.	Depesa CD, Jurgens CY, Lee CS, et al. Nurse performance metrics: a scoping review. J Nurs Adm, 2023, 53(2): 110-115.
5.	南銳伶, 白慶琳, 陳桂蘭, 等. 國內護理績效管理的研究進展. 護理管理雜志, 2015, 15(1): 41-43.
6.	Madlabana CZ, Mashamba-Thompson TP, Petersen I. Performance management methods and practices among nurses in primary health care settings: a systematic scoping review protocol. Syst Rev, 2020, 9(1): 40.
7.	Hsiao WC, Stason WB. Toward developing a relative value scale for medical and surgical services. Health Care Financ Rev, 1979, 1(2): 23-38.
8.	莊逸洲. 美國 RB-RVS(醫療資源基準相對價值表)在長庚醫院之應用. 臺灣公共衛生學會雜志, 1992, 11(4): 357-365.
9.	Hsiao WC, Becker ER. Paying physicians according to their resource-costs: the development of a resource-based relative value scale. Health Policy, 1989, 12(3): 257-261.
10.	Harris-Shapiro J. RBRVS (Medicare Resource-Based Relative Value Scale) revisited. J Health Care Finance, 1998, 25(2): 49-54.
11.	Williams TR. A geologic survey of the medicare RBRVS system. J Am Coll Radiol, 2004, 1(3): 192-198.
12.	蔡欣汝. 常態化疫情防控下 Z 醫院 RBRVS 科室績效考核體系應用與優化研究. 南寧: 廣西財經學院, 2023.
13.	賴薇薇. RBRVS 在公立醫院的運用分析——以 S 醫院為例. 財經界, 2023(34): 54-56.
14.	郭蕾. 基于 RBRVS 和 DRGs 的 J 公立醫院績效管理研究. 荊州: 長江大學, 2024.
15.	溫美林, 顏濤, 徐飛, 等. 基于 RBRVS 理論的績效改革探索與實踐. 中國醫院管理, 2021, 41(12): 84-87.
16.	劉世澤. 基于 RBRVS 的 S 公立醫院績效考核體系研究. 南京: 南京理工大學, 2024.
17.	Lara-Millán A, Ruppel EH. The American ‘doc fix’: Incremental policy change and the growth of US healthcare spending. Econ Soc, 2024, 53(2): 205-226.
18.	Mcclellan M, Berenson R, Chernew M, et al. Medicare physician payment reform: securing the connection between value and payment. Washington, DC: Brookings Institution Engelberg Center for Health Care Reform, 2015.
19.	Barer ML, Evans RG, Labelle RJ. Fee controls as cost control: tales from the frozen North. Milbank Q, 1988, 66(1): 1-64.
20.	Barr DA. Bending the Medicare cost curve for physicians’ services: lessons learned from Canada. J Gen Intern Med, 2012, 27(11): 1555-1559.
21.	Kwon WK, Kim JH, Moon HJ, et al. The Korean Spinal Neurosurgery Society; are we reimbursed properly for spinal neurosurgical practices under the korean resource based relative value scale service?. J Korean Neurosurg Soc, 2017, 60(1): 47-53.
22.	Shah DRM, Bold RJM, Yang ADM, et al. Relative value units poorly correlate with measures of surgical effort and complexity. J Surg Res, 2014, 190(2): 465-470.
23.	Choi YH, Kwon TH, Chung CY, et al. Comparison of current relative value unit-based prices and utility between common surgical procedures, including orthopedic surgeries, in South Korea. Cost Eff Resour Alloc, 2024, 22(1): 27.
24.	Ogata Y, Kobayashi Y, Fukuda T, et al. Measuring relative work values for home care nursing services in Japan. Nurs Res, 2004, 53(3): 145-153.
25.	黃德海, 王冬. 非營利性醫院的企業式經營: 向長庚醫院學管理. 北京: 化學工業出版社, 2014.
26.	費敏, 查蘭芬, 張巖, 等. 某婦幼保健院基于 RBRVS 和 DRG 方法開展績效評價的實踐. 中國醫院, 2024, 28(4): 99-101.
27.	汪兆平. 千佛山醫院: 拿來主義的績效創新. 中國醫院院長, 2013(19): 60-63.
28.	許鳳燕, 何子安, 夏文明, 等. 基于 RBRVS 原理的醫院工作量體系構建與考核應用. 江蘇衛生事業管理, 2023, 34(5): 630-632, 641.
29.	毛麗潔, 余儒, 賀彩芳, 等. 以工作量為基礎的護理績效核算方案構建. 中華護理雜志, 2014, 49(12): 1487-1491.
30.	白曉霞, 曹勍, 王波, 等. 手術室績效薪酬分配方案的設計及應用. 中華護理雜志, 2017, 52(11): 1356-1360.
31.	徐小飛, 劉丹, 高紅衛, 等. 基于 RBRVS 的績效分配模式在神經外科護理單元績效管理中的應用. 護理研究, 2021, 35(6): 1087-1090.
32.	劉杰, 溫美林, 徐飛, 等. 以相對價值為尺度的績效評價體系在護理人員績效管理中的應用. 海軍醫學雜志, 2020, 41(6): 685-687.
33.	Imai K. Occupational factors contributing to low self-esteem in registered nurses and licensed practical nurses: a multivariate analysis. J UOEH, 2001, 23(1): 13-22.
34.	丁玉蘭, 池清華, 鄭蓉婷, 等. 基于 RBRVS 護理績效評估體系的應用效果. 中國衛生標準管理, 2020, 11(21): 145-147.
35.	江其玟, 焦夢悅, 范若云, 等. 價值共創視角下公立醫院績效考核體系優化路徑與實踐. 中國衛生經濟, 2024, 43(2): 69-74.
36.	許劍紅, 劉媛, 田佳, 等. RBRVS 績效分配在公立醫院成本管理中的應用. 衛生經濟研究, 2021, 38(7): 62-64, 68.
37.	彭理斌, 葉明剛, 閔德俊, 等. 某三甲醫院基于 RBRVS 護理負荷的護理績效方案應用及效果評價. 新疆醫學, 2018, 48(10): 1137-1139, 1142.
38.	張平, 陳理, 周華, 等. 基于 RBRVS 的麻醉恢復室護理績效薪酬分配方案的設計與應用. 循證護理, 2019, 5(12): 1136-1139.
39.	牛巍, 趙晨, 宋葆蕓. 基于勞動價值的護理績效獎金分配模式的探討. 中國衛生經濟, 2015, 34(5): 89-91.
40.	Laugesen MJ. The resource-based relative value scale and physician reimbursement policy. Chest, 2014, 146(5): 1413-1419.
41.	史琳. 在醫院績效分配中應用 RBRVS 的難點與對策. 當代會計, 2021(15): 129-130.
42.	楊棋, 庚碩, 劉瑾, 等. 公立醫院 RBRVS 與 DRG 管理工具結合應用的思考——基于績效管理視角. 衛生經濟研究, 2021, 38(3): 57-58, 62.
43.	Saba VK, Arnold JM. Clinical care costing method for the Clinical Care Classification System. Int J Nurs Terminol Classif, 2004, 15(3): 69-77.
44.	李磊, 夏景林, 羅力. RBRVS 在公立醫院薪酬分配改革中的應用分析. 中國醫院管理, 2014, 34(11): 42-45.
45.	Choi JW, Kim SJ, Park HK, et al. Effects of a mandatory DRG payment system in South Korea: analysis of multi-year nationwide hospital claims data. BMC Health Serv Res, 2019, 19(1): 776.
46.	李文婕, 陳龍浩, 章寧, 等. 基于 RBRVS 和 DRG 理論的 K 醫院薪酬分配和績效實踐研究. 甘肅醫藥, 2024, 43(1): 60-63.
47.	Curtin L. Determining costs of nursing services per DRG. Nurs Manage, 1983, 14(4): 16-20.
48.	Luo AJ, Chang WF, Xin ZR, et al. Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm. Int J Ophthalmol, 2018, 11(2): 308-313.
49.	吳昊. RBRVS 在公立醫院的績效管理探究. 會計師, 2021(13): 56-58.
50.	Hao J, Yao H, Kong L, et al. The work relative value estimation assessment in China: an empirical research for common surgical procedures. Front Public Health, 2024, 12: 1385616.

1. ?zer ?, U?urluo?lu ?, Sungur C, et al. The relationship between authentic leadership, performance and intention to quit the job of nurses. Hosp Top, 2019, 97(3): 73-79.
2. 張天瑾. EL 二甲綜合醫院績效管理優化研究. 沈陽: 沈陽工業大學, 2023.
3. Rapin J, Pellet J, Mabire C, et al. How does nursing-sensitive indicator feedback with nursing or interprofessional teams work and shape nursing performance improvement systems? A rapid realist review. Syst Rev, 2022, 11(1): 1-177.
4. Depesa CD, Jurgens CY, Lee CS, et al. Nurse performance metrics: a scoping review. J Nurs Adm, 2023, 53(2): 110-115.
5. 南銳伶, 白慶琳, 陳桂蘭, 等. 國內護理績效管理的研究進展. 護理管理雜志, 2015, 15(1): 41-43.
6. Madlabana CZ, Mashamba-Thompson TP, Petersen I. Performance management methods and practices among nurses in primary health care settings: a systematic scoping review protocol. Syst Rev, 2020, 9(1): 40.
7. Hsiao WC, Stason WB. Toward developing a relative value scale for medical and surgical services. Health Care Financ Rev, 1979, 1(2): 23-38.
8. 莊逸洲. 美國 RB-RVS(醫療資源基準相對價值表)在長庚醫院之應用. 臺灣公共衛生學會雜志, 1992, 11(4): 357-365.
9. Hsiao WC, Becker ER. Paying physicians according to their resource-costs: the development of a resource-based relative value scale. Health Policy, 1989, 12(3): 257-261.
10. Harris-Shapiro J. RBRVS (Medicare Resource-Based Relative Value Scale) revisited. J Health Care Finance, 1998, 25(2): 49-54.
11. Williams TR. A geologic survey of the medicare RBRVS system. J Am Coll Radiol, 2004, 1(3): 192-198.
12. 蔡欣汝. 常態化疫情防控下 Z 醫院 RBRVS 科室績效考核體系應用與優化研究. 南寧: 廣西財經學院, 2023.
13. 賴薇薇. RBRVS 在公立醫院的運用分析——以 S 醫院為例. 財經界, 2023(34): 54-56.
14. 郭蕾. 基于 RBRVS 和 DRGs 的 J 公立醫院績效管理研究. 荊州: 長江大學, 2024.
15. 溫美林, 顏濤, 徐飛, 等. 基于 RBRVS 理論的績效改革探索與實踐. 中國醫院管理, 2021, 41(12): 84-87.
16. 劉世澤. 基于 RBRVS 的 S 公立醫院績效考核體系研究. 南京: 南京理工大學, 2024.
17. Lara-Millán A, Ruppel EH. The American ‘doc fix’: Incremental policy change and the growth of US healthcare spending. Econ Soc, 2024, 53(2): 205-226.
18. Mcclellan M, Berenson R, Chernew M, et al. Medicare physician payment reform: securing the connection between value and payment. Washington, DC: Brookings Institution Engelberg Center for Health Care Reform, 2015.
19. Barer ML, Evans RG, Labelle RJ. Fee controls as cost control: tales from the frozen North. Milbank Q, 1988, 66(1): 1-64.
20. Barr DA. Bending the Medicare cost curve for physicians’ services: lessons learned from Canada. J Gen Intern Med, 2012, 27(11): 1555-1559.
21. Kwon WK, Kim JH, Moon HJ, et al. The Korean Spinal Neurosurgery Society; are we reimbursed properly for spinal neurosurgical practices under the korean resource based relative value scale service?. J Korean Neurosurg Soc, 2017, 60(1): 47-53.
22. Shah DRM, Bold RJM, Yang ADM, et al. Relative value units poorly correlate with measures of surgical effort and complexity. J Surg Res, 2014, 190(2): 465-470.
23. Choi YH, Kwon TH, Chung CY, et al. Comparison of current relative value unit-based prices and utility between common surgical procedures, including orthopedic surgeries, in South Korea. Cost Eff Resour Alloc, 2024, 22(1): 27.
24. Ogata Y, Kobayashi Y, Fukuda T, et al. Measuring relative work values for home care nursing services in Japan. Nurs Res, 2004, 53(3): 145-153.
25. 黃德海, 王冬. 非營利性醫院的企業式經營: 向長庚醫院學管理. 北京: 化學工業出版社, 2014.
26. 費敏, 查蘭芬, 張巖, 等. 某婦幼保健院基于 RBRVS 和 DRG 方法開展績效評價的實踐. 中國醫院, 2024, 28(4): 99-101.
27. 汪兆平. 千佛山醫院: 拿來主義的績效創新. 中國醫院院長, 2013(19): 60-63.
28. 許鳳燕, 何子安, 夏文明, 等. 基于 RBRVS 原理的醫院工作量體系構建與考核應用. 江蘇衛生事業管理, 2023, 34(5): 630-632, 641.
29. 毛麗潔, 余儒, 賀彩芳, 等. 以工作量為基礎的護理績效核算方案構建. 中華護理雜志, 2014, 49(12): 1487-1491.
30. 白曉霞, 曹勍, 王波, 等. 手術室績效薪酬分配方案的設計及應用. 中華護理雜志, 2017, 52(11): 1356-1360.
31. 徐小飛, 劉丹, 高紅衛, 等. 基于 RBRVS 的績效分配模式在神經外科護理單元績效管理中的應用. 護理研究, 2021, 35(6): 1087-1090.
32. 劉杰, 溫美林, 徐飛, 等. 以相對價值為尺度的績效評價體系在護理人員績效管理中的應用. 海軍醫學雜志, 2020, 41(6): 685-687.
33. Imai K. Occupational factors contributing to low self-esteem in registered nurses and licensed practical nurses: a multivariate analysis. J UOEH, 2001, 23(1): 13-22.
34. 丁玉蘭, 池清華, 鄭蓉婷, 等. 基于 RBRVS 護理績效評估體系的應用效果. 中國衛生標準管理, 2020, 11(21): 145-147.
35. 江其玟, 焦夢悅, 范若云, 等. 價值共創視角下公立醫院績效考核體系優化路徑與實踐. 中國衛生經濟, 2024, 43(2): 69-74.
36. 許劍紅, 劉媛, 田佳, 等. RBRVS 績效分配在公立醫院成本管理中的應用. 衛生經濟研究, 2021, 38(7): 62-64, 68.
37. 彭理斌, 葉明剛, 閔德俊, 等. 某三甲醫院基于 RBRVS 護理負荷的護理績效方案應用及效果評價. 新疆醫學, 2018, 48(10): 1137-1139, 1142.
38. 張平, 陳理, 周華, 等. 基于 RBRVS 的麻醉恢復室護理績效薪酬分配方案的設計與應用. 循證護理, 2019, 5(12): 1136-1139.
39. 牛巍, 趙晨, 宋葆蕓. 基于勞動價值的護理績效獎金分配模式的探討. 中國衛生經濟, 2015, 34(5): 89-91.
40. Laugesen MJ. The resource-based relative value scale and physician reimbursement policy. Chest, 2014, 146(5): 1413-1419.
41. 史琳. 在醫院績效分配中應用 RBRVS 的難點與對策. 當代會計, 2021(15): 129-130.
42. 楊棋, 庚碩, 劉瑾, 等. 公立醫院 RBRVS 與 DRG 管理工具結合應用的思考——基于績效管理視角. 衛生經濟研究, 2021, 38(3): 57-58, 62.
43. Saba VK, Arnold JM. Clinical care costing method for the Clinical Care Classification System. Int J Nurs Terminol Classif, 2004, 15(3): 69-77.
44. 李磊, 夏景林, 羅力. RBRVS 在公立醫院薪酬分配改革中的應用分析. 中國醫院管理, 2014, 34(11): 42-45.
45. Choi JW, Kim SJ, Park HK, et al. Effects of a mandatory DRG payment system in South Korea: analysis of multi-year nationwide hospital claims data. BMC Health Serv Res, 2019, 19(1): 776.
46. 李文婕, 陳龍浩, 章寧, 等. 基于 RBRVS 和 DRG 理論的 K 醫院薪酬分配和績效實踐研究. 甘肅醫藥, 2024, 43(1): 60-63.
47. Curtin L. Determining costs of nursing services per DRG. Nurs Manage, 1983, 14(4): 16-20.
48. Luo AJ, Chang WF, Xin ZR, et al. Diagnosis related group grouping study of senile cataract patients based on E-CHAID algorithm. Int J Ophthalmol, 2018, 11(2): 308-313.
49. 吳昊. RBRVS 在公立醫院的績效管理探究. 會計師, 2021(13): 56-58.
50. Hao J, Yao H, Kong L, et al. The work relative value estimation assessment in China: an empirical research for common surgical procedures. Front Public Health, 2024, 12: 1385616.

West China Medical Journal

Application of Resource-based Relative Value Scale evaluation system in nursing performance distribution reform in China

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