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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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.	Özer Ö, Uğurluoğlu Ö, 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.	张天瑾. EL 二甲综合医院绩效管理优化研究. 沈阳: 沈阳工业大学, 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.	南锐伶, 白庆琳, 陈桂兰, 等. 国内护理绩效管理的研究进展. 护理管理杂志, 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.	庄逸洲. 美国 RB-RVS(医疗资源基准相对价值表)在长庚医院之应用. 台湾公共卫生学会杂志, 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. 常态化疫情防控下 Z 医院 RBRVS 科室绩效考核体系应用与优化研究. 南宁: 广西财经学院, 2023.
13.	赖薇薇. RBRVS 在公立医院的运用分析——以 S 医院为例. 财经界, 2023(34): 54-56.
14.	郭蕾. 基于 RBRVS 和 DRGs 的 J 公立医院绩效管理研究. 荆州: 长江大学, 2024.
15.	温美林, 颜涛, 徐飞, 等. 基于 RBRVS 理论的绩效改革探索与实践. 中国医院管理, 2021, 41(12): 84-87.
16.	刘世泽. 基于 RBRVS 的 S 公立医院绩效考核体系研究. 南京: 南京理工大学, 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.	黄德海, 王冬. 非营利性医院的企业式经营: 向长庚医院学管理. 北京: 化学工业出版社, 2014.
26.	费敏, 查兰芬, 张岩, 等. 某妇幼保健院基于 RBRVS 和 DRG 方法开展绩效评价的实践. 中国医院, 2024, 28(4): 99-101.
27.	汪兆平. 千佛山医院: 拿来主义的绩效创新. 中国医院院长, 2013(19): 60-63.
28.	许凤燕, 何子安, 夏文明, 等. 基于 RBRVS 原理的医院工作量体系构建与考核应用. 江苏卫生事业管理, 2023, 34(5): 630-632, 641.
29.	毛丽洁, 余儒, 贺彩芳, 等. 以工作量为基础的护理绩效核算方案构建. 中华护理杂志, 2014, 49(12): 1487-1491.
30.	白晓霞, 曹勍, 王波, 等. 手术室绩效薪酬分配方案的设计及应用. 中华护理杂志, 2017, 52(11): 1356-1360.
31.	徐小飞, 刘丹, 高红卫, 等. 基于 RBRVS 的绩效分配模式在神经外科护理单元绩效管理中的应用. 护理研究, 2021, 35(6): 1087-1090.
32.	刘杰, 温美林, 徐飞, 等. 以相对价值为尺度的绩效评价体系在护理人员绩效管理中的应用. 海军医学杂志, 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.	丁玉兰, 池清华, 郑蓉婷, 等. 基于 RBRVS 护理绩效评估体系的应用效果. 中国卫生标准管理, 2020, 11(21): 145-147.
35.	江其玟, 焦梦悦, 范若云, 等. 价值共创视角下公立医院绩效考核体系优化路径与实践. 中国卫生经济, 2024, 43(2): 69-74.
36.	许剑红, 刘媛, 田佳, 等. RBRVS 绩效分配在公立医院成本管理中的应用. 卫生经济研究, 2021, 38(7): 62-64, 68.
37.	彭理斌, 叶明刚, 闵德俊, 等. 某三甲医院基于 RBRVS 护理负荷的护理绩效方案应用及效果评价. 新疆医学, 2018, 48(10): 1137-1139, 1142.
38.	张平, 陈理, 周华, 等. 基于 RBRVS 的麻醉恢复室护理绩效薪酬分配方案的设计与应用. 循证护理, 2019, 5(12): 1136-1139.
39.	牛巍, 赵晨, 宋葆芸. 基于劳动价值的护理绩效奖金分配模式的探讨. 中国卫生经济, 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. 在医院绩效分配中应用 RBRVS 的难点与对策. 当代会计, 2021(15): 129-130.
42.	杨棋, 庚硕, 刘瑾, 等. 公立医院 RBRVS 与 DRG 管理工具结合应用的思考——基于绩效管理视角. 卫生经济研究, 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, 罗力. RBRVS 在公立医院薪酬分配改革中的应用分析. 中国医院管理, 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, 陈龙浩, 章宁, 等. 基于 RBRVS 和 DRG 理论的 K 医院薪酬分配和绩效实践研究. 甘肃医药, 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.	吴昊. RBRVS 在公立医院的绩效管理探究. 会计师, 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. Özer Ö, Uğurluoğlu Ö, 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. 张天瑾. EL 二甲综合医院绩效管理优化研究. 沈阳: 沈阳工业大学, 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. 南锐伶, 白庆琳, 陈桂兰, 等. 国内护理绩效管理的研究进展. 护理管理杂志, 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. 庄逸洲. 美国 RB-RVS(医疗资源基准相对价值表)在长庚医院之应用. 台湾公共卫生学会杂志, 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. 常态化疫情防控下 Z 医院 RBRVS 科室绩效考核体系应用与优化研究. 南宁: 广西财经学院, 2023.
13. 赖薇薇. RBRVS 在公立医院的运用分析——以 S 医院为例. 财经界, 2023(34): 54-56.
14. 郭蕾. 基于 RBRVS 和 DRGs 的 J 公立医院绩效管理研究. 荆州: 长江大学, 2024.
15. 温美林, 颜涛, 徐飞, 等. 基于 RBRVS 理论的绩效改革探索与实践. 中国医院管理, 2021, 41(12): 84-87.
16. 刘世泽. 基于 RBRVS 的 S 公立医院绩效考核体系研究. 南京: 南京理工大学, 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. 黄德海, 王冬. 非营利性医院的企业式经营: 向长庚医院学管理. 北京: 化学工业出版社, 2014.
26. 费敏, 查兰芬, 张岩, 等. 某妇幼保健院基于 RBRVS 和 DRG 方法开展绩效评价的实践. 中国医院, 2024, 28(4): 99-101.
27. 汪兆平. 千佛山医院: 拿来主义的绩效创新. 中国医院院长, 2013(19): 60-63.
28. 许凤燕, 何子安, 夏文明, 等. 基于 RBRVS 原理的医院工作量体系构建与考核应用. 江苏卫生事业管理, 2023, 34(5): 630-632, 641.
29. 毛丽洁, 余儒, 贺彩芳, 等. 以工作量为基础的护理绩效核算方案构建. 中华护理杂志, 2014, 49(12): 1487-1491.
30. 白晓霞, 曹勍, 王波, 等. 手术室绩效薪酬分配方案的设计及应用. 中华护理杂志, 2017, 52(11): 1356-1360.
31. 徐小飞, 刘丹, 高红卫, 等. 基于 RBRVS 的绩效分配模式在神经外科护理单元绩效管理中的应用. 护理研究, 2021, 35(6): 1087-1090.
32. 刘杰, 温美林, 徐飞, 等. 以相对价值为尺度的绩效评价体系在护理人员绩效管理中的应用. 海军医学杂志, 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. 丁玉兰, 池清华, 郑蓉婷, 等. 基于 RBRVS 护理绩效评估体系的应用效果. 中国卫生标准管理, 2020, 11(21): 145-147.
35. 江其玟, 焦梦悦, 范若云, 等. 价值共创视角下公立医院绩效考核体系优化路径与实践. 中国卫生经济, 2024, 43(2): 69-74.
36. 许剑红, 刘媛, 田佳, 等. RBRVS 绩效分配在公立医院成本管理中的应用. 卫生经济研究, 2021, 38(7): 62-64, 68.
37. 彭理斌, 叶明刚, 闵德俊, 等. 某三甲医院基于 RBRVS 护理负荷的护理绩效方案应用及效果评价. 新疆医学, 2018, 48(10): 1137-1139, 1142.
38. 张平, 陈理, 周华, 等. 基于 RBRVS 的麻醉恢复室护理绩效薪酬分配方案的设计与应用. 循证护理, 2019, 5(12): 1136-1139.
39. 牛巍, 赵晨, 宋葆芸. 基于劳动价值的护理绩效奖金分配模式的探讨. 中国卫生经济, 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. 在医院绩效分配中应用 RBRVS 的难点与对策. 当代会计, 2021(15): 129-130.
42. 杨棋, 庚硕, 刘瑾, 等. 公立医院 RBRVS 与 DRG 管理工具结合应用的思考——基于绩效管理视角. 卫生经济研究, 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, 罗力. RBRVS 在公立医院薪酬分配改革中的应用分析. 中国医院管理, 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, 陈龙浩, 章宁, 等. 基于 RBRVS 和 DRG 理论的 K 医院薪酬分配和绩效实践研究. 甘肃医药, 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. 吴昊. RBRVS 在公立医院的绩效管理探究. 会计师, 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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