中国全科医学2017，Vol.20Issue(7)：768-772,783,6.DOI:10.3969/j.issn.1007-9572.2017.07.002
社区卫生服务机构岗位聘用制与绩效工资制的实施情况及激励作用研究
Implementation and Incentive Function of Contract Employment and Performance - based Payment System in Community Health Service Institutions
王泳仪 1徐玲 2张明吉 1王伟 3贺蕾 1严非2
作者信息
- 1. 200032 上海市,复旦大学公共卫生学院,卫生部卫生技术评估重点实验室,国民健康社会风险预警协同创新中心
- 2. 100044 北京市,国家卫生与计划生育委员会卫生统计信息中心
- 3. 200025 上海市,上海交通大学公共卫生学院
- 折叠
摘要
Abstract
Objective To understand the implementation situation and the incentive function of contract employment and performance - based payment system in community health service institutions in four provinces and cities of China. Methods This study used a multi - stage sampling method. By purposive sampling method,Shandong Province and Shanghai City were selected from the eastern region,and Anhui Province was selected from the central region. Shaanxi Province was selected from the western region;and the provincial capital city and one prefecture - level city with good community health service development were selected from the three provinces respectively;district was selected from each city (including Shanghai)respectively and seven districts totally. According to the type of holding body and staff size of community health service institutions in each district, stratified sampling was carried out to extract three community health service institutions at most from each layer,and a total of 61 community health service institutions were selected. Using cluster sampling,all the 713 on - duty health workers at the investigation day were selected from each community health service institutions as the subjects,and 6 community health workers were selected as the interview subjects. The self - designed questionnaire included the basic situation of the community health technical personnel,the implementation of the contract employment system,and the implementation of the performance - based payment system. From August to September 2013,self - administered questionnaire was used to investigate the subjects. 713 questionnaires were sent out and 656 valid questionnaires were collected. The effective response rate of the questionnaires was 92. 0%. At the same time of questionnaire survey,in - depth interviews were conducted to evaluate the contract employment and performance - based payment systems. Results Among 61 institutions,27 institutions with holding body of public ownership and 18 with holding body of private ownership had implemented the contract employment system. In these 45 institutions the annual income of off - staff personnel covered (82. 9 ± 16. 6)% of the in - staff personnel,while in the 16 institutions that have not implemented contract employment system,the annual income of off - staff personnel covered (53. 0 ± 17. 4)% of the in - staff personnel,and these two were significantly different (P < 0. 05). Among 34 institutions with holding body of public ownership, 24 had implemented the performance - based payment system. 64. 7% (180 / 278)of the staff in the community health service center and 85. 1% (63 / 74)of the staff in the community health service station believed that the performance appraisal had incentive function. 42. 1% (153 / 363)of community health workers believed that the fairness of income distribution of the institution is good. Conclusion Contract employment system and performance - based payment system play an important role in ensuring the income equality and improving the enthusiasm of the employees,but further exploration in breaking the limitation of authorized strength,disaggregate links between authorized strength and welfare and establishing scientific performance - based payment system are still needed. It is recommend that improve contract employment system and increase income channels to ensure income of health workers;set the proportion of performance salary reasonably to give full play to the guiding role of performance -based payment system.关键词
社区卫生服务/岗位聘用制/绩效工资制/激励作用Key words
Community health services/Contract employment system/Performance - based payment system/Incentive function分类
医药卫生引用本文复制引用
王泳仪,徐玲,张明吉,王伟,贺蕾,严非..社区卫生服务机构岗位聘用制与绩效工资制的实施情况及激励作用研究[J].中国全科医学,2017,20(7):768-772,783,6.
