我国基层医疗卫生机构实施绩效工资的政策分析

杨肖光; 代涛; 王芳

引用本文：杨肖光,代涛,王芳.我国基层医疗卫生机构实施绩效工资的政策分析[J].中国卫生政策研究,2013,6(5):15-20

我国基层医疗卫生机构实施绩效工资的政策分析

投稿时间：2013-04-09 修订日期：2013-05-08 PDF全文浏览 HTML全文浏览

中国医学科学院医学信息研究所/卫生政策与管理研究中心

摘要:目的：分析基层医疗卫生机构绩效工资政策制定、实施及效果，为完善制度设计和政策执行提供建议。方法：运用定性研究的思路与方法，在北京、河南、安徽和重庆四省市基层医疗卫生机构开展现场调研，并对所收集的定性资料进行整理和分析。结果：实施绩效工资后基层医务人员工资收入整体有所增加，但存在收入平均化、工作量与收入不对等、激励效果不明显等问题，基层医务人员和管理者对绩效工资认可度不高。工资总额核定标准较低、绩效工资制度设计中缺乏增长机制、工资增长与工作负荷增长不相匹配以及绩效考核不完善等是导致绩效工资激励作用有限的主要原因。结论：绩效工资制度的进一步完善需要合理核定绩效工资总额，真正反映基层医务人员的劳动价值；建立基层医务人员收入增长机制，增强激励作用；科学设置以质量为导向的绩效考核标准和指标，充分发挥绩效工资的引导作用；与人力资源改革同步推进绩效工资制度改革，建立有效的激励新机制。

关键词:绩效工资基层卫生激励机制政策分析

基金项目:中澳卫生与艾滋病项目“医药卫生体制改革评价研究”；中央级公益性科研院所基本科研业务费“深化医药卫生体制改革监测与评价研究”

The national essential public health services project in China: progress and equity

Abstract:Objective: In this paper, we analyze the effectiveness of pay for performance in primary healthcare institutions and make some policy recommendations. Methods: A qualitative research method was used on data acquired from Beijing, Henan, Anhui, and Chongqing. Results: Although pay for performance in primary health care is increasing, satisfaction levels remain low because of perceived low average income and inequitable distribution of workload. Pay for performance is not being seen as a strong incentive for some reasons, such as lack of growth mechanism, unequal workload and income. Conclusion: First, annual wages should reasonably to reflect the value of health workers. Second, pay for performance should be further promoted to create enthusiasm. Third, quality oriented performance assessment should be tailored to different posts. Finally, the pay for performance should keep pace with human resources reform so that new incentive mechanisms are established.

Key words:Pay for performance Primary healthcare Incentive mechanisms Policy analysis

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