Study on compensation mechanism reform of primary healthcare institutions in Zhejiang province
10.3760/cma.j.issn.1000-6672.2020.01.002
- VernacularTitle: 浙江省基层医疗卫生机构补偿机制改革试点评估
- Author:
Minzhuo HUANG
1
;
Yuanyuan LI
;
Xiaoqian HU
;
Yuxuan GU
;
Xuemei ZHEN
;
Xueshan SUN
;
Jingming WEI
;
Hengjin DONG
Author Information
1. Center for Health Policy Studies, Zhejiang University School of Medicine, Hangzhou 310058, China
- Publication Type:Journal Article
- Keywords:
Primary healthcare institutions;
Compensation mechanisms;
Work equivalents;
Evaluation;
Zhejiang province
- From:
Chinese Journal of Hospital Administration
2020;36(1):5-9
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the new compensation mechanism for primary healthcare institutions in Zhejiang province, in terms of fairness, performance, incentive mechanism and sustainability in pilot areas.
Methods:Evaluation indicators were constructed based on stakeholder theory, fairness theory, expectation theory and sustainable development theory.Focus group interviews were conducted with stakeholders and quantitative data were collected through questionnaires. Meanwhile, the financial compensation, income and expenditure and work equivalent data were collected from such institutions of the four pilot areas, with quantitative data subject to descriptive analysis.
Results:This study found the reform used reasonable proportion of funds allocated(the proportion of basic salary for employees was lower than 50%)and adjustment factors(1.0-1.8)of different primary healthcare institutions to guarantee the fairness of the reform; the increase of work equivalents(the per capita work equivalents of medical staff in pilot counties had increased from 38.435 million in the previous year to 42.590 million work equivalents)reflected the performance outcomes of the reform. The incentive and sustainability of the reforms were the weak parts. These were mainly due to the fact that the internal distribution system of primary healthcare institutions failed to make corresponding reforms.
Conclusions:The reform of the compensation mechanism based on the equivalent method has changed medical staff′s perception of the distribution of funds. The principle of" more pay for more work" and the use of information technology to capture work equivalents have improved the enthusiasm of primary medical staff and the operational efficiency of these institutions, thus, making reform generally scientific and reasonable.
