1.Study on the Salary Distribution Equity of Health Technicians in China
Mian XIA ; Min'gou WANG ; Shengjie YIN ; Shuai JIANG
Chinese Health Economics 2024;43(5):1-4,22
Objective:To explore deficiencies in the reform of China's health remuneration system through empirical data,provide data support and references for optimization of China's remuneration policy for health technicians.Methods:The Gini coefficient is calculated based on the data of CHIP to analyze the equity of salary distribution of health technicians in different regions and different genders.Results:Health technicians'income is rising and at a higher level in society.Eastern,urban,and male health technicians receive higher salary;income distribution gap across regions and female is increasing;income distribution in health industry is more even than most industry.Conclusion:It is needed to continue to push forward the reform of the health remuneration system,balance efficiency and equity,formulate income distribution scheme according to local conditions,strengthen attention and protection to the income distribution for female health technicians.
2.Evolutionary Game Analysis of the Implementation of the Annual Salary System for Principal Officials in Public Hospi-tals
Mian XIA ; Shengjie YIN ; Shuai JIANG ; Meili ZHANG
Chinese Health Economics 2024;43(5):5-8
Objective:It explores how to promote the effective implementation of the annual salary system in public hospital.Methods:On the basis of the existing annual salary system reform,through evolutionary game model,it analyzes the key factors that affect strategy selection of government and principal person in charge of hospitals during the implementation of the annual salary sys-tem.Results:In addition to the interaction between behavioral agents,the cost of government supervision,the internal and external pressure of social and administrative systems affect the strategic choice of government.The level and structure of annual salary,the difficulty degree of achieving performance goals and intensity of punishment affect the strategic choice of the main person in charge of hospital.Conclusion:In order to improve the implementation of the annual salary system,government should make a reasonable sala-ry scheme,improve the reward and punishment mechanism and reduce transaction costs.
3.Analysis on Influencing Factors of the Work Performance of Medical Staff in Tertiary Hospitals in Henan Province
Mengyu YANG ; Shuai JIANG ; Mian XIA ; Yibo ZUO ; Hang FU ; Chengzeng WANG
Chinese Health Economics 2024;43(5):9-12
Objective:To understand the current situation of work performance and influencing factors of medical staff in tertiary hospitals in Henan Province,in order to provide references for improving their performance level.Methods:An electronic questionnaire was used to investigate the work engagement and work performance of medical staff in a sample hospital in Henan Province,and multiple regression analysis was used to explore the relationship between work engagement and work performance.Results:The total score of medical staff's job performance was 45.18±5.78;Cronbach's α coefficient of the questionnaire's reliability ranged from 0.870 to 0.964;medical staff's job commitment was positively correlated with their job performance;and the highest level of educational attainment,occupational category,and job commitment were the main influencing factors of job performance(P<0.05).Conclusion:There is still much room for improvement in the work performance of medical staff in tertiary hospitals in Henan Province,and hospitals should focus on improving the work capacity of medical staff and actively improving work engagement in order to enhance the level of medical staff performance.
4.Research on the Influence Mechanism of Primary Physicians'Salary Satisfaction on the Turnover Tendency in Wuhan
Mian XIA ; Yining GAO ; Haomiao LI ; Meizhou JIANG ; Mingou WANG ; Shuai JIANG
Chinese Health Economics 2024;43(5):13-17
Objective:To analyze the influence mechanism of primary physicians'salary satisfaction on the turnover tendency,explore the moderating role of professional identity,and to provide a basis for enhancing the stability of the primary care physician workforce.Methods:The questionnaire survey method was used to study the salary satisfaction,professional identity and turnover ten-dency among 298 primary care doctors in the main urban area of Wuhan,and 284 valid questionnaires were obtained.The data were statistically analyzed.Results:The propensity to leave scores of primary care physicians aged 40 to 50 years,with bachelor's de-gree and 11 to 15 years of work were(3.01±0.87),(3.02±0.90),and(3.03±0.86),respectively,with high were high turnover tendency;primary care physicians'salary satisfaction and professional identity had a negative effect on the propensity to leave(P<0.001);and professional identity had a negative effect on the salary satisfaction and turnover tendency(P<0.001).Conclusion:Primary physicians'propensity to leave is more pronounced in the high-quality human capital group,with moderate security but in-sufficient incentives for pay;higher levels of professional identity reduce the relationship between pay satisfaction and propensity to leave.
5.Study on the Influence Mechanism of Salary Satisfaction on Job Performance of Nursing Staff in Henan Province
Yibo ZUO ; Mian XIA ; Shuai JIANG
Chinese Health Economics 2024;43(5):18-22
Objective:To understand the current situation of nursing staff's salary satisfaction and job performance in Henan Province,and to explore the mechanism of salary satisfaction's influence on job performance.Methods:Electronic questionnaire was used to investigate the salary satisfaction,job performance and job involvement of nursing staff in sample public hospitals in Henan Province,and structural equation model was used to analyze the influence path of salary satisfaction on job performance.Results:The scores of nurses'salary satisfaction,job performance and job involvement were(68.59±19.99),(48.95±6.53)and(82.27±18.22)respectively.Nursing salary satisfaction was significantly and positively correlated with job performance(r= 0.594,P<0.01)and work engagement(r= 0.600,P<0.01).The standardized path coefficient of nursing staff's salary satisfaction on job performance was 0.637(P= 0.002).Conclusion:Pay satisfaction for caregivers has a significant positive impact on job outcomes,and job engagement serves as a mediator between reward satisfaction and job outcomes.It is suggested to improve the salary satisfaction and job involvement of nursing staff in order to promote the improvement of job performance.
6.Exploration of China's Modernized Health Insurance Governance with the Disproportionate Share Mechanism of Traditional Chinese Medicine
Liyun ZHU ; Yazhou ZHU ; Fuqun XIAO ; Lizhong LIANG
Chinese Health Economics 2024;43(5):23-27,33
The 20th National Congress report proposed the most important and core strategic path of national governance:Chinese modernization.Under the guidance of the top-level design,the healthcare security system needs to find a new paradigm of healthcare security governance under the Chinese modernization that is both in line with Chinese characteristics and the basic laws and characteristics of the world's sanitary resources.Combined with the 20th National Congress report,the medical reform tasks of"promoting the development and governance of medical services,medical insurance and pharmaceutical synergy"and"promoting the inheritance of Traditional Chinese Medicine"are required to learn from the international"disproportionate share"health resources compensation system.From the perspective of necessity and adaptability,it explore the Traditional Chinese Medicine(TCM)disproportionate share mechanism of medical insurance,in order to maximize the realization of the strategic purchasing goal of health insurance and to provide a systematic,standardized and sustainable modernized Chinese health insurance model for the continuous support of TCM medicine special diagnosis and treatment with medical insurance resources.
7.Research on the Path Selection of Attracting Overseas Medical Consumption Backflow under the New Development Pattern of"Dual Circulation"
Chinese Health Economics 2024;43(5):28-33
Attracting the return of overseas medical consumption is not only a driving force for promoting supply side structural reform and improving industrial development quality and efficiency under the current"dual circulation"new development pattern,but also a powerful lever and new engine for promoting high-quality economic development.The main reasons for attracting the outflow of domestic medical consumption include the pursuit of advanced medical technology from abroad,the attraction of high-quality medical services from overseas,the huge price difference between domestic and foreign medical consumption,and domestic policies,laws,and institutional restrictions.Measures need to be taken to improve the level of medical technology,increase the supply of medical consumption,improve the quality of medical services,optimize the medical consumption environment,and reduce medical service costs to attract the return of overseas medical consumption.
8.Study on the Solution to the"Trilemma"of Health Policy
Chinese Health Economics 2024;43(5):34-36,67
Objective:To explore whether there is a solution to the trilemma of health policy,and to reveal whether the health policy and policy portfolio can simultaneously improve the"health","wealth"and"equity"of residents.Methods:The study constructs a dynamic stochastic general equilibrium model and indicator estimation procedure that includes human health capital,and used Bayesian model comparison method to determine reasonable model settings.Using numerical simulation methods,by adjusting the corresponding parameters,it also simulates the policy effect of implementing comprehensive medical supervision policy and medical quality management policy separately,as well as the policy effects of combining these two policies.Results:Simply implementing comprehensive medical supervision policy may lead to the deviation of health outcomes from health affordability and financing equity,and simply implementing medical quality management policy may lead to the deviation of health affordability from health outcomes and financing fairness,and the combination of these two policies can effectively solve the trilemma of health policy.Conclusion:The problem of health policy trilemma is not unsolvable,and the mutual deviation of"health","wealth"and"equity"can be reconciled through reasonable policy combination design.
9.A Study of Policy Synergy in 71 Pilot Cities of DIP Payment
Xiangfei LI ; Yibing HAN ; Wei YANG
Chinese Health Economics 2024;43(5):37-42
Objective:To explore the policy synergy of 71 Diagnosis-Intervention Packet(DIP)pilot cities from the perspective of policy synergy at both the national and provincial levels.Methods:Policy evaluation dimensions were constructed by text mining method,and the surface plots of policy consistency were drawn by the Policy Modeling Consistency Index(PMC),and the degree of policy synergy between each city and national policies and with cities in the province were calculated by correlation analysis.Results:Different levels of policy in pilot cities and the policy differences among pilot cities mainly focus on policy disclosure,core elements,and infrastructure,at the central level,most cities maintain a high degree of consistency with the state in terms of policy nature,management measures,infrastructure,and policy evaluation,and the policy timeliness,policy perspective,and core elements still need to be improved;at the provincial level,cities within the 20 provinces show characteristics in low level of complete synergy,high level of close synergy and differentiated partial synergy.Conclusion:The 71 DIP pilot cities have established a preliminary policy system,but there are still more cities with missing policies and a lack of coordination.In the future,efforts should be made to advance the policy development process,promote the improvement of the policy system,and promote coordination among pilot cities in policy implementation.
10.The Key Problems and Countermeasures of High-Quality Development of the Basic Medical Security System in China
Guosong SHU ; Chunlin JIN ; Linan WANG
Chinese Health Economics 2024;43(5):43-47
It analyzes the development achievements of the construction of the basic medical security system and the key issues of its high-quality development in China,and puts forward the countermeasures of promoting the high-quality development of the basic medical security system.In recent years,China's basic medical security system has made remarkable development achievements,but it is still facing a series of problems in the areas of participation,financing,treatment guarantee security and fund supervision.The implementation of accurate participation and expansion,the improvement of the financing mechanism,and the promotion of synergistic development and governance of medical care,medical insurance and pharmaceuticals are the keys to meeting the residents'growing health needs and promoting the high-quality development of China's basic medical security system.
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