广西实施基本药物制度配套的人事制度改革问题分析

Analysis of the supportive personnel system reform for reinforcing the essential medicine system in Guangxi

目的 研究广西实施基本药物制度配套的人事制度改革及其给广西乡镇卫生院带来的影响和存在的问题.方法 对24所乡镇卫生院院长（副院长）及财务人员进行访谈,对8个县所有卫生院约80％医务人员进行问卷调查,分析基本药物制度对乡镇卫生院的影响.结果 44.02％的被调查医务人员认为实施基本药物制度改革后工作热情下降,乡镇卫生院的医生平均工资下降（P=0.027）,奖励性工资没有体现出不同岗位人员间的差别,基层医学人才流失加剧.结论 新的人事制度改革存在激励机制不科学和一些政策操作性差等问题,应在科学测定绩效工资差距、实施“医学人才双向流动”政策等方面进一步加以完善.

Objective To study the supportive personnel system reform for implementing the essential medicine system in Guangxi,as well as its impacts on the township hospitals and problems so incurred.Methods Deans （and/or vice deans）and financial staff of 24 townships hospitals were interviewed,while 80% of medical staff of health centers in 8 counties were subject to a questionnaire survey,to evaluate impacts of the essential medicine system on township hospitals.Results As shown in the outcomes,44.02%of those surveyed were less enthusiastic after the new system was put in place,township health center doctors found their average salary decreased（P=0.027）,and the rewarding salary failed to distinguish differences among posts,which all worsened the brain drain of these doctors.Conclusion The new personnel system is found with setbacks of poor incentive mechanism and poor operability.Thus further improvement should be made in scientific measurement of the gaps found in the performance-based pay,and the implementation of the＆quot;two-way flow of medical personnel＆quot; policy.