浙江遂昌县基层医疗卫生机构绩效考核分配机制探索

Exploration of the mechanism for performance appraisal and allocation of primary healthcare institutions in Suichang county of Zhejiang province

浙江省遂昌县针对基层医疗卫生机构实施绩效工资制度后出现卫生技术人员积极性下降等问题，在绩效工资总量封顶和财政“差额补助、总量控制”的政策大背景下，探索实行分级绩效考核和分配机制，将乡镇卫生院绩效考核结果与核拨财政专项补助及核定人均奖励性绩效工资标准实行“双挂钩”，提高奖励性绩效工资占比，实行单位人均绩效工资水平浮动、单列院长绩效工资、设立偏远山区补贴等政策。建议完善绩效工资总量和财政补助的正常增长机制，专项补助与付费购买相结合、资金补偿与服务绩效相挂钩的补偿新机制，多劳多得、优绩优酬的内部绩效工资分配激励新机制。

In view of such outcomes of the performance pay practice at primary healthcare institutions as decline of motivation of medical workers, the county explored the mechanism of graded performance appraisal and allocation, against the macro background of ceiling setting for the total of performance pay and ＂balance subsidy and total amount control＂ fiscal policy. The following measures are taken, namely a ＂dual linkage＂ to relate the performance appraisal outcome of a township hospital with both allocation of fiscal subsidy and setting of the merit-based performance pay standard per person; higher ratio of merit-based performance pay; floating of the performance pay level per person for the institution in question; separation of the performance pay of the chief leader from others; and subsidies for remote mountainous areas. It is proposed by the author to build a routine increase mechanism for both the total of performance pay and fiscal subsidies, to combine specific subsidy with pay for services, and to join funding compensation with service performance. These measures are expected to create a new mechanism for performance pay allocation, featuring more pay for more work and more pay for better performance.