公立医院改革中的医生薪酬问题研究——基于上海市公立医院的经验数据

Research on Doctors' Salary in the Reform of Public Hospitals——Based on empirical data of public hospitals in Shanghai

新医改启动十年,我国医疗健康领域得到了蓬勃发展。本文用上海公立医院医生薪酬数据分析了医生薪酬水平、薪酬结构与公立医院运营效率、治疗效果以及经济收益之间的关系。研究发现:(1)医生薪酬水平越高,医疗资源利用率越高;薪酬激励强度与资源利用率呈"倒U型"关系;(2)医生薪酬水平和浮动工资比例对医疗效果的影响不显著;(3)医生薪酬水平越高,为医院带来的经济效益越高;薪酬激励强度与医院经济效益呈"倒U型"关系。在此基础上提出政策建议:应该适当的提高医生的薪酬水平,让医生提供的医疗服务与其价值相符,也能提高医生的积极性;在设定绩效工资的时候,应合理设定绩效工资的比例,平衡好公立医院医生的激励程度,同时也应当考虑到激励对行业健康发展的影响;在薪酬设计中要注重医疗服务质量的指标,关注医疗服务的结果。

The new medical reform has been launched for ten years, and China’s medical and health fields have been booming. This paper analyzes the relationship between doctors’ salary level,salary structure, public hospital operation efficiency, treatment effect and economic benefits by using the doctor’s salary data of Shanghai public hospitals. The study found that:(1) the higher the doctor’s salary level, the higher the utilization rate of medical resources;the salary incentive intensity and resource utilization rate are "inverted U-type";(2) the effect of doctor salary level and floating salary ratio on medical effect is not Significant;(3) The higher the doctor’s salary level, the higher the economic benefit brought to the hospital;the salary incentive intensity and the hospital’s economic benefit are"inverted U-shaped". On this basis, the policy recommendations are made: the doctor’s salary level should be appropriately raised, the medical service provided by the doctor should be consistent with its value, and the enthusiasm of the doctor can be improved. When setting the performance salary, the proportion of the performance salary should be reasonably set. Balance the incentives of doctors in public hospitals,and also consider the impact of incentives on the healthy development of the industry;pay attention to the indicators of medical service quality in pay design, and pay attention to the results of medical services.