中国公立医院医生薪酬收入的现状与趋势分析

Current status and trend of phsician compensation in Chinese public hospitals

背景:我国公立医院改革不断深入,人社部也在2016年9月发文提出允许医疗卫生机构突破现行事业单位工资调控水平,允许业务收入结余部分可用于人员绩效奖励,即"两个允许"。目的:描述"两个允许"政策实施前后我国主要三级公立医院临床医生薪酬的现状及变化情况。方法:采用分层抽样,在全国31个省会城市的136~144家主要三级公立医院通过问卷自答方式调查医生的实际年收入和期望年收入,并用比值、定基比和增长速度等指标描述薪酬的变化情况。结果:医生平均实际年收入从2016年的9.57万元增加到2019年的12.22万元。实际年收入水平最低是急诊科(11.54万元),最高是口腔科(15.63万元)。医生期望年收入从2016年的21.06万元增加到2019年的23.67万元,基本是其实际年收入的两倍。四年间,医生平均实际年收入与城镇职工平均年收入相比,其比值基本保持在1.5倍(2016年是1.54倍,2019年是1.48倍)。结论:2016-2019年四年间我国主要三级公立医院医生实际年收入虽略有增加但总体变化不大,2019年自报平均实际年收入是期望收入的一半。

With the further development of Chinese public hospital reform, ministry of human resources and social security issued a policy of Two Permissions-permitting public hospitals to go beyond the current compensation limitations on government affiliated institutions and permitting public hospitals to use their own cash flow surpluses for personnel incentive payments. We aimed to analyze the change of physician compensation in Chinese tertiary hospitals before and after the implementation of the policy. Physicians from 136 ~ 144 selected hospitals in 31 provincial capitals were sampled stratifying on their academic rank and were surveyed on their self-reported actual compensations and expected ones from 2016 to 2019. Ratios, relative ratios and growth rates were used to describe the changes of compensations in the four years. The result shows that the average annual actual compensation increased from 95.7 thousand in 2016 to 122.2 thousand in 2019 with physicians from emergency departments receiving the lowest(115.4 thousand) while those from stomatology departments getting the highest(156.3 thousand) in 2019. Their expected compensations increased from 210.6 thousand in 2016 to 236.7 thousand in 2019 and remained about twice of the actual ones throughout the period. The ratios of physicians’ average compensation to that of urban employees stayed close to 1.5 over this period(1.54 in 2016, 1.48 in 2019). In conclusion, during the four-year period from 2016 to 2019, physicians’ average actual annual compensation only increased marginally. It reached 122.2 thousand, which maintained at only half of physicians’ expectation and about 1.5 times of the average income of urban employee.