收入差距视角下四川省公立医院医务人员薪酬现状研究

A Study on the Salary Status of Medical Staff in Public Hospitals of Sichuan Province Based on the Income-gap Perspective

目的:了解四川省公立医院薪酬水平现状及其影响因素,为薪酬制度改革提供参考建议。方法:抽取四川有21个地市(州)118家薪酬改革试点公立医院86503名医务人员薪酬数据,采用广义线性模型进行分析。结果:2019年医务人员年均应发收入为155359.09元,浮动工资占比71.60%,川南和川西比成都低15.37%和14.39%,妇幼保健院比综合医院高8.32%,三级医院比未定级医院高25.33%,护士、药师、技师、管理人员和后勤人员比医生分别低12.33%、16.67%、8.84%、11.09%和19.14%,合同制人员比编制内人员低4.49%,院领导比一般人员高104.18%,正高职称比无职称者高108.66%,中专、大专、本科、硕士和博士比高中及以下高1.13%、4.57%、12.03%、26.21%和48.87%。结论:医务人员收入增加,薪酬向高层次人才倾斜,同工同酬逐步实现,薪酬改革逐见成效,但外部和内部公平性有待提升,逐利风险尚未消除。建议政府合理提升医务人员薪酬水平与基本工资占比,提升外部公平性,医院实行精细化薪酬管理,拉开不同岗位收入差距,提升内部公平性。

Objective:To understand the salary level in public hospitals and its influencing factors in Sichuan Province,and provide suggestions for the reform of the salary system.Methods:The salary data of 86503 medical staff in 118 salary reform public hospitals from 21 prefectures and cities were extracted,and the generalized linear model was used for analysis.Results:In 2019,the average annual payable income of medical staff was 155359.09 yuan,and floating part accounted for 71.60%.Southern Sichuan and Western Sichuan were 15.37%and 14.39%lower than Chengdu.Maternal and child health hospitals were 8.32%higher than general hospitals;tertiary hospitals were 25.33%higher than ungraded hospitals;nurses,pharmacists,technicians,management staff and logistics staff were 12.33%,16.67%,8.84%,11.09%and 19.14%lower than doctors.The contracted staffs were 4.49%lower than the government employed,and the hospital leaders were 104.18%higher than the general staff,higher professional titles were 108.66%higher than those without professional titles.Technical secondary,junior college,undergraduate,master and doctoral degrees were 1.13%,4.57%,12.03%,26.21%and 48.87%higher than those of high school and below.Conclusion:The income of medical staff are increased,salaries are tilted towards high-level talents,and equal pay for equal work has been gradually practiced.Salary system reform have gradually achieved the goals.However,external and internal fairness needs to be improved,and the risk of profit-seeking has not yet been eliminated.It is recommended that the government reasonably increase the proportion of medical staff’s salary level and basic salary,improve external fairness,and implement refined salary management in hospitals to widen the income gap between different positions as so to improve internal equity.