公立医院内部薪酬制度改革顶层设计及实践探析

Top-level design and practice exploration of salary reform in public hospitals

改革公立医院薪酬制度,对增强公立医院公益性、激发医务人员工作积极性、推动高质量发展,有正向激励作用。笔者介绍了华中科技大学同济医学院附属协和医院自2018年以来分步推进医、护、技、管分序列薪酬制度改革探索,包括基于医疗组的医师绩效改革、以护理垂直管理为基础的护理绩效改革、以资源边际效益为主的医技绩效改革、基于岗位职责和360°考评的管理绩效改革。实践显示,薪酬制度改革可促进医疗服务能力提升,提高护士满意度,缩短医技检查等待时间,保障绩效"国考"成绩及医院综合排名稳中有升。各医院在研究落实薪酬制度改革政策要求时,需因地制宜,以精准、安全的信息系统为支撑,重点考量分配模式、薪酬结构和资金来源等。

The salary reform of public hospitals has a positive incentive effect on enhancing the public welfare of public hospitals,stimulating the enthusiasm of medical staff,and promoting high-quality development.The authors introduced the practice and exploration of the sequential salary system reform in Union Hospital,Tongji Medical College of Huazhong University of Science and Technology since 2018.It included the reform of physician performance based on medical groups,the reform of nursing performance based on vertical nursing management,the reform of medical technology performance based on resource marginal utilization,and the reform of management performance based on job responsibilities and 360°evaluation.The practice has showed that the salary reform could promote the improvement of medical service ability,improve nurses′satisfaction,shorten the waiting time for medical technical examination,and steadily improve the performance of"National Examination"and the comprehensive ranking of hospitals.When studying and implementing the policy requirements of salary system reform,hospitals in different regions should take measures in accordance with local conditions,with accurate and safe information systems as the support,and focus on the distribution mode,compensation structure and funding sources.