全国职业病诊断机构工作及激励机制现状分析

Current status analysis of work and incentive mechanism of institutions for occupational disease diagnosis in China

目的掌握全国职业病诊断机构开展职业病诊断工作积极性现状,了解机构在诊断工作方面的激励机制基本情况等,为进一步开展职业病诊断工作提供参考依据。方法2021年4月,按照分层抽样法,抽取全国12个省份29家职业病诊断机构的管理人员通过问卷星进行职业病诊断机构工作及激励机制现状调查。结果全国29家职业病诊断机构开展职业病诊断工作有积极性的有16家,占比55.2%。统计分析结果显示,职业病诊断机构开展职业病诊断工作的积极性与地区分布、单位分类、单位级别、机构内诊断管理部门设置、资质类别、近3年诊断病例数、申请诊断病源量、职业病诊断医师及仪器设备配置情况无关(P>0.05)。有激励机制的职业病诊断机构开展职业病诊断工作的积极性(100.0%)明显高于无激励机制的机构(43.5%),差异有统计学意义(P<0.05)。结论全国职业病诊断机构开展职业病诊断工作的积极性不高,建议机构应重点关注诊断的激励机制等方面。此外,建议相关部门采取制定职业病诊断收费标准、完善职业病诊断工作支持保障政策等措施来提升职业病诊断机构开展职业病诊断工作的积极性,以促使职业病诊断机构更好地完成全国职业病诊断工作。

Objective This paper aims to investigate the degree of motivation in Chinese occupational disease diagnosis institutions,understand the general information of incentive mechanisms in disease diagnosis,and provide evidence for further occupational disease diagnosis.Methods In April 2021,the administrative personnel of 29 occupational disease diagnosis institutions in 12 provinces of China,following the stratified sampling method,were selected to investigate the current status of occupational disease diagnosis institutions and incentive mechanisms through Wenjuanxing,an online questionnaire platform.Results The high motivation rate of attitude towards occupational disease diagnosis in 29 occupational disease diagnosis institutions in China was 55.2%(16/29).The statistical analysis results showed that the degree of motivation in occupational disease diagnosis institutions was not related to regional distribution,unit type,unit level,setting of diagnostic and management departments within the institutions,qualification category,number of diagnosed cases in the past 3 years,number of sources of diseases applied for diagnosis,occupational disease diagnosticians and instrument and equipment allocation(P>0.05).The degree of motivation in occupational disease diagnosis institutions with incentive mechanisms was significantly higher than that of institutions without incentive mechanisms(100.0%vs.43.5%;P<0.05).Conclusion The degree of motivation of national occupational disease diagnosis institutions is not high,and it is recommended that institutions should focus on the incentive mechanism.Moreover,it is recommended that relevant departments take measures such as establishing charging standards and issuing supporting guarantee policies for occupational disease diagnosis to enhance the degree of motivation in occupational disease diagnosis institutions,so as to promote occupational disease diagnosis institutions to better complete the national occupational disease diagnosis.