尤溪县公立医院医生薪酬制度的系统动力学分析

System Dynamics Analysis of the Reform of Compensation System in Public Hospitals in Youxi County

目的探究福建省尤溪县公立医院医生薪酬制度改革对医生行为的影响机制及其改革成效。方法运用系统动力学,借鉴马斯洛需要层次理论,分析尤溪县公立医院医生薪酬制度改革举措对医生行为的影响机制。结果尤溪县公立医院医生薪酬制度改革通过影响医生的逐利动机、规避风险动机、追求声誉动机和自我实现动机,引导医生行为。改革后,医生薪酬水平明显提升,医院收入结构得以优化,控费成效初步显现,县域内就诊率明显提高。结论尤溪县公立医院医生薪酬制度改革通过优化激励约束机制,取得明显改革成效,但也存在潜在的问题,需要进一步改善。

Objective To explore the mechanism and effect of compensation system reform on doctors in public hospitals in Youxi County,Fujian Province. Methods Based on the theory of Maslow’s hierarchy of needs,the paper used system dynamics to analyze the influence mechanism of compensation system reform on doctors’ behavior in public hospitals in Youxi County. Results The reform of the doctors’ compensation system in the public hospital of Youxi County guided doctors’ behavior by influencing doctors’ profit-seeking,avoiding risk,pursuing reputational and self-fulfilling motives. After the reform,the level of doctors’ salary improved significantly,the hospital’s income structure was optimized,the effectiveness of the control fee was revealed initially,and the visiting rate of patients within the county increased obviously. Conclusion The reform of the doctors’ compensation system in public hospitals of Youxi County has achieved significant effectiveness by optimizing the incentive and restraint mechanism,but there are also potential problems that need further improvement.