Ran Li-Mei, Luo Kai-Jian, Wu Yun-Cheng, Yao Lan, Feng You-Mei
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Outpatient Department, Affiliated Hospital of Guiyang Medical College, Guiyang, 550001, China.
J Huazhong Univ Sci Technolog Med Sci. 2013 Apr;33(2):309-314. doi: 10.1007/s11596-013-1116-9. Epub 2013 Apr 17.
Physician payment system (PPS) is a principal incentive system to motivate doctors to provide excellent care for patients. During the past decade, physician remuneration in China has not been in proportional to physician's average work load and massive responsibilities. This paper reviewed the constitution of the PPS in China, and further discussed the problems and issues to be addressed with respect to pay for performance. Our study indicated that the lower basic salary and bonus distribution tied to "profits" was the major contributor to the physician's profit-driven incentive and the potential cause for the speedy growth of health expenditures. We recommend that government funding to hospitals should be increased to fully cover physicians' basic salary, a flexible human resource and talent management mechanism needs to be established that severs personal interest between physicians and hospitals, and modern performance assessment and multiplexed payment systems should be piloted to encourage physicians to get the more legitimate compensation.
医师薪酬制度(PPS)是激励医生为患者提供优质医疗服务的主要激励制度。在过去十年中,中国医师的薪酬与医师的平均工作量和巨大责任不成正比。本文回顾了中国PPS的构成,并进一步讨论了绩效薪酬方面需要解决的问题。我们的研究表明,基本工资较低以及与“利润”挂钩的奖金分配是导致医生逐利动机的主要因素,也是医疗费用快速增长的潜在原因。我们建议应增加政府对医院的资金投入,以全额支付医生的基本工资,建立灵活的人力资源和人才管理机制,切断医生与医院之间的个人利益联系,并试行现代绩效评估和多元化支付系统,以鼓励医生获得更合理的薪酬。