Misfeldt Renee, Linder Jordana, Lait Jana, Hepp Shelanne, Armitage Gail, Jackson Karen, Suter Esther
Senior Research and Evaluation Consultant, Workforce Research and Evaluation, Alberta Health Services, Alberta, Canada.
J Health Serv Res Policy. 2014 Jan;19(1):52-61. doi: 10.1177/1355819613505746. Epub 2013 Oct 29.
To review the effectiveness of financial and nonfinancial incentives for improving the benefits (recruitment, retention, job satisfaction, absenteeism, turnover, intent to leave) of human resource strategies in health care.
Overview of 33 reviews published from 2000 to 2012 summarized the effectiveness of incentives for improving human resource outcomes in health care (such as job satisfaction, turnover rates, recruitment, and retention) that met the inclusion criteria and were assessed by at least two research members using the Assessment of Multiple Systematic Reviews quality assessment tool. Of those, 13 reviews met the quality criteria and were included in the overview. Information was extracted on a description of the review, the incentives considered, and their impact on human resource outcomes. The information on the relationship between incentives and outcomes was assessed and synthesized.
While financial compensation is the best-recognized approach within an incentives package, there is evidence that health care practitioners respond positively to incentives linked to the quality of the working environments including opportunities for professional development, improved work life balance, interprofessional collaboration, and professional autonomy. There is less evidence that workload factors such as job demand, restructured staffing models, re-engineered work designs, ward practices, employment status, or staff skill mix have an impact on human resource outcomes.
Overall, evidence of effective strategies for improving outcomes is mixed. While financial incentives play a key role in enhancing outcomes, they need to be considered as only one strategy within an incentives package. There is stronger evidence that improving the work place environment and instituting mechanisms for work-life balance need to be part of an overall strategy to improve outcomes for health care practitioners.
回顾经济激励和非经济激励在提高医疗保健领域人力资源战略效益（招聘、留用、工作满意度、旷工率、人员流动率、离职意向）方面的有效性。
对2000年至2012年发表的33篇综述进行概述，总结了符合纳入标准且至少由两名研究人员使用多系统综述质量评估工具评估的激励措施在改善医疗保健领域人力资源成果（如工作满意度、人员流动率、招聘和留用）方面的有效性。其中，13篇综述符合质量标准并纳入概述。提取了关于综述描述、所考虑的激励措施及其对人力资源成果影响的信息。对激励措施与成果之间的关系信息进行了评估和综合。
虽然经济补偿是激励措施中最广为人知的方法，但有证据表明，医疗保健从业者对与工作环境质量相关的激励措施反应积极，包括职业发展机会、改善工作与生活平衡、跨专业协作和职业自主权。较少有证据表明工作负荷因素，如工作需求、重组的人员配置模式、重新设计的工作流程、病房实践、就业状况或员工技能组合对人力资源成果有影响。
总体而言，改善成果的有效策略的证据参差不齐。虽然经济激励在提高成果方面发挥着关键作用，但它们应仅被视为激励措施组合中的一种策略。有更充分的证据表明，改善工作场所环境和建立工作与生活平衡机制需要成为改善医疗保健从业者成果的总体战略的一部分。
