Zhao Yaxin, Zhou Zhongliang, Zhai Xiaohui, Liu Guanping, Wang Zhichao, Deng Qiwei
College of Humanities and Social Development, Northwest A&F University, Xianyang, Shaanxi, China.
School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Front Public Health. 2025 Jun 10;13:1555819. doi: 10.3389/fpubh.2025.1555819. eCollection 2025.
In 2017, the government initiated a pilot program for the public hospitals' pay system (RPHPS) aimed at enhancing physician compensation. We investigated the extent to which the reform impacted the physicians' pay and analyzed the factors that determine their pay.
This cross-sectional study utilized China Public Hospitals' Compensation Reform Survey from 2017, which included a sample of 178,622 physicians. Total annual pay and annual performance-based pay were considered as the primary outcomes, while basic pay, allowance, and other forms of pay were classified as the secondary outcomes. We employed coarsened exact matching and hierarchical linear analysis to investigate the relationship between the RPHPS and pay, as well as the factors influencing pay.
The total annual pay and annual performance-based pay of physicians in the exposure group were significantly higher by 6.3% (coef: 0.06; < 0.01) and 19.2% (coef: 0.19; < 0.001), respectively, compared to the control group. We did not find a significant relationship between RPHPS and basic pay or allowances. Physicians' pay was associated with gender, age, educational status, professional titles, years of working, and departments. Male physicians received 4% higher total annual salary and 6% higher performance-based pay than their female counterparts.
Positive relationships were observed between the RPHPS and both the total annual pay and performance-based pay of physicians. Significant gender disparities were identified in total annual pay, performance-based pay, and allowances. The government should promote the RPHPS to enhance physicians' pay and implement initiatives aimed at achieving equal pay for equal work, irrespective of gender.
2017年，政府启动了公立医院薪酬制度试点项目（RPHPS），旨在提高医生薪酬。我们调查了该改革对医生薪酬的影响程度，并分析了决定其薪酬的因素。
这项横断面研究利用了2017年中国公立医院薪酬改革调查，样本包括178,622名医生。年度总薪酬和年度绩效薪酬被视为主要结果，而基本工资、津贴和其他形式的薪酬被归类为次要结果。我们采用粗化精确匹配和分层线性分析来研究RPHPS与薪酬之间的关系以及影响薪酬的因素。
与对照组相比，暴露组医生的年度总薪酬和年度绩效薪酬分别显著高出6.3%（系数：0.06；<0.01）和19.2%（系数：0.19；<0.001）。我们未发现RPHPS与基本工资或津贴之间存在显著关系。医生的薪酬与性别、年龄、教育程度、职称、工作年限和科室有关。男性医生的年度总薪酬比女性医生高4%，绩效薪酬高6%。
观察到RPHPS与医生的年度总薪酬和绩效薪酬之间存在正相关关系。在年度总薪酬、绩效薪酬和津贴方面发现了显著的性别差异。政府应推进RPHPS以提高医生薪酬，并实施旨在实现同工同酬、不分性别的举措。
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