社区卫生服务机构岗位聘用制与绩效工资制的实施情况及激励作用研究

发布时间：2018-05-13 19:52

本文选题：社区卫生服务 + 岗位聘用制　；参考：《中国全科医学》2017年07期

【摘要】：目的了解我国四省市社区卫生服务机构岗位聘用制与绩效工资制的实施情况及其对社区卫生人员的激励作用。方法本研究采用多阶段抽样方法。采用立意抽样,在东部地区选取山东省、上海市,在中部地区选取安徽省,在西部地区选取陕西省;在3个省各抽取省会所在市和1个社区卫生服务发展较好的地级市;在每个市(包括上海市)各抽取1个区,共7个区。采用分层抽样,在每个区依据社区卫生服务机构举办主体类型和人员规模分层抽样,每层最多抽取3家社区卫生服务机构,共抽取61家社区卫生服务机构。采用整群抽样,在每家社区卫生服务机构选取调查当日所有在岗的社区卫生人员共713例作为本研究对象,并从中抽取社区卫生人员6例作为访谈对象。自行编制调查问卷,问卷主要内容为:社区卫生人员的基本情况;岗位聘用制的实施情况;绩效工资制的实施情况。于2013年8—9月,采用自填式调查问卷进行调查。共发放问卷713份,回收有效问卷656份,问卷的有效回收率为92.0%。在进行问卷调查同时,开展深度访谈,访谈内容为对岗位聘用制和绩效工资制的评价。结果 61家社区卫生服务机构中,有27家公有制举办主体、18家私有制举办主体的社区卫生服务机构实施了岗位聘用制。实施岗位聘用制的45家社区卫生服务机构中,编外社区卫生人员年收入占编内人员年收入的比例为(82.9±16.6)%;未实施岗位聘用制的16家社区卫生服务机构中,编外社区卫生人员年收入占编内人员年收入的比例为(53.0±17.4)%,两者间差异有统计学意义(P0.05)。34家公有制举办主体的社区卫生服务机构中,有24家实施了绩效工资制。64.7%(180/278)的社区卫生服务中心人员、85.1%(63/74)的社区卫生服务站人员认为绩效考核有激励作用。42.1%(153/363)的社区卫生人员认为该机构的收入分配公平性较好。结论岗位聘用制和绩效工资制对保障社区卫生人员的收入公平性、提高积极性起到一定作用;但是要打破编制的限制、解除编制与福利的联系、建立科学的绩效工资制度,还需要进一步探索。建议探索完善岗位聘用制,增加收入渠道,保证社区卫生人员收入,合理设置绩效工资比例,充分发挥绩效工资的引导作用。
[Abstract]:Objective to investigate the employment system and performance wage system of community health service institutions in four provinces and cities of China and their incentive effect on community health workers. Methods the method of multi-stage sampling was used in this study. In the eastern region, Shandong Province, Shanghai, Anhui Province and Shaanxi Province were selected in the eastern region, Shanghai, Anhui Province and Shaanxi Province in the western region, and the provincial capitals and one prefecture-level city with better development of community health services were selected in each of the three provinces. In each city (including Shanghai), each selected one district, a total of 7 districts. Stratified sampling was adopted in each district according to the main body type and personnel size of the community health service organization. A maximum of 3 community health service institutions were selected in each layer and 61 community health service institutions were selected. Using cluster sampling, 713 community health workers were selected from each community health service institution as the subjects of this study, and 6 community health workers were selected as the interview subjects. The main contents of the questionnaire are as follows: the basic situation of community health personnel, the implementation of the post employment system, and the implementation of the performance pay system. From August to September 2013, self-completed questionnaire was used. A total of 713 questionnaires were sent out and 656 valid questionnaires were collected. The effective recovery rate of the questionnaires was 92.0. At the same time, in-depth interviews were conducted, which included the evaluation of post employment system and performance pay system. Results out of 61 community health service institutions, 27 were public owned and 18 were private owned. Of the 45 community health service institutions that implemented the post appointment system, the annual income of non-staff community health workers accounted for 82.9 卤16.6% of the annual income of the staff in the staff, while in the 16 community health service institutions that did not implement the post employment system, the proportion of annual income of non-staff community health workers to the annual income of the staff members was 82.9 卤16.6m. The proportion of annual income of non-staff community health workers to the annual income of staff in the series was 53.0 卤17.40.The difference between the two groups was statistically significant (P0.050.34). There are 24 community health service station staff who have implemented the performance pay system. 64.70.180 / 278) the community health service station staff think that the performance appraisal has the incentive function. 42.1and 153- 363.) the community health workers think that the income distribution fairness of the community health service center is better than that of the community health service center. Conclusion the post employment system and the performance pay system play a certain role in ensuring the income fairness and improving the enthusiasm of the community health personnel, but we should break the limits of the establishment, release the relationship between the establishment and the welfare, and establish a scientific performance wage system. Further exploration is needed. It is suggested that the system of post employment should be improved, the income channel should be increased, the income of community health personnel should be guaranteed, the proportion of performance salary should be set up reasonably, and the guiding role of performance salary should be fully brought into play.
【作者单位】：复旦大学公共卫生学院卫生部卫生技术评估重点实验室国民健康社会风险预警协同创新中心;国家卫生与计划生育委员会卫生统计信息中心;上海交通大学公共卫生学院;
【分类号】：R197.61

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