| BackgroundIn 2006,Chinese public hospitals started the fourth salary system reform,and implemented the Post Performance Salary system.It was the first time that the concept of performance-based wages was proposed.However,due to the lack of unified performance evaluation standards and principles of guidance,and the huge differences between hospitals,the performance-based salary system facing a lot of difficulties in the implementation process.And the effect is mixed.As a provincial Traditional Chinese Medicine Hospital,the sample hospital’s development status has an important impact in the region.In view the fact that the original performance appraisal methos could not meet the needs of the hospital’s development,the sample hospital reformed the original bonus accounting method in 2015.And a new method,Resource-Based Relative Value Scale evaluation system combined with a comprehensive target-based performance,was implemented.ObjectiveThe paper aims to investigate physicisns’ satisfaction with salary performance appraisal reforms,and analyze the impacts of performance appraisal reforms on physicians’ income and related indicators of hospital operation.It was analyzed from the perspectives of physicians’ satisfaction,income,service efficiency,service volume and other related indicators.Based on these analyses,this paper tries to sum up the experiences,find deficiencies,explore the influence factors,and then provide some references to improve the salary performance system.MethodsIn this study,stratified random sampling method was used to investigate the physicians’s satisfaction degree of salary performance,and description analisis,single factor variance analysis and Independent Sample T test were used to make the single factor analysis on the satisfaction of the physician’s performance appraisal and influencing factors.This study used the Binary Logistic Regression model to screen the influencuing factors of the physician’s salary performance appraisal.This study combined with the actual situation of the hospital to determine the analysis indiactors and the time periods.At the same time,combined with the operating data of the samole hospitals,before and after the performance reform,some indicators were analyzed by the method of Paired Sample T Test and comparative analysis,such as physicians’ income,service efficiency(average length of hospital stay,bed occupancy rate)and service volume(surgery times,discharges),the structure of hospital revenue and expenditure(the proportion of drug income to total income,the proportion of personnel expenditure to total expenditure).Results(1)Though the analysis of physician’s salary satisfaction queationnaire and the impact of reforms on hospital-related operational indicators,this paper found that physician’ s age,working years,education background,job title and income affect the physician’s salary performance-assessment satisfaction.Among them,education background is a protective factor in the satisfaction of salary performance appraisal,undergraduate and below physicians’ satisfaction is 8.354 times that of doctor;income is a risk factor,physicians with a monthly income of less than 6000 yuan are 0.003 times higher than physicians with a salary of 15000 yuan or more;physicians’satisfaction with content setting dimension and evaluation method dimension are higher than application and feedback dimension as well as incentive effect dimension,satisfaction degree of subject participation dimension is the lowest;(2)Though the analysis of related indicators,such as physician’s income,service efficiency,income and expenditure structure before and after the salary performance reform,it was found that these indicators were all improved to varying degrees,among which physician’s income,discharges and average length of stay have improved statistically.And the utilization of bedsapce increased by 6.95%year-on-year,the proportion of medicines decreased by 3.54%compared with the corresponding period of last year.Conclusions and SuggestionsThough the analysis of physicians’ sarisfaction questionnaires and related indicators,it was found that physicians have higher satisfaction with performance appraisal methods and content settings;and physicians’ income,service volume,service efficiency,and hospital income and expenditure structure were improved.However,there are still has some issues,such as the low participation in the salary performance-assessment,the imcomplete information feedback mechanism,and high proportion of drugs.Therefore,based on this study,the following recommendations are made:(1)Strengthen the promotion of salary performance-assessment,make physicians understand and clarify the content,indicators,and goals of performance-assessment.(2)Collect performance feedback information though multiple channels,and establish a sound performance information feedback mechanism.(3)Continuously optimize income structure,control the proportion of western medicine,and promot the sustainable development of hospitals. |
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