Study On Incentive Mechanism Of Rural Country Level Medical Institutions Staff In Henan Province

ObjectiveAimed at analyzing the problems reflected by the staff of rural county-level medical institutions in Henan Province,and using relevant theories to propose relevant incentive frameworks in response to the problems,effective suggestions are made for improving the enthusiasm of the staff and provide reference for the government to formulate relevant policies.MethodsThe data used in this paper was derived from the investigation of the incentive mechanism of the staff of county-level medical institutions in Henan Province.The design of the questionnaire was based on research experience,with reference to relevant literature,and in combination with the pre-survey situation.The content of the questionnaire includes three aspects: personal basic information,consumption information and incentive mechanism.The investigators were all composed of graduate students and conducted unified training before the investigation.The investigation unit selected medical institutions in four counties of Kaifeng County,Baofeng County,Mengjin County and Huaiyang County of Henan Province.A total of 1800 doctors,nurses,technicians and management personnel at the county-level medical institutions were investigated using the cluster sampling method.,Collected 1612 valid questionnaires,the questionnaire recovery rate of 89.56%.This paper based on the current situation,aiming at the problem and according to reletive theories,this paper studies the design of the incentive mechanism framework:1.We used the problem coding method to analyze the difficult issues that need to be solved by superiors in the life,work load,and work of medical staff at the county level.2.We used the concentration trend(such as average number)and discrete trend(such as standard deviation),two variable Logistic regression analysis,linear regression analysis and other statistical methods to analyze the income level,working load and other problems of the respondents,the status of satisfaction and the importance of incentive factors.3.Aiming at the problem of research,the framework of incentive mechanism is designed by social distribution equity determines social production efficiency theory,Rawls’ s justice theory,value chain theory,scientific management theory,system theory and so on.Results1.The analysis of the first problem of life difficulties found that regardless of unit,gender,age,job title,or occupation,all staff members believe that the most important issue in life difficulties is income.There is no time to spend time with family members and difficulties in living.The number of people involved is also relatively large.The solution to the problem of the income of staff in medical institutions is a top priority.Dealing with this issue will also help solve other problems.The first problem analysis of work difficulties found that,regardless of unit,gender,age,job title,or occupation,the work difficulties reported by the staff in the surveyed medical institutions mainly focused on the three issues of doctor-patient relationship,work pressure,and income.The reason is that medical institutions and patients are closely linked to their physical health and lives.Their staff are worried about the relationship between doctors and patients,and they also have greater work pressure than the general industry.Under such pressure,staff will think that income is far less than the workload and work pressure.In addition to the above three problems,the working environment is also a concern in the work.2.In the analysis of fairness and efficiency indicators,most respondents believe that their income level is low,they do not meet expected pay or minimum guarantees,and they are unfair to pay and income;working hours are longer than the state’s prescribed working hours,and statutory Holidays often work overtime,and the rest time is too short,which results in the survey respondents working enthusiasm is not high,work efficiency and other issues.Among them,in this county-level medical institution survey,the annual income of the management personnel is about 25,551.61 yuan per year;followed by the doctor,the annual income is about 23,731 yuan per year;the third is the technician,and the annual income is about 20,436 yuan per year;The fourth is nurses,and the annual income is about 18,611 yuan per year;lastly,the other people’s annual income is about 18,298 yuan per year.The annual income of other personnel is taken as the unit 1.The ratio of the average annual salary of doctors,nurses,managers,technicians and other personnel is about 1.3: 1.01: 1.4: 1.1:1.There is little difference in the ratio of wages for each occupation.2.Survey on the status of satisfaction survey mainly analyzed the income items in the survey form and found that the surveyed people did not have a high overall evaluation of the job and the score of their professional satisfaction was low among them,the scores of income,job risk,job fairness,job intensity,occupational environment,social respect,job promotion opportunities,job satisfaction,and access to training and improvement opportunities are lower than the general scores.Satisfactory value(60 points).Through multivariate linear regression analysis,it is found that the factors that affect the satisfaction index below the general satisfaction value are affected by demographic variables and sociological variables.Most of the respondents did not change their current professional job aspirations,which is mainly due to the influence of their careers and family members’ lifestyles;most of the respondents did not take actions to exchange their current professional job,which is mainly due to occupation and hospital type.4.The evaluation of the importance of motivation factors found that the respondents believe that the income level,promotion mechanism for titles,and social respect are all important,and that the factors of importance are different due to differences in age,occupation,and family members’ lifestyles.In the design of the incentive mechanism framework,these incentive factors can be taken into consideration.ConclusionIn view of the problems arising,this paper designs the framework of incentive mechanism by social distribution equity determines social production efficiency theory,Rawls’ s justice theory,value chain theory,scientific management theory,system theory and so follows:1.Improve the salary system for rural county-level medical institutions and establish a mechanism for performance work.Use the distribution according to work as the basis for assessment.Emphasize the concept of more labor and more employment and achieve differentiated wage standards.2.We scientifically manage all aspects of work from both institutional and technical aspects.We shift hospitals from “extensive” management to “detailed” management to reduce redundant procedures and to shorten work.3.To maximizing effciency while retaining the current compensation framework without compromising the current interests of the staff,the priority will be given to the allocation of vulnerable groups for medical care,and the incremental redistribution will be implemented fairly.The United States is a country where external and internal market economic resources are relatively well-balanced.The average annual wage ratio of doctors,nurses,administrators,technicians,and other personnel in the United States is about 3.5: 1.2:2: 1.08:1,and doctors have the highest income.Compared with the average annual income ratio of the staff of medical institutions in the United States,the average annual income of county-level medical institutions staff in this survey does not reflect the high-income status of doctors.If China wants to gradually move closer to the market economy,it should adopt the principle of social distribution equity determines social production efficiency theory and Rawls’ s justice theory.In the allocation of market economic resources,we should give priority to doctors vulnerable groups and improve the doctor’s income.4.We ought to rationally use human resources,strengthen the internal and external rational flow of talents,increase the utilization rate of talents,and increase incomes to make their incomes go to market economy.At the same time,we can improve the internal harmony of medical institutions to achieve the best state of fairness.5.Improve the promotion and training mechanism for the staff of the county-level medical institutions,and improve the staff’s work skills while improving their satisfaction.Innovation pointsAccording to literature search,we confirm the following innovations.1.For the first time,the incentive mechanism of staff in rural county-level medical institutions is studied in the whole country.2.This article starts from the empirical analysis of life and work issues,fairness indicators,efficiency indicators,willingness and satisfaction status,and motivation factors.The research work is more systematic.3.This paper makes a comprehensive use of the empirical results of the data and the "market resource allocation theory","social distribution fairness determines the theory of social production efficiency" and "Rawls justice theory" to design the framework of the staff incentive mechanism of county-level medical institutions,which is not in the country at present.