| Research backgroundPersonnel outside the establishment are the product of personnel management of China’s party and government organizations and enterprise and public institution. With the development of economy and society, personnel outside the establishment changed greatly. Their roles in the departments and the units are more and more important, but their marginalized roles still remain to be improved. As a public institution of safeguarding people’s life and health, public hospitals have personnel outside establishment, which is an objective reality. Personnel outside establishment play significant roles while there exist some management difficulties and risks, which require further study and careful exploration.The personnel management of public institutions (public hospital included) lacks obviously behind the development of our times, which could not meet the requirements of socialist market economic system and of the development of social undertakings. Strict establishment management limits the development of public hospital. To solve the restriction and the development, the way hospitals adopted is to hire personnel outside establishment, which is used continuously and becomes a common phenomenon in the personnel management of public hospital. The government has strengthened post management of public hospitals; however, most public hospitals still stay at the stage of traditional personnel management. Such rigid institution mechanism to some certain has promoted the development of personnel outside establishment. The stimulating factors formed in the development of medical and health industry in social service becomes the innate driving force of the growth of personnel outside establishment. The roles personnel outside establishment playing in the development of hospital construction are more and more important, but their status and salaries still remain to be improved, lacking correct treatment and attention it should be given. Though the size of personnel outside establishment keep increasing, which relieves the problems of human resource of hospitals, it also brings new problems and challenges to hospital management. With the development of the society and the economy, the fast increase of medical requirement, as well as further implement of political and economic systems and medical reforms, there are more and more problems in management of personnel outside establishment. Various unpredictable problems may bring new troubles to hospital management, which asks public hospitals take efficient and timely measures.Research objectives and significancePersonnel outside establishment are an important part and beneficial supplement of human resources of public hospitals. To strengthen the management of personnel outside establishment has active significance for public hospitals to adapt the development of market economy and in promoting comprehensive and scientific development of the hospital. Management study of personnel outside establishment is the objective requirement of enhancing service level and guaranteeing service quality of the hospital. It is the natural selection of public hospitals to improving the scientific level of human resource management and promoting hospitals’ sustainable development. It is an efficient way for public hospitals to maintain the legal rights of the hospital and personnel outside establishment. This research may promote the study of human resource management of public hospitals, with guiding significance to management of personnel outside establishment. It could promote the development of public hospitals. It has certain academic value in theoretic study of management of personnel outside establishment and offers good thoughts and suggestions to human resource management in market economy.Data sources and research methodsThe data of this research are mainly from documents and on-field investigation. Through searching documents and references, arranging, classifying and analyzing, relevant concepts and categories of personnel outside establishment are clarified, and the differences and similarities of each category are analyzed and compared. On basis of human resource management theory, incentive theory, harmony theory and equity theory, the theory framework of management of personnel outside establishment is put forward. The on-field investigation is based on the actual conditions of Jinan hospitals. This research adopts the method of complete investigation. In September,2012, personnel outside establishment of14public hospitals affiliated to Jinan Health Bureau were selected as the research objects, who were asked to fill in questionnaire survey. Based on their levels these14public hospitals include6tertiary hospitals,7second-class hospitals and1first-class hospital; based on their types, these14hospitals include7general hospitals,6specialized hospitals and1TCM hospital.2524questionnaires were released and2118were retrieved, which was83.91%. The valid questionnaires were2114, with the total recovery rate of83.76%. The analyzing methods of the data mainly include descriptive statistical analysis, single factor analysis of statistical reference and multi-factor analysis of statistical reference. The statistical analysis software is SPSS15.0. Major results1. Analysis of personnel outside establishment of Jinan public hospitalsVacancy is a common phenomenon of Jinan public hospitals. Personnel outside establishment of Jinan public hospitals are a large number, which keeps increasing in the proportion of the staff of the hospital. They play an important role in various posts of hospitals and contribute greatly to the development of hospitals. Scientific and justice employment and assessment systems are lacked for personnel outside establishment; wide use of personnel outside establishment breaks the range of traditional auxiliary posts. The employment methods are with direct employment as the major method and labor dispatch and human agency as the auxiliary. Personnel outside establishment have difficulties in safeguarding their rights for lack of legal protection. Hospitals mainly adopt the manner of "laying emphasis on working while neglecting training". In most public hospitals, the inequalities in the workplace exist generally. The pays of personnel outside establishment are generally lower, with serious "equalitatarianism". Their salary pattern is simple, lacking economic salary, which could not reflect their posts, professional skills and working performances.2. Analysis of satisfaction of personnel outside establishment of Jinan public hospitalsMost personnel outside establishment are not sure about their salaries, which shows that they are generally not satisfied with their salaries, that they have the hope to have their salaries increased, and that they have no clear definition and understanding of their roles in the development of the hospital. Through analysis of variance of their satisfaction about their salary and their work, the differences between different posts, hospitals of different levels and types, personnel with different education backgrounds, professional titles, incomes, with or without bonus, equal pay for equal work and unequal pay for equal work have statistical significance, which shows that personnel of different factors are different in attitudes towards their salaries and work. Besides, personnel of different sexes, ages and working time also have different attitudes in their satisfaction with their salaries. Through multi-variable linear return analysis of the general satisfaction of personnel outside establishment, the influencing factors are mainly sense of achievements, ratio between income and workload, stability of the work, implement of unit’s policy, freedom of judgment, working conditions, opportunities of working independently, being busy, working independently, free judgment and the manner of the leaders to their subordinates.3. Analysis of turnover intention of personnel outside establishment of Jinan public hospitalsIn the past three years, turnover of the personnel outside establishment has kept increasing and the turnover intention exists universally. The results of statistical analysis shows that there is no difference of the turnover intention of the personnel of different hospitals, sexes, ages, education backgrounds and working time (p>0.05); there is significant difference of the turnover intention of the personnel of different hospitals levels and types, careers, professional titles, incomes, bonus, inequality in workplace and signing contracts and five-insurance payment (p<0.05). The scores of turnover intention increase greatly with the upgrading of the hospital levels. The turnover intention of technicians scores the highest, while that of the working peoples the lowest. The score of turnover intention reduces obviously with their increase of incomes. The scores of turnover intention of personnel outside establishment with bonus are obviously lower than those without bonus. The lower of their satisfaction about their work may lead to quit of the job; however, if the possibility of obtaining exterior work increases, their satisfaction about the work may not be lowered. Low salary, family and chance of study are the three major reasons for the personnel’s turnover; salary, development space and technical skills are the main reasons of their back in office.4. Analysis of job burnout of personnel outside establishment of Jinan public hospitalsThis research analyzes job burnout from three dimensions, i.e. emotional exhaustion, cymcism and professional efficacy. The statistical results shows that these three dimensions has differences (p<0.05) with the differences of demographic characteristics, the factors of which are hospital types, career, working time, whether income and bonus equal for equal work. The three dimensions of cymcism shows no difference (p>0.05) with the difference of demographic characteristics, the factors of which are age and professional title. In terms of emotional exhaustion and cymcism, the lassitude level increases obviously with the increase of the hospital levels (P<0.01); there is no hospital difference in professional efficacy (P>0.05). In terms of emotional exhaustion and cymcism, the lassitude level of nurses and other medical workers is the highest, while that of the managers is the lowest (P<0.01); in terms of professional efficacy, the lassitude level of radiological workers is the highest, while that of the logistics worker is the lowest (P<0.01). The lassitude level of female in emotional exhaustion and professional efficacy is obviously higher than that of male(P<0.05), but there is no obvious difference in cymcism(P>0.05). Professional title has no difference in emotional exhaustion and cymcism, but in professional efficacy, the lassitude level increases gradually with the rise of professional titles (P<0.01). The lassitude level of all three dimensions lowers obviously with the income increasing gradually (P<0.01). The lower of satisfaction of their work may lead to their lassitude in their work, especially such lassitude will be expressed in their work, and then emotional tiredness may come up. The emotions and working attitudes of personnel outside establishment will related to more exterior factors, such as working conditions, policies and salaries.5. Insecurity analysis of personnel outside establishment of Jinan public hospitalsGenerally personnel outside establishment feel insecure with their work. The statistic results suggest that factors that affect physician’s insecurity are levels and types of hospitals, careers, education background, working time, income, bonus, equal pay for equal work, signing contract and five-insurance payment; the factor of age has no difference in insecurity and its two dimensions. The insecurity of personnel outside establishment increases significantly with the increase of the hospital levels; the insecurities of nursing and other medical workers are the highest, while those of the managers are the lowest; the quality insecurity of female is obviously higher than that of male; the insecurity of personnel outside establishment increases with the increase of their working time; the insecurity level reduces obviously with the increase of their incomes; the insecurity of personnel without bonus is obviously higher than that of those with bonus; the insecurity of their work may lead to the reduce of their work satisfaction, which may also lead to their turnover intention. The tiredness, coldness and indifference, as well as low efficiency of their work are closely related with their quality insecurity of their work.Conclusion and policy suggestionBased on the specific conditions and existing problems of personnel outside establishment of Jinan public hospital, this research puts forward the following measures and suggestions:build perfect reasonable scientific management system of personnel outside establishment, guiding them to exert positive effects; protect their legal rights, constructing harmonious labor relations; construct systematic scientific incentive mechanism, reducing effectively dissatisfaction and tiredness of their work; exert the role of coherence and incentive of hospital culture, attracting and encouraging personnel outside establishment; establish reasonable and fair salary system based on their actual conditions; do well career planning and training, providing good development chances; do well ideological work and psychological work, easing the tendency of bad mood. This research demonstrates that hospital managers shall build the people-oriented ideology of human resources, establish the changing mechanism of human resource adapted to market requirements, building a management atmosphere of treating personnel equally without discrimination. |
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