| ObjectivesWe aimed to investage the status of compensation and compensation satisfaction among physicians in Chinese tertiary hospital,and provide suggestion to authorities and hospital managers through quantitative and qualitative analysises.Contents1.The distribution of physician compensation,compensation composition and compensation satisfaction.2.The factors which effect compensation and compensation satisfaction.We tried to explore the factors,including management of hospital and physician characteristics,associated with those indexesMethods1.Literature and policy review:after reviewing both foreign and domestic progress of compensation system,we designed the hospital questionnaire,physician questionnaire and interview outline.2.Quantitative study:multistage sampling method was applied.136 hospitals were selected based on convenience out of 31 provinces in China.In the second sampling stage targeted physicians were sampled based on the actual ratio of professional title categories.20785 physicians were selected ultimately.Hospital questionnaire and physician questionnaire were filled by hospital managers and physicians respectively.3.Qualitative study:Besides the case report from sample hospital,we also interviewed some hospital administrators and physicians to give lessons and experiences to other hospital,and to explore the potential reasons associated with those compensation indexes.4.Satistic analysis:ANOVA and X2 tests were performed to compare those indexes among subgroup.Associations between those indexes and different level variables(province,hospital and individual level)were estimated using multilevel regression models.Results1.The average monthly compensation was 9313 yuan(95%CI:9250-9377 yuan)which was as 1.89 times as the gross domestic product per capita.2.The ratio of floated compensation to fixed compensation was 3.02.3.The actual compensation was 53.1%of the expected compensation(950%CI:52.87%-53.39%).4.The scores for satisfaction about the value of compensation,compensation system and the incentive effect of compensation were 2.54(95%CI:2.53-2.55),3.25(95%CI:3.24-3.26)and 2.92(95%CI:2.91-2.93)respectively.5.Weekly work hours were positively associated with the compensation satisfaction(OR=0.99,95%CI:0.98-0.99).Longer weekly work hours resulted in bigger gap between actual and expected compensation(Estimate value=-0.06,P<0.001).6.Higher ratio of personnel funding to total income leaded higher satisfaction about the value of compensation,compensation system and the incentive effect of compensation(OR=1.20,95%CI:1.10-1.30;OR=1.10,95%CI:1.01-1.20;OR=1.10,95%CI:1.01-1.20 respectively).The higher ratio of personnel funding to total income leaded narrower gap between actual and expected compensation(estimate value=0.16,P<0.001).ConclusionsIt was a national large sample study.Both quanitative and qualitive study were used in this study.To explore the effect of the different level variables,the multilevel model was also used in this study.After several years of compensation reform,compensation system satisfaction was optimistic.However,the compensation was still low and floated compensation had relatively large proportion.The most complaint was out of portion of the input and output.The complexed bonus evaluation system impeded the incentive of compensation.As a result,health care service price system reform,cost control and service efficiency improvement are ways to increase the income to better remunerate physicans.The proportion of the fixed compensation could be increased by benefits adjustment.The number of full-time employers might need to be increased.Sufficient physicians could lessen heavy work load and prevent overtime work beyond the regulated work hours.Meanwhile,overtime work should be remunerated.The reasonable bonus assessment system is needed. |
PDF Full Text Request