Effectiveness Evaluation On New Labor Distribution Mechanism In Community Health Service Center

Effectiveness evaluation on new labor salary distribution mechanism in community health service center[Objective] To understand the reform effect on labor salary distribution and discover the existing problems, and put forward the improvement measures by evaluating the new labor salary distribution mechanism effect in some community health service center.[Methods] Systematic evaluate the labor salary distribution reform program in a community health service center, analyze the goal degree expected to achieved, discover the existing problems in this labor salary distribution system and make clear the effectiveness and shortage by Pre and Post Comparison method. Investigation the agency, staff and community residents to evaluate the reform effect on labor salary distribution, and also the understand distribution coefficient of labor salary distribution scheme, distribution indicators and hospital management, further to improve the general framework of labor distribution scheme.[Results] In the problem of goals achieving and original problems solving, the new labor salary distribution mechanism cut the relation between the medical staff income and medical business income, so it solved the phenomenon "induction of the medical staff making extra prescription, billing and commission". In the problem of basic medical and public health, it performed advantage in guiding medical staff to finish public health work and make sure the quality. In the problem of distribution indicators, it considered the distribution quality, risk, civilized service, technology and management, which made sure the quality can be improved, showed comprehensive evaluation. In the problem of distribution mechanism, it considered the workload, diluted the charging standard, which showed "more pay for more work" policy. Moreover, it linked the services to labor income, which improved the medical staff efficiency in some degree.[Conclusion] The new labor salary distribution mechanism reached to some reform objectives and solved some existing problems in the original program, but also showed a great gap to ideal objective, which mainly reflected in the following respects:the rising proportion of drugs, the rising tendency income-expenditure fiscal balance and financial funding, hardness maintaining in hospital income-expenditure balance, lax cost control, not fully using health resources, workload not be quantitative, the knowledge and technical level of medical staff can’t be showed. We suggested that:all the indicators should be reasonable with scientific evaluation standard; in addition to workload, the difference in knowledge, technical level of different operators should be considered; moreover, we should improve the cost consciousness and health resources efficiency; At the last, we should control the prescription and at the same time, improve the income-cost balance, to reduce the hospital budget deficit.