| Objective Taking the public hospitals participated in the reform of the salary system in Sichuan Province as the survey objects,to understand the salaries of employees before and after the reform,to analyze the factors related to the salary level,performance pay,salary structure and employees’ satisfaction,and to summarize the problems of salary distribution.Combined with the reform policies and reform measures to carry out effectiveness researches,to analyze the difficulties and weakness of the salary distribution reform of public hospitals in Sichuan Province,so as to provide references for the health administrative department and public hospitals to improve the salary system.Methods Literature review was used to understand the theories,current situations and countermeasures of the salary system reform of public hospitals at home and abroad,to collect relevant information on the salary reform of the hospital employees.Questionnaire survey was used to collect the basic situations,salaries and salary satisfaction situations of the survey area,hospitals and hospital employees.Focus group discussions,individual in-depth interviews were used to explore the difficulties and causes of salary reform in survey areas and hospitals.Statistical methods such as descriptive analyses,comparative analyses,and influencing factors analyses were used to analyze quantitative data.Subjective analyses were used to analyze qualitative data to summarize the conclusion.Results The salary level and performance pay level of employees from public hospitals were different in different types of regions,hospitals and employees.The multi-factor analysis showed that the salary level in 2016 was greatly affected by the doctors’ daily medical treatments,the hospital level,and the salary distribution method.The performance pay level was greatly affected by the financial personnel’sinvestment,the doctors’ daily medical treatments,and the salary distribution method.The salary level in 2018 was greatly affected by the professional title,employment nature and position,and performance pay level was greatly affected by the professional title.In 2016,the fixed income of employees accounted for 20.3%,and20.19% in 2018.The multi-factor analysis showed that the ratio of floating income to fixed income in 2016 was greatly affected by the financial personnel’s investment,total medical income,and public hospital assessment subject.In 2018,the employment nature,professional title and hospital level had a greater impact.The reform of the salary system of public hospitals was progressing slowly,with an average lag of 9 months.The fixed income of the survey hospitals increased by5.12% annually,and floating income increased by 1.16%.The fixed income of the reform group accounted for a higher proportion than the unreformed group.The annual total income increased by 9.62% annually,and the average annual growth rate of performance pay was 11.77%.The growth of the reform group was higher than that of the unreformed group.The medical income increased by 8.36% annually,the increase in surgical fee income was the highest(20.29%),followed by nursing expenses(18.79%)and medical expenses(18.40%),and the increase in drug income was the lowest(2.12%).In addition to consumables and inspection fee income,the other income of the reform group increased more than the unreformed group.The hospital’s personnel expenditure increased by 16.94% annually,and the reform group personnel expenditure increase was much higher than the unreformed group.The satisfaction score of the respondents on the pay level was 2.97±0.98.The satisfaction score of the salary structure was 1.87±0.86.The satisfaction score of the performance appraisal system was 3.32±0.92.The satisfaction score of the pay reform effect was 2.55±0.77.The results of factor analysis showed that the salary satisfaction of employees in all dimensions was most affected by the salary increase.Conclusions and Suggestions The salary level of public hospital employees was acceptable,and the gap between different regions and hospitals was large.The satisfaction of employees on the salarylevel was medium.The salary structure of public hospital employees was unreasonable.The fixed salary accounted for a low proportion.And the floating salary accounted for a higher proportion,witch may lead to a profit-oriented orientation.The satisfaction of salary structure was medium.The internal distribution of salary in public hospitals was unreasonable,lacking internal fairness.The income gap between internal and external personnel was large.The income gap between different positions was small.Excess labor was not properly compensated.The progress of public hospital salary system reform was slow,but the reform effect showed.The salary level reflected moderate growth.The distribution forms was diversified.The salary structure had gradual optimization.And medical income and personnel expenditure had reasonable increase.But the supporting policies of comprehensive medical reforms were not fully in time.Based on the above conclusions,the following suggestions were proposed.The financial compensation mechanism should be improved to ensure funding sources.The government financial input and the proportion of personnel expenditures should be increased appropriately.And the implementation of supporting policies such as medical price service adjustment should be accelerated.The salary level of public hospital employees should be reasonably determined,and the total amount of compensation should be dynamically adjusted,and the proportion of personnel expenses in hospital expenses should be gradually increased.The salary structure should be optimized,and the proportion of fixed income should be increased.In-hospital pay distribution should reflect differences and fairness.A scientific and reasonable performance appraisal and evaluation mechanism should be established.Feedback channels for employees’ compensation information and communication should be established. |
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