Construction Of The Job Evaluation Index System For Doctors' Post Values In County-level Public Hospitals Based On Point-factor Method

Background In recent years,the medical industry and the relationship between doctors and patients have become the focus of public opinion.As a student in a medical school,I have experienced the “new crown pneumonia” epidemic,which has made me more deeply appreciate the characteristics of “high risk,high labor strength and high technical content” in the medical industry.The issue of salary design for medical staff is one of the important contents of public hospital reform.The research on the value of doctors' positions can establish the relative value of doctors' positions,which is beneficial to the establishment of a fair salary distribution system in public hospitals.Based on the policy documents of public hospital reform,this paper bases on the actual situation of the development and operation of county-level public hospitals in China,and uses related theoretical methods to construct a system of job evaluation indexes for county-level public hospital doctors.Based on the theoretical basis,a questionnaire was designed to carry out field surveys.The research analyze the position scores of doctors at county-level public hospitals,and divide job levels.Objective This research is based on a quantitative research method,the factor counting method,and through sorting out and analyzing mainstream job evaluation models at home and abroad,referring to the British NHS job evaluation system,combining the characteristics of China's medical and health industry and the functional positioning of county-level public hospitals,to build the job evaluation index system for doctors' post values in county-level public hospitals.Based on an empirical survey of clinicians in 12 county-level public hospitals in Anhui Province,this paper divides doctors' job scoring levels,establishes doctors' job levels,and provides a theoretical basis for the reform of the county-level public hospital's doctors' salary distribution system.Methods This study uses the literature review method to sort out papers,monographs,and policy documents related to job evaluation at home and abroad,and collect and sort related research results and job evaluation models.The expert consultation method was adopted in this study.After three rounds of consultations by 18 experts,the evaluation index of doctor positions in county-level public hospitals was established.This study uses the analytic hierarchy process to calculate the weight coefficients of the index system at all levels.This study used a questionnaire survey to conduct a questionnaire survey among clinicians in 12 county-level public hospitals in Anhui Province.In this study,statistical software such as Epidata3.1 and SPSS16.0 were used for data entry and analysis.Results(1)The authoritative degree coefficients of the first two rounds of expert consultation in this study were 0.778 and 0.803,respectively,indicating that the expert consultation has higher credibility and the consultation results are better.Kendall's harmony coefficient was used to test the coordination degree of the experts' scores at all levels.The coordination degree of the first two rounds of expert consultation was better,P <0.05, and the consistency of the consultation results was high.(2)Through the first two rounds of expert consultation,statistical analysis,and discussions at the task group meeting,finally established four levels of indicators: “post qualifications,skills,risks and responsibilities,work intensity and environment”,10 levels of indicators,37 three-level indicators of county-level public hospital doctor position evaluation indicators.(3)Through the third round of expert consultation,combined with expert scoring,and using AHP software,calculate the weight coefficients of the index system at all levels.Among them,the weighting coefficients of the four first-level indicators are “post qualification 0.2012,skills 0.4216,risk and responsibility 0.2188,work intensity and environment 0.1584”.(4)The score of doctors in county-level public hospitals: The average score of 1,895 clinicians participating in this questionnaire was 768.4 points,of which the highest score was a chief physician in orthopedics,which was 958.3 points,and the score was less than 500 points.There is an attending physician in the emergency department with a score of 302.4.In this study,a 50-point gradient was used to classify 1895 doctors' job scores into 10 levels.(5)In this survey,a questionnaire was designed based on the constructed index system.The total score was assigned 1000 points,and each of the four dimensions was assigned as “post qualifications 201 points,skills 422 points,risk and responsibility 219 Points,work intensity and environment 158 points”.The 1895 clinicians surveyed mainly came from 21 different clinical departments,and there were significant differences in the scoring rates of doctors in different departments in each dimension.Conclusions Based on the point-factor method,combined with literature review,expert consultation,analytic hierarchy process and other methods,a set of county-level public hospital doctor position evaluation indicators system including 4 first-level indicators,10 second-level indicators,and 37 third-level indicators were constructed.And based on this indicator system as a theoretical basis,a questionnaire was designed to investigate the position scoring of 1,895 clinicians in 12 county-level public hospitals in Anhui Province.The results of the position scoring were initially divided into 10 levels,which is the salary distribution system for county-level public hospital doctors reform provides theoretical support.