浅谈新医改下公立医院薪酬分配与绩效考核方案改革思路

摘要

公立医院是提供医疗服务的主要机构，同时也是医生工作的主要场所，对医生的管理和激励承担主要责任。我国公立医院普遍以平均主义和经济利益为导向进行绩效管理。这使得医患利益发生冲突，进一步导致医患关系紧张、医疗行为不积极等现象，医疗生态环境持续恶化。但大部分国外医疗，虽然也会存在与我国的一些共性问题，但在医生薪酬管理上，均没有表现出明显的社会矛盾和不合理的管理措施。而唯有我国特别的表现出医生薪酬过低与分配不公。因此，有必要通过对比国内外的公立医院医生薪酬管理措施，结合薪酬管理和绩效考核的基本理论，来分析找出在新医改环境下，我国公立医院存在的主要改革难点，并试图提出符合薪酬管理科学的改革思路和解决办法。

     关键词　新医改；医生；薪酬；绩效考核；工资；

目 录

摘要·······························································································1

目录·······························································································2

第1 章 薪酬与薪酬管理的基本理论··············································· 4

1.1 薪酬及其相关概念······································································· 4

1.1.1 固定工资················································································ 4

1.1.2 可变工资················································································ 4

1.2 薪酬管理概念及相关理论······························································ 4

1.2.1 内部一致性与职位评价······························································ 5

1.2.2 外部竞争力与市场薪酬调查························································ 6

1.2.3 绩效报酬的公平性···································································· 7

1.2.4 薪酬管理过程的公平性······························································ 7

第2 章 绩效管理的概念与方法······················································ 7

2.1 绩效管理的概念与意义································································· 8

2.1.1 绩效管理的概念······································································· 8

2.1.2 绩效管理的目的与意义······························································ 8

2.1.3 绩效管理的常用考核指标··························································· 8

2.2 绩效管理的常用方法···································································10

2.2.1 BSC（平衡计分卡）···································································10

2.2.2 KPI（关键业绩指标）································································10

2.2.3 360度考核··············································································10

2.3 医疗适用绩效管理方法的选择·······················································11

2.3.1 区分行政人员与医疗人员绩效管理方法········································11

2.3.2 区分不同岗位（科室）的绩效管理方法···········································12

2.3.3 内部一致性与不同职位的绩效管理方法········································13

第3 章 国外公立医院医生薪酬管理实践与总结····························13

3.1 英国公立医院医生薪酬管理实践··················································· 13

3.1.1 英国公立医院的医生的工资组成················································ 13

3.1.2 英国公立医院的医生的考核主体················································ 13

3.1.3 英国公立医院的医生薪酬审查机构············································· 13

3.1.4 英国公立医院的医生的等级······················································ 14

3.1.5 英国公立医院的医生的薪酬组成················································ 14

3.1.6 英国公立医院的医生的基本工资················································ 14

3.1.7 英国公立医院的医生的绩效工资················································ 15

3.2 美国公立医院医生薪酬管理实践····················································16

3.2.1 美国的公立医院组成································································16

3.2.2 美国的公立医院报酬要素··························································17

3.2.3 美国的公立医院绩效工资··························································17

3.2.4 美国的公立医院额外酬金··························································18

3.3 国外公立医院医生薪酬管理实践总结············································· 18

3.3.1 国外公立医院医生薪酬管理的重点··············································18

3.3.2 英美两国公立医院医生薪酬管理的共同点·····································18

第4 章 我国公立医院医生薪酬管理实践的现状与思考··················19

4.1 我国公立医院医生薪酬制度的发展进程··········································· 19

4.2 我国公立医院医生薪酬管理存在的主要问题···································· 19

4.3 新医改对我国公立医院医疗环境的影响·········································· 20

4.3.1 新医改政策给医院经济运行带来的影响······································· 20

4.3.2 新医改政策给医院技术发展带来的影响······································· 22

4.4 新医改下我国公立医院医生薪酬管理改革的实施建议························ 23

4.4.1 明确医务人员收入水平的定位····················································23

4.4.2 提高公立医院人员薪酬水平·······················································24

4.4.3 合理核定公立医院工资总量·······················································24

4.4.4 健全绩效工资总量调整机制·······················································25

4.5 未来我国公立医院医生薪酬管理改革的思路探索······························ 25

4.5.1 改革的基本思路······································································25

4.5.2 改革的具体建议······································································25

4.5.3 改革的推进策略······································································26

参考文献····················································································· 27

致 谢··························································································· 28