Incentives For Medical Staff In County-level Hospitals Of Traditional Chinese Medicine Under The Medical Consortium Model Effect Study

ObjectiveBy investigating the current status of human resources and the implementation of incentive measures in 5 county-level traditional Chinese medicine hospitals in the health alliance of Liuzhou,the effect of the incentive mechanism is evaluated,the influencing factors are explored,and countermeasures and suggestions for improving the incentive mechanism of medical staff in county-level traditional Chinese medicine hospitals are proposed based on the Porter-Lawler comprehensive incentive model,to provide experience and reference for the policy formulation and reform of talent incentive in the health alliance.Methods1.Literature research method: Search the official websites of the National Health Commission,State Administration of Traditional Chinese Medicine,Guangxi Zhuang Autonomous Region Health Commission,Liuzhou Municipal Government,Liuzhou Municipal Health Commission and other official websites and electronic databases such as CNKI,Wanfang,Weipu,Pub Med,Elsevier Science,and review the contents,theories and literature related to personnel incentive guarantee in medical confederation policy.2.Questionnaire survey method:Questionnaire survey was conducted on medical staff of five county-level Chinese medicine hospitals in the Health Allicanceby means of convenient sampling.The respondents were medical staff who were on duty during the survey period..3.Interview method : Use semi-structured interviews to conduct depth interview with relevant personnel.The interviewees included personnel from the health administrative department,hospital management and hospital technical post.4.Statistical analysis method:The Epidata software was used to establish a database,and the questionnaire was double-entered and checked for errors.Use SPSS23.0 software to analyze the reliability and validity of the data.Descriptive analysis,χ₂ test,t test,analysis of variance,binary Logistic regression analysis and other methods were used for statistical analysis.The inspection levelα=0.05.Results1.The supporting policies and guiding documents of medical confederations in China have been gradually improved,but the policies and measures for personnel protection and incentive need to be further improved.Relevant government departments have poor coordination in the implementation of relevant policies on personnel protection and incentive in medical confederations,with difficulty in connection and coordination of various links and lack of coherence,and policy effectiveness needs to be improved.2.After the formation of the health alliance,the ratio of health technicians to the number of beds in county-level TCM hospitals is 1:1.27,the ratio of doctors to nurses is 1:1.5,and the ratio of medical skills is 1:0.52.The ratio of nurses to the number of beds is 1: 0.62.Except for the ratio of doctors to nurses,all indicators have not reached the assessment standards for the service capacity of national second-level public hospitals and county-level TCM hospitals.Medical staff were mainly recruited（59.36%）,with junior college education or below（74.65%）,junior professional title（48.57%）,and young and middle-aged age（80.57%）.The staff structure showed the characteristics of “low academic qualifications,low professional titles,and youthfulness feature”.3.After five years of exploration,an incentive mechanism combining system incentive,performance appraisal incentive,promotion and development incentive and cultural incentive has been formed within the health alliance,which has made some achievements in helping county level traditional Chinese medicine hospitals to introduce and retain talents,improve the salary and treatment of medical staff and enhance the comprehensive medical service ability of the hospital.4.Five years after the implementation of medical association,the awareness rate of medical staff in county-level traditional Chinese medicine hospitals about the policy of medical association and the reform plan of performance-based pay in medical association was 37.38% and 48.00% respectively.There were significant differences in the evaluation of performance appraisal system,performance salary distribution plan,personal training and development opportunities for medical staff of different hospitals,jobs,professional titles,working years,and annual incomes（P<0.05）.The higher the position,professional title,working years,and annual income,the better the cognition level and evaluation.5.The overall satisfaction score of the incentive mechanism of medical staff in county-level traditional Chinese medicine hospitals within the medical association was 3.56±0.55,which was at the general satisfaction level;among the eight evaluation dimensions of incentive mechanism satisfaction,the scores from high to low were work relationship（3.88±0.58）,medical consortium construction（3.72±0.62）,social identity（3.66±0.67）,promotion and development（3.64±0.72）),hospital management（3.50±0.71）,work itself（3.47±0.65）,working environment（3.40±0.75）,salary and benefits（2.96±0.87）.6.The overall satisfaction scores of incentive mechanism of medical staff in county traditional Chinese medicine hospitals with different demographic characteristics were different.Among them,there was statistical significance in the overall satisfaction scores of incentive mechanism among medical personnel with different titles,working years and annual income（P < 0.05）.7.The time when county traditional Chinese medicine hospitals joined the health alliance and the professional title,working years and annual income of the medical staff were the important factors affecting the overall satisfaction of the incentive mechanism.Conclusion and suggestionAt present,there are still have problems such as insufficient total human resources,unreasonable structure,imperfect incentive system of county-level traditional Chinese medicine hospitals,low cognitive evaluation of medical staff on policies and incentive measures,and low overall satisfaction of incentive mechanism.In response to these problems,the government should increase financial investment,strengthen coordination among various departments,and ensure the practice environment for medical staff;the medical consortium should further implement human resource sharing mechanisms,improve salary performance incentives,improve talent cultivation and training mechanisms,and reform professional titles Promotion mechanism,emphasis on honor incentives and emotional incentives,and strengthen the internal cultural integration of the medical consortium;medical staff themselves should strengthen the construction of professional ethics,clarify their role positioning,and actively learn to improve their own abilities.Through the comprehensive and effective incentives for medical staff,the county-level TCM hospitals in the medical consortium can attract,retain and use talents,and better guarantee and promotethe reform and development of the health alliance.