The Study Of Performance Pay In Basic Medical And Health Institutions Of Three Counties In Fujian

Objective: To analyze the implementation, existing problems and influence onthe operational efficiency of basic medical and health institutions of performance payand the current status of satisfaction of medical staff towards performance pay inbasic medical and health institutions in Xianyou, Fuding and Jianyang counties,Fujian province; to provide practical advice and references to improve theperformance pay，working efficiency of medical staff in basic medical and healthinstitutions and operational efficiency of basic medical and health institutions.Methods: According to the arrangement of Fujian Medical Reform Office,Agriculture Department agency and Personnel of Fujian provincial Health Bureau andaccording to the level of economic development and the implementation of theaccounting system and the basic drug system, A questionnaire survey was adopted toinvestigate175medical staff in Xianyou, Fuding and Jianyang counties. Meanwhilesemi-structured interview was adopted to ask39of them to know about the currentsituation and the implementation and existing problems of performance pay. Inaddition, we organized representatives in health authorities and basic medical andhealth institutions of Xianyou, Jianyang and Fuding to fill in the tables about situationin basic medical and health institutions, so that we could get situations of localprimary health care services, financial conditions and personnel and other operatingconditions from2008to2011. Finally we used data envelopment analysis to calculateand analyze the whole efficiency, technical efficiency, scale efficiency, total factorproductivity efficiency and other indicators of basic medical and health institutionsbefore and after the implementation of performance pay.Results:98.28%of subjects knew about pay for performance policy.81.71%ofsubjects supported the policy.65.71%of subjects achieved an increase in their incomeafter the implement of performance pay.49.14%of subjects said their working enthusiasm was improved. Research showed that the unreasonable allocation ofperformance pay, the reduction of allowance and the lack of incent of medical staffwere three major problems which influenced on performance pay. All average scoresof efficiency index in three counties in2011were significantly lower than those in2009. The proportion of institutions with positive whole efficiency in three countieswas45.65%in2009, while that in2011was23.91%. The proportion of institutionswith positive technical efficiency in three counties was63.04%in2009, while that in2011was30.43%. The proportion of institutions with positive scale efficiency in threecounties was47.83%in2009, while that in2011was26.09%. Comparison amongthree counties showed scores of every index in Jianyang county before and after theimplementation of performance pay were all significantly higher than those in theother two counties.Conclusion: According to this study, the implementation of performance paywas generally unhindered and it has got basic policy anticipation of steadying thewage and welfare of medical personnel. But meanwhile, there were problems existingin content of policy, inspiration of allocation plan and how to promote thedevelopment of basic medical and health institutions. Besides, effects on mobilizingpositivity of medical personnel is not so obvious, which even caused the decline ofoperational efficiency of basic medical and health institutions. Thus the investment onbasic medical and health institutions should be further strengthened and the incentivecontents of performance pay should be perfected to incent medical personnel’sworking enthusiasm and increase the using efficiency of health resources. Thefinancial security mechanisms should be built to keep the wage growing steadily andthe incentive of performance pay should be enhanced. We also need to increasefavorable policy for medical personnel who work in basic medical and healthinstitutions.