ABSTRACT
Objective:To form the workload relative value of 10 general surgery projects in Anhui province based on the theoretical framework of resource-based relative value scale(RBRVS).Methods:Cluster sampling was used to identify the 12 county-level public hospitals surveyed from July to August 2019; Expert consultation method was used to select the benchmark project of general surgery and the measured projects; Magnitude estimation was used by doctors surveyed to find the relative evaluation of the surgeries selected, and RBRVS principle was used to find surgeon workload relative value of the 10 surgeries; Pearson correlation analysis was used to analyze the relationship between the charging price of surgeries and the relative value of surgeons′ workload in Anhui province.Results:The study found the time consumption, work intensity relative value and surgeon work load relative value of 10 general surgeries; The relative value of the current surgical item price was positively correlated with the relative value of the doctor′s workload, and the correlation coefficient was r=0.928, P<0.01(bilateral). But in some surgeries, the pricing fails to represent the relative value of the workload. Conclusions:Based on RBRVS theory, 10 localized relative value scales of general surgeons′ workload were developed via empirical studies from such dimensions as time consumption, mental labor, physical labor and risk stress; Pearson′s correlation analysis found part of the pricing in general surgeries as groundless.
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Objective:Using the method-point-factor to construct a system of evaluation indexes for clinician positions in county-level public hospitals to assess the relative value of clinician positions in county-level public hospitals in Anhui province.Methods:Questionnaire survey was used for a questionnaire survey of 12 county-level public hospitals in northern Anhui, central Anhui and southern Anhui in the province from July to August 2019. The content of the questionnaire survey mainly includes such doctor′s basic information as gender, age, and department, as well as the doctor′s score on the four dimensions of " post qualification, skills, risks and responsibilities, work intensity and environment" . In this study, Excel 2010 and SPSS 16.0 were used to perform descriptive statistical analysis on the collected data.Results:In this study, a job evaluation system for doctors in county-level public hospitals was established, covering 4 level-1 indicators, 10 level-2 indicators, and 37 level-3 indicators. Among the 1 895 clinical doctors participating in the survey in 12 county-level public hospitals, the average score of doctor′s job evaluation was 768.4 points, of which the neurosurgeons had the highest average score of 800.90 points and endocrinologists had the lowest average score of 735.40 points. There were differences in the overall score rate in the four dimensions of job evaluation, in the order of " risk and responsibility, work intensity and environment, skills, job qualification" (80.09%>79.49%>79.24%>66.72%).Conclusions:The results and grades of clinical doctors′ job evaluation were reasonable. The overall trend of the scores was in line with the job characteristics of doctors, and provided a theoretical basis for improving the internal performance salary distribution system of county-level public hospitals.
ABSTRACT
In order to solve the drawbacks of egalitarianism,induced demand and ineffective incentive in the current distribution mode,the leverage of the salary mobilization and the hospital development is used to put forward the relative value of RBRVS as the theoretical guide to accounting the medical service project,and to establish doctor post value and comprehensive goal assessment system.Finally,a salary distribution model for doctors in county-level hospitals based on doctors' workload post value and comprehensive goals assessment will be formatted,which will reflect public welfare and incentive mechanism.
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This paper introduces the background, implication and construction of the county health services community (County medical alliance) model in Anhui Province under the background of new medical reform,and briefly introduces the relationship between medical insurance, enhancing the ability to upgrade and standardize services and medical treatment integration of the typical experience.It also analyses the challenges faced in the construction of medical syndicate, such as the mechanism of regional environmental restriction, compensation and assessment mechanisms which have not been established yet, and the sustainable development of information technology that has lagged behind, and put forward the policy suggestion to improve the construction of medical community, with a view to providing reference for the next work.