ABSTRACT
Objective:To analyze the salary characteristics of medical institutions and the influencing factors of personnel expenditure as found in the salary system reform of public hospitals in Sichuan province, for reference in furthering such reform in public hospitals.Methods:The data of personnel expenditure, business operation and medical services came from 96 medical institutions in 21 cities(prefectures)of Sichuan province from 2017 to 2020 by means of institutional survey. The average salary level and salary structure of medical staff were used to describe the salary characteristics, and the total salary was presented by the level of personnel expenditure. The measurement data was represented by M(IQR), the counting data was described by frequency and constituent ratio, and the influencing factors of personnel expenditure were analyzed by generalized linear mixed model. Results:From 2017 to 2020, the personnel expenditure of medical institutions increased by 13.04% annually. In 2020, the per capita salary level of medical staff was 151 900 yuan, while the basic salary and performance salary accounted for 16.20% and 54.60% of personnel expenditure respectively. The analysis results of the generalized linear mixed model showed that the average cost of patients per visit( β=0.596), the level of drugs and sanitary materials consumed per 100 yuan medical income( β=0.286), the number of medical visits( β=0.328), and the years [(2018, 2019, 2020) β=0.025, 0.052, 0.066] were positively correlated to personnel expenditure, while the average length of stay( β=-0.693), the proportion of medical service income( β=-0.392), and the balance rate of income and expenditure( β=-0.062)were negatively correlated to personnel expenditure( P<0.05). The proportion of fiscal subsidy revenue, regional GDP and asset-liability ratio were not the influencing factors of personnel expenditure( P> 0.05). Conclusions:In the reform of the salary system of the province, its salary level of medical institutions has surpassed the current wage ceiling of these institutions. As the salary distribution was mainly made based on the workload, the " baton" role of the salary system reform has begun to pay off. However, the basic guarantee role of compensation has not yet been fully leveraged.Further reform is needed in upgrading refined management, and timely dynamic adjustment of personnel expenditure in combination with the hospital's financial performance and cost analysis, and reasonably optimizing the level of medical staff compensation.
ABSTRACT
Objetivou-se com este trabalho comparar modelos de predição de plantas sobreviventes de Eucalyptus grandis. Utilizaram-se os seguintes modelos: modelo linear misto com os dados transformados, utilizando-se as transformações angular e BOX-COX; modelo linear generalizado misto com distribuição binomial e funções de ligação logística, probit e complemento log-log; modelo linear generalizado misto com distribuição Poisson e função de ligação logarítmica. Os dados são provenientes de um experimento em blocos ao acaso, para avaliação de progênies maternas de Eucalyptus grandis, aos 5 anos de idade, em que a variável resposta são plantas sobreviventes. Para comparação dos efeitos entre os modelos foram estimadas as correlações de Spearman e aplicado o teste de permutação de Fisher. Foi possível concluir que, o modelo linear generalizado misto com distribuição Poisson e função de ligação logarítmica se ajustou mal aos dados e que as estimativas para os efeitos fixos e predição para os efeitos aleatórios, não se diferenciaram entre os demais modelos estudados.
The objective of this work was to compare models for prediction of the survival of plants of Eucalyptus grandis. The following models were used: linear mixed model with the transformed data, by utilizing the angular transformations and BOX-COX; generalized linear mixed model with binomial distribution and logistic functions, probit and complement log-log links; generalized linear mixed model with Poisson distribution and logarithmic link function. The data came from a randomized block experiment for evaluation of Eucalyptus grandis maternal progenies at five years old, in which the variable response are surviving plants. For comparison of the effects among the models the correlations of Spearman were estimated and the test of permutation of Fisher was applied. It was possible to conclude that: the generalized linear mixed model with Poisson distribution and logarithmic link function misadjusted to the data; the estimates for the fixed effects and prediction for the random effects did not differ among the to other studied models.