Study on compensation mechanism reform of primary healthcare institutions in Zhejiang province

Abstract

Objective To evaluate the new compensation mechanism for primary healthcare institutions in Zhejiang province, in terms fairness, performance, incentive mechanism and sustainability in pilot areas. Methods Evaluation indicators were constructed based on stakeholder theory, fairness theory, expectation theory and sustainable development theory.Focus group interviews were conducted with stakeholders and quantitative data were collected through questionnaires. Meanwhile, the financial compensation, income and expenditure and equivalent data were collected from such institutions the four pilot areas, with quantitative data subject to descriptive analysis. Results This study found the reform used reasonable proportion funds allocated(the proportion basic salary for employees was lower than 50%)and adjustment factors(1.0-1.8)of different primary healthcare institutions to guarantee the fairness the reform; the increase equivalents(the per capita equivalents medical staff in pilot counties had increased from 38.435 million in the previous year to 42.590 million equivalents)reflected the performance outcomes the reform. The incentive and sustainability the reforms were the weak parts. These were mainly due to the fact that the internal distribution system primary healthcare institutions failed to make corresponding reforms. Conclusions The reform the compensation mechanism based on the equivalent method has changed medical staff′s perception the distribution funds. The principle of more pay for more work and the use information technology to capture equivalents have improved the enthusiasm primary medical staff and the operational efficiency these institutions, thus, making reform generally scientific and reasonable. Key words: Primary healthcare institutions; Compensation mechanisms; Work equivalents; Evaluation; Zhejiang province