Abstract:

Objective To analyse the challenge in reform of salary distribution system in public hospitals, and put forward suggestions. Methods Annuals released by the Ministry of Health and National Bureau of Statistics of China were retrieved, the incomes and expenditures of hospitals between 2003 and 2010 were analysed, and the salary increase of staff in public hospitals was compared with that in other institutions. On-site survey on workload of medical staff in 18 municipal hospitals in Shanghai was also conducted. Results The input of government in public hospitals was less than 10%, which was significantly lower than the salary expenditures (＞26%), and the income of drugs still accounted for 45% of the total income of hospitals. The performance-based pay system and workload evaluation proposed in medical reform posed significant influence on current salary distribution system, which would result in shortage by 3.26% to 7.38%. The data of workload were hard to obtain, and the standard was hard to determine. Conclusion Both opportunities and challenges exist in current salary distribution system in public hospitals, and hospital management should be enhanced to balance between current salary distribution system and performance-based pay system.

Key words: public hospital, compensation management, pay for performance, job workload