【作者】 余畅；

【导师】 李巍；

【作者基本信息】 重庆医科大学 ， 社会医学与卫生事业管理， 2018， 硕士

【摘要】 目的:在新医改的背景下,厘清公立医院编制管理理论框架,总结编制管理的历史进程及相关政策的设计思路,分析重庆市公立医院编制管理中的问题,结合调查结果和访谈情况,提出今后公立医院编制人事管理改革持续性发展的建议和措施,为相关部门制定编制改革政策提供依据。方法:本研究采用查询文献、问卷调查和定性访谈结合的方法,构建新医改背景下公立医院编制改革研究的框架。通过网络、书籍和年鉴,汇总整理分析相关文献资料;通过EpiData2.1和SPSS17.0软件对问卷数据进行录入和统计分析,包括一般描述性分析、单因素分析和多因素Logistic回归分析;定性访谈采用个人深入访谈法。结果:1.在本样本中有38%的医务人员支持全部取消编制,28%的医务人员认为应该在现基础上继续增加编制,24%的医务人员认为保持现状(编制审批制和外聘结合形式),10%支持采取编制备案制。不同岗位(P=0.000)、学历(P=0.009)、职称(P=0.001)、月收入(P=0.001)、是否有编(P=0.000)、同工同酬情况(P=0.000)的医务人员对编制改革类型的选择有统计学意义。影响医务人员选择不同编制改革类型的显著因素分别为职称、是否有编、同工同酬和月收入情况2.64.4%的非编人员支持取消编制,75.65%的在编人员认为应保持现状或增加编制。3.医务人员对工作的总体满意度的占比为79.1%。在编和非编人员在工作总体(P=0.014)、职称评定晋升(P=0.020)、充分发挥能力的机会(P=0.007)、薪酬(P=0.019)上的满意度占比有统计学意义。认为编制内外差别较大的方面有:福利待遇、养老社保、薪酬待遇。4.只有38.2%的医务人员非常关注国家编制改革的相关消息,其余的不太关注甚至不关注。讨论:重庆市主城区公立医院编内外人员对编制改革类型认识一致性不高。在编制改革中要注意各方利益群体需求,注意保证在编人员的合法权利,同时增加非编人员的权利。影响医务人员选择不同编制改革类型的显著因素分别为职称、是否有编、同工同酬和月收入情况。医务人员对工作的总体满意度为中等偏上的水平,但医务人员认为在薪酬福利、工作稳定性、养老社保、职称评定方面差别较大,因此编制后续改革需要在这几方面努力调整,保证相对公正。更多还原

【Abstract】 Objective:Under the background of the new medical reform,the clarification of the theoretical framework for the management of public hospitals,the summary of the history of the preparation of the staffing of government affiliated institutions management and the design of relevant policies,analysis of the problems in the preparation and management of public hospitals in Chongqing,combined with the results of the survey and the results of the interview,proposed future Public hospitals formulate suggestions and measures for the continuous development of personnel management reforms,and provide the basis for the health administrative department to establishment reform policies for the formulation.Methods: This study adopts the methods of inquiry literature,questionnaire survey and qualitative interview to construct the framework of the reform research of public hospitals in the the staffing of government affiliated institutions under the new medical reform.Through the network,books and almanac,summarize and analyze relevant literature materials;The questionnaire data were statistically analyzed by Epi Data2.1 and SPSS17.0 software,including general descriptive statistical analysis and single factor analysis.Qualitative interview adopts personal in-depth interview method.Results: 1.In this sample,38% of medical personnel support the complete cancellation of the establishment,28% of medical staff believe that it should continue to increase the preparation on the basis of current,24% of medical staff believe that maintaining the status quo(composition approval system and external combination form),10 % supports the preparation of the preparation system.Different positions(P=0.000),educational background(P=0.009),professional title(P=0.001),monthly income(P=0.001),whether they are permanent staff or supernumerary staff(P=0.000),and equal pay for equal work(P=0.000)situation influence medical staff choose the reform types.The significant factors that affect the choice of different types of reform for medical staff are professional title,whether in or out system,equal pay for equal work and monthly income.2.64.4 per cent of the supernumerary staff supported the cancellation,and 75.65 per cent of the permanent staff supported that the maintain the current situation and increase the staffing quota.3.The proportion of medical staff’s overall satisfaction with work is 79.1%.There was a statistically significant difference in overall job satisfaction(P=0.014),job title promotion(P=0.020),full-play opportunities(P=0.007),and pay satisfaction(P=0.019)among editors and non-programmers.It is believed that the differences in the preparation of internal and external differences include: benefits,pensions and social security,and remuneration packages.4.Only 38.2 percent of the medical staff are concerned about the country’s reforms,and the rest are not even concerned.Discussion: There is a low consensus on the type of reform of public hospitals in Chongqing city.In the establishment reform,we should pay attention to the needs of the interests of all parties,pay attention to ensuring the legitimate rights of the permanent staff,and increase the rights of the supernumerary staff.The significant factors that affect the choice of different types of reform for medical staff are professional title,in or out system,equal pay for equal work and monthly income.Medical personnel to the work of the average level of overall satisfaction,but the medical staff think in terms of salary and welfare,work stability,old-age social security、professional title appraisal difference is bigger,so need to prepare the subsequent reform in terms of these respects to adjust,ensure the relatively fair.更多还原