I 摘要 在国家推进新医改的大背景下，公立医院的发展环境、发展模式、发展重点 都发生了较大变化，人才成为了新时期医院竞争的关键，人才激励的重要性也更 加凸显。适应新医改的变化和要求，建立起既能体现公立医院的公益性导向，又 能调动医务人员积极性和主动性的激励机制，具有重要的现实意义。一线医生作 为医院的基石，是公立医院医生中人数最多、工作量最大、薪酬水平偏低、直面 医患矛盾的群体，也是当前激励体系中问题最突出、受关注较小、离职率较高的 群体。一线医生的激励问题是当前公立医院激励体系的难点和重点。 论文以 A 医院一线医生的激励问题为研究对象，立足马斯洛的需求层次理 论、郝茨伯格的双因素理论、亚当斯的公平理论和斯金纳的强化理论等激励相关 理论，系统梳理国内外研究公立医院激励问题的相关文献，通过分析典型案例、 开展问卷调查和实地访谈，收集大量第一手资料，结合管理学、经济学理论和自 身工作经验，分析 A 医院一线医生激励体系存在的问题，提出改进和完善的建 议。论文的主要内容包括，研究的背景和意义；研究方法和研究思路；相关理论 及国内外研究现状；A 医院一线医生激励体系的现状；A 医院一线医生激励体系 所存在的问题；A 医院一线医生激励机体系的改进目标、思路、原则和具体方案。 论文的主要结论包括，一是一线医生激励机制应顺应时代变化和医改的要求 进行调整。二是一线医生激励体系的调整应适应激励需求多元化、个性化的变 化，增强针对性。三是一线医生激励体系应坚持公立医院公益性的导向。四是一 线医生激励体系的成功实施不仅需要激励体系方案设计优化，还需要前中后期完 善的保障措施来确保相关制度落地落实。论文在新医改背景下提出的对公立医院 一线医生激励体系优化的思路和具体改进措施具有一定的创新性和推广价值。 关键词，公立医院，一线医生，激励体系ABSTRACT II ABSTRACT The development environment, mode and focus of public hospitals have changed greatly under the background of the new health care reform. Talents have become the key factor affect the hospital competition in the new era, so the talent incentive has become more important. It is of great practical significance to adapt to the changes and requirements of the new medical reform and to establish an incentive mechanism that can not only reflect the public welfare orientation of public hospitals, but also mobilize the enthusiasm and initiative of medical staff. As the cornerstone of the hospital, the front-line doctors are the group with the largest number, the largest workload, the lower salary and confronting the contradiction between doctors and patients directly in public hospitals. They are also the group with the most serious problems, less attention and higher turnover rate in the current incentive system. The incentives for front-line doctors is the difficulty and focus of the current incentive system in public hospitals. Taking the front-line doctors in A hospital as a research object, this paper systematically combs the relevant literature on incentives in public hospitals at home and abroad based on Maslow's hierarchy of needs, Hatzberg's two-factor theory, Adams' equity theory and Skinner's reinforcement theory, collects first hand information through analyzing typical cases, conducting questionnaires and field interviews, analyses the problems in the incentive system of front-line doctors in A hospital by combining management theory, economics theory and own work experience, and puts forward suggestions for improvement and perfection. The main contents of the paper include: research background, significance, methods and ideas; related theories and research status at home and abroad; the present situation and the problems of the incentive system for front-line doctors in A hospital;the objectives, ideas, principles and specific programs of improving the incentive mechanism for front-line doctors in A hospital. The main conclusions of this paper include: Firstly, the incentive mechanism of front-line doctors should be adjusted in accordance with the changes of the times and the requirements of health care reform. Secondly, the adjustment of the incentive system for front-line doctors should adapt to the diversification and individualization of incentive needs and enhance pertinence. Thirdly, the incentive system of front-lineABSTRACT III doctor should adhere to the guidance of public welfare in public hospitals. Fourthly, the successful implementation of the first-line doctor incentive system requires not only the optimization of the incentive system design, but also the improvement of safeguards in the early, middle and late stages to ensure the implementation of the relevant system. The paper proposes some ideas and specific improvement measures for the optimization of the incentive system for front-line doctors in public hospitals is innovative and worthy of promotion under the background of the new health care reform. Keywords: public hospitals, front-line doctors, incentive system目录 IV 目 录 第一章 绪论.................................................................................................................... 1 1.1 研究背景 ............................................................................................................ 1 1.2 研究意义 ............................................................................................................ 2 1.3 研究方法 ............................................................................................................ 3 1.4 研究思路及分析框架 ........................................................................................ 4 第二章 理论基础............................................................................................................ 6 2.1 激励理论 ............................................................................................................ 6 2.2.1 需求层次理论 .......................................................................................... 6 2.2.2 双因素理论 .............................................................................................. 7 2.2.3 公平理论 .................................................................................................. 7 2.2.4 强化理论 .................................................................................................. 8 2.2.5 专业技术人才激励理论 .......................................................................... 8 2.2 激励体系 ............................................................................................................ 8 2.2.1 物质激励 .................................................................................................. 9 2.2.2 非物质激励 .............................................................................................. 9 2.3 激励效果 .......................................................................................................... 10 2.4 国内外研究现状 .............................................................................................. 11 2.4.1 国内研究现状 ........................................................................................ 11 2.4.2 国外研究现状 ........................................................................................ 12 第三章 A 医院一线医生激励体系的现状.................................................................. 14 3.1 A 医院一线医生现状 ....................................................................................... 14 3.1.1 A 医院概况 ............................................................................................. 14 3.1.2 A 医院一线医生现状 ............................................................................. 16 3.2 A 医院一线医生物质激励现状 ....................................................................... 18 3.2.1 薪酬福利方面激励现状 ........................................................................ 19 3.2.2 单项奖励激励现状 ................................................................................ 22 3.3 A 医院一线医生的非物质激励 ....................................................................... 22 3.3.1 职务晋升激励 ........................................................................................ 22 3.3.2 荣誉激励 ................................................................................................ 24 3.3.3 培训激励 ................................................................................................ 24目录 V 3.4 A 医院一线医生现行激励体系效果评价 ....................................................... 25 第四章 A 医院一线医生激励体系的问题分析.......................................................... 26 4.1 问卷调查分析 .................................................................................................. 26 4.1.1 样本基本情况 ......................................................................................... 26 4.1.2 薪酬福利激励分析 ................................................................................. 27 4.1.3 单项奖励激励分析 ................................................................................. 29 4.1.4 晋升激励分析 ........................................................................................ 30 4.1.5 荣誉激励分析 ........................................................................................ 32 4.1.6 培训激励分析 ........................................................................................ 34 4.1.7 问卷调查结论 ......................................................................................... 37 4.2 物质激励体系的问题分析 .............................................................................. 38 4.2.1 薪酬福利激励方面的问题 .................................................................... 38 4.2.2 单项奖励激励的问题 ............................................................................ 40 4.3 非物质激励体系的问题分析 .......................................................................... 40 4.3.1 晋升激励的问题 .................................................................................... 41 4.3.2 荣誉激励的问题 .................................................................................... 42 4.3.3 培训激励的问题 .................................................................................... 43 第五章 A 医院一线医生激励体系的改进.................................................................. 45 5.1 改进目标、思路和原则 .................................................................................. 45 5.1.1 改进目标 ................................................................................................ 45 5.1.2 改进思路 ................................................................................................ 45 5.1.3 改进原则 ................................................................................................ 45 5.2 A 医院一线医生物质激励改进 ....................................................................... 46 5.2.1 优化薪酬激励考核要素 ........................................................................ 47 5.2.2 提升临床一线医生薪酬水平 ................................................................ 48 5.2.3 丰富福利种类，提升福利针对性 ........................................................ 48 5.2.4 缩短单项奖惩响应时间 ........................................................................ 49 5.2.5 做好政策的宣讲和解释工作 ................................................................ 49 5.3 A 医院一线医生非物质激励改进 ................................................................... 49 5.3.1 优化晋升激励机制 ................................................................................ 49 5.3.2 强化荣誉激励 ........................................................................................ 51 5.3.3 优化培训激励 ........................................................................................ 52 5.3.4 改进其他非物质激励 ............................................................................. 52目录 VI 第六章 结束语.............................................................................................................. 54 致谢................................................................................................................................ 56