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“以药养医”破局医改动真格 专家:有药品降价8.9%
具体来讲,梁万年表示,薪酬制度改革关键内容有:要优化公立医院薪酬结构,如何根据不同公立医院的情况,包括在一个公立医院内部不同岗位的情况,有效地根据功能定位和岗位职责要求,建立一个科学合理的薪酬结构,这是试点地区要进行探索的。
其次,要合理确定公立医院薪酬水平。现在,公立医院薪酬水平的核定是按照一般事业单位统一规定来做的,但是说医疗卫生行业,具有人才培养周期长、劳动强度大、职业风险高、需终身学习等特点。“为此,需要在试点地区进行突破,合理确定公立医院的薪酬水平。总量上去了,收入结构更加科学合理了,薪酬制度对医务人员的激励作用也就出来了。”梁万年说。
另外, “可以鼓励地方对公立医院探索院长年薪制改革。”梁万年表示,院长代表政府来管理医院,薪酬就由财政直接拨付,和医院收入没有关系。但是政府对院长要进行严格考核,考核的结果要和核定医院总的薪酬水平挂钩,用这套机制让院长回归到他代表政府来管理医院的角色上来。还有些地方对医务人员实行年薪制,比如说福建省三明市。这些方面也鼓励试点地区用多种方式探索经验。
最后,是落实公立医院分配自主权。梁万年指出,薪酬总量一旦明确以后,如何分配,如何体现向一线人员的倾斜;如何来体现工作量、工作质量和老百姓的满意度,如何彻底切断医务人员收入和药品、检查收入直接挂钩的问题,需要给公立医院充分自主权,由公立医院根据情况制定绩效分配办法,要避免“大锅饭”。
(责编:孙博洋、夏晓伦)
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