国内外全科医生激励机制对比与启示

全科医生作为居民健康的“守门人”,其数量和质量成为完善基本医疗服务的关键。完善的全科医生激励机制不仅能促进全科医生提升自身能力、降低离职意愿,还有助于保证基层医疗队伍的稳定。目前,国内对于全科医生激励机制的探索仍处于起步阶段,缺乏完整且完善的实践体系。本研究梳理英国、澳大利亚、美国,以及我国深圳市、厦门市和上海市的激励机制经验,总结我国全科医生激励机制仍然存在的问题(激励方式单一、激励效果不明显导致缺乏职业吸引力、激励机制科学性不高导致各地区配置不平衡、各地区激励政策不同并落实缓慢),在此基础上,结合我国“健康中国”战略的背景,从将全科医学列入国家临床重点专科、建立权威的全科医生专业学术机构和监管机构、建立统一的绩效考核体系、完善多元的物质激励和非物质激励机制、借助信息化手段完善竞争和惩罚机制及组建一支高效的全科医生服务团队方面提出建议,以期为我国基层全科医生激励机制研究提供新思路。

Research Progress and Prospects of Incentive Mechanisms for General Practitioners in China and Abroad

General practitioners are the gatekeepers when it comes to residents' healthcare. This means that the quality and quantity of their services will play a key role in improving basic medical services. The most appropriate incentive mechanism for general practitioners can improve their ability, minimize the desire to leave, and promote the stability of teams. Currently, China lacks a comprehensive and flawless practice system, and the exploration of incentives for general practitioners is still in its infancy, and there is a lack of a complete and effective practice system. This study highlights the critical importance of incentives and incentive mechanisms. It summarizes the experience of the United Kingdom, Australia, the United States, Shenzhen, Xiamen, and Shanghai with relatively mature incentive mechanisms in China and abroad. Additionally, to summarise the current problems that still exist in the incentive mechanism for general practitioners in China (single incentive approach, lack of career attraction due to the lack of obvious incentive effect, poor science of incentives leads to uneven allocation across regions, different incentive policies across regions and slow implementation) . As part of this strategy, together with the strategy of "Healthy China", innovative ideas are put forward in terms of enrolling general practice in national key clinical specialty, establishing authoritative professional academic institutions and regulatory institutions, developing a unified performance appraisal system, improving the diversified material and non-material incentive mechanisms, improving the competition and punishment mechanisms by means of information, and forming an efficient general practitioner service teams. In order to provide new research methods for investigating the incentive system of primary general practitioners in China.