公平视角下护理人员绩效工资分配的改善策略

描述了医疗机构护理人员绩效工资分配办法的现状,在提出基本工资发放存在显性不公平的基础上,进一步揭露了绩效工资分配中的隐性不公平问题,即基本工资较高一方侵占了工资较低一方的部分绩效工资。同时,提出绩效工资分配中隐性不公平程度与护理人员的工资差距和低工资护理人员的数量密切相关。针对传统分配办法的隐性不公平现象,提出了改善绩效工资分配不公平的策略并对改进的效果进行了验证。最后,指出了新型绩效工资分配办法的主要功能主要在于改进公平,而不是提高效率,并应用利益相关者分析方法,对新型分配制度的可行性进行了分析和讨论。     

公立医院内部绩效工资分配三阶段测算方法研究

目的 建立适应公立医院改革背景的医院内部绩效工资分配测算方法。方法 监控样本医院内部绩效工资分配的运行情况,梳理绩效工资分配测算方法的短板。进行文献研究、医务人员访谈,分析医务人员反馈意见。对绩效工资分配模拟测算结果进行对比分析。结果 建立了包含基础奖、完成率奖、超额奖的三阶段测算方法,依据科室在各阶段的贡献程度测算绩效工资。三阶段测算方法能有效实现医院控制内部绩效工资分配的效率与公平的平衡,方法运行稳健。结论 三阶段测算方法促进医院改进内部绩效工资分配工作的质量和效率。     

以岗位等级考核为主体的绩效分配模式探讨

科学、合理的内部分配是调动医护人员工作积极性的杠杆之一。岗级考核分配方案的实施是我院内部分配制度改革的重要内容，随着卫生事业改革的不断深入及医院的可持续发展，需要继续完善内部分配制度，实行注入要素内涵的岗位工资及以“成本核算”为基础的效益奖励的绩效分配模式，真正建立起医院内部的长效激励机制。     

直接比例法产生科室绩效工资总量的研究与操作

直接比例法产生科室绩效工资符合医院财务制度要求,通过设计不同的比例差别来体现专业、社会效益与经济效益的不同,克服了传统的“收支结余”提取绩效工资中的不公平因素。医护分开核算、设计不同的绩效工资比例,能够避免医护分配中的矛盾。实施员工二次分配、加强公益性、约束性指标的考核可以避免单纯追求经济效益现象。     

对完善我国公立医院绩效分配模式的思考

公立医院绩效分配模式的完善是公立医院改革的重点和难点。在全国推行绩效工资的宏观背景下,探讨绩效分配模式具有十分重要的现实意义。公立医院绩效的内涵可以总结为经济运行绩效、患者绩效和社会绩效。一个完善的绩效分配方式的理想目标是三者的统筹兼顾,但现实中,我国的医院差异很大,应在充分考虑各种影响因素的基础上,因地制宜地选择顺应卫生体制改革要求的绩效分配模式,以公益性和公平性为目标,寻求各方利益的平衡点,实现由原来的工资奖金分配制度向绩效工资改革的平稳过渡。

     

公立医院绩效工资二次分配中的难点与对策

通过分析公立医院院科两级管理与绩效工资二次分配中的难点和焦点问题,提出了构建工作量效能“四维驱动”绩效工资二次分配模式,对于化解绩效工资二次分配中的矛盾、充分调动医务人员的积极性具有重要的作用。     

公立医院绩效工资分配公平性方法研究

公立医院绩效工资分配的公平性是调动医务人员积极性、建立公益性的绩效分配体系的关键。分类设计绩效工资、计分法确定各类群体的差距、处理好医护差距、群体内别差距、改革收支结余计提绩效工资的核算方式等综合方法能够体现分配的公平性。

     

医院内部绩效改革对转变运行机制的影响分析

目的 探讨医院内部绩效考核与分配制度改革对医院内部运行机制的影响。方法 建立实施以工作量为基础,以加强质量控制、强化服务对象满意,重视成本控制,同时兼顾管理效率和持续发展能力的绩效考核体系绩效薪酬分配方案。结果 医院各项运行指标及质量指标同比明显提高。结论 内部绩效改革对医院医疗综合质量及服务能力的提升产生了积极的影响。     

临床医师薪酬分配与绩效实证研究

目的 研究基于绩效的临床医师薪酬分配办法和适当拉开薪酬差距是否能有效提升医院的绩效水平。方法 采用变异系数衡量临床医师的薪酬差距,采用对照研究的方法评估医院的绩效提升水平。结果 外科医师薪酬差距拉开幅度最大,其余依次为儿科、内科和医技科,2006—2010年医院绩效优于对照医院。结论 通过薪酬分配制度改革的实践,基于绩效适当拉开薪酬差距,激发临床医师的积极性,增强医疗团队活力,提高绩效水平,提升医院综合实力。     

三级公立医院临床医生绩效工资考核指标体系研究 ——基于平衡计分卡和层次分析法视角

医院绩效改革的一个重要命题就是如何通过绩效工资改革使公立医院改变僵化的趋利模式,回归公益性并调动医务人员的积极性。要解决这个问题,就必须以绩效工资考核指标体系为抓手,围绕突出岗位价值、实际贡献、服务质量和患者满意度等方面,构建临床医生绩效工资考核指标体系。通过发挥临床医生绩效工资考核指标体系的导向作用,使公立医院担负起公益性和自身发展的双重责任。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细     

Selection with two alleles and complete dominance

For a plant selection model with frequency-independent viabilities, fertilities and selfing rates, it is shown that apart from global fixation, for certain parameter combinations a protected polymorphism and facultative fixation (either allele may become fixed according to initial frequencies) may both occur. Facultative fixation requires different selling rates for the dominant and recessive type. Protection of the polymorphism requires resource allocation for male and female function. In this connection the problem of purely genetically caused population extinction is discussed.
For general frequency dependence and regular segregation, the chances for establishment of a completely recessive gene are compared to those of a completely dominant gene. It is proven that the process of establishment of the recessive gene, despite a fitness advantage, may be considerably endangered by drift effects if random mating prevails. The recessive gene may reach the same effectivity in establishment as a dominant gene, only if the recessive homozygote mates exclusively with its own type during the period of establishment.