推进医疗服务价格改革是价格机制改革和深化医药卫生体制改革的重要内容.北京医耗联动综合改革是北京市医药分开综合改革的不断深化,是完善医疗机构补偿机制的又一次改革.从政策体系的多源理论视角,以政策制定过程中的3大来源(问题源流、政策源流和政治源流)为切入点,系统梳理和分析北京医耗联动综合改革政策的制定过程,为完善医耗联动综合改革政策提供参考.

目的:调研分析部分医疗卫生机构团委书记选任现状,为其未来合理化选任提出对策建议.方法:定量研究与定性研究相结合,运用描述性分析法、Colaizzi现象学七步分析法对数据进行整理和分析.结果:提出了当前团委书记选任工作中的4个核心主题,即初选条件、任职模式、任职压力、任职效果.单一专职模式、混合兼(临床)专模式、混合兼(管理)专模式更利于团委书记开展工作.专职团委书记的满意度高于兼职团委书记.结论:医疗卫生机构应结合新形势要求和工作实际,坚持能位匹配,把好人员选拔质量关;坚持动态适应,韧性调整任职模式;注重情感支持,充分发挥个人价值;坚持培养原则,充分利用岗位平台.

Objective:To understand the real feelings of new medical employees in public hospitals and analyze the influencing factors of their job satisfaction.Methods:From September to December 2019, we adopted the phenomenological research method to conduct semi-structured interviews with 27 new clinical medical staff from three tertiary general hospitals in Beijing for the purpose of understanding their working experience. The 7-step analysis method of Colaizzi phenomenology was used to collate and analyze the data.Results:The five main factors that affect the job satisfaction of new medical staff include job background, job content, expectation and support, interpersonal interaction and hospital culture. Nineteen respondents said they worked long hours and felt overwhelmed. Twenty-five respondents reported that good interpersonal interaction helped improve their work experience.Conclusions:Their satisfaction can be improved by bettering the working environment, implementing person-post value matching, providing emotional support, improving the compensation incentive mechanism, focusing on career development and strengthening humanized management.

目的:探讨家长式领导对公立医院员工创新行为影响的作用机制.方法:采取整群随机抽样方法,对北京市5所三级甲等医院的325名员工应用家长式领导量表、组织承诺量表、医院员工创新行为量表进行横断面问卷调查.结果:(1)仁慈领导与德行领导对医院员工创新行为有显著正向影响;(2)威权领导对医院员工创新行为具有显著负向影响;(3)仁慈领导与德行领导对医院员工创新行为具有显著的正向交互作用;(4)组织承诺在仁慈领导、德行领导、威权领导对员工创新行为的影响中发挥部分中介效应.结论:医院管理者应采取或借鉴仁慈领导行为和德行领导行为,提高员工的组织承诺水平,为员工创新行为提供必要的支持.

Objective To analyze challenges existing in the human resources allocation at a tertiary hospital in Beijing and explore tactics for improving health manpower quality and distribution. Methods This study adopted retrospective and descriptive research methods to analyze the basic composition of hospital human resources, namely the numbers, age, educational background and academic titles. It also made descriptive and deductive analysis on the dynamic development of hospital human resources from 2012 to 2017. Results The proportion of hospital staff is balanced in general, yet with too many off-staffs; the proportion of various staff types is irrational. The overall age structure, makeup of education backgrounds to be improved; Lack of high-level talents; Lack of emphasis on career development planning for management and nursing staff. Conclusions The development of health human resources is evolving from quantity growth to that of staff competence improvement and staff makeup optimization. The hospital should explore and innovate approaches in staffing reform, draft manpower development plan scientifically, explore innovation means to make human scientific development planning, optimize the structure of human resources, innovate the talent evaluation mechanism and give full play to the incentive role of talent evaluation, guide professional training programs for health professionals, improve the efficiency of health human resources and work for balanced and coordinated development.

目前,我国医疗资源分配不均衡,优质资源多集中于三级医院,导致分级诊疗难以落实到位,无法满足人民群众对健康的高要求,因此医药卫生领域的供给侧改革势在必行.《"健康中国2030"规划纲要》提出创新医疗卫生服务供给模式,全面建立成熟完善的分级诊疗制度.医联体模式可以通过整合内部医疗资源,引导优质资源下沉,进而实现分级诊疗的目标.本文以首都医科大学附属北京朝阳医院医联体的"专全结合"慢性病管理团队为例,介绍了团队内的综合医院专科医师、社区医院全科医生及健康管理师如何开展医联体特色的家庭医生式签约服务,并分析其特点和积极作用,为分级诊疗的全面实施提供参考.

稳定优秀的人才队伍是医院实现可持续发展、争创“品牌医院”的重要保障.然而,随着卫生人才制度的不断完善与人才流动渠道的多元化,专家及新员工的流失严重制约着医院的发展.如何有效应对不同离职因素导致的人才流失已成为医院人力资源管理的重大课题.笔者通过数据分析研究了某大型医院员工离职现状,探索影响医务人员离职的主要因素有薪酬福利因素、家庭原因、医务人员长期工作产生的职业倦怠感、发展晋升方面的问题、进修深造等,并从加强人才引进的管理、健全人才培养的机制、促建和谐工作环境、加强岗位管理与员工激励等方面讨论了降低员工离职率的对策.