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The mechanisms of motivation of medical care workers in public hospitals

Date: Poster sessions
Source: Forum 11
Authors: Tao Dai, Director, Institute of Medical Information, Chinese Academy of Medical Sciences, People's Republic of China


Medical care worker motivation is widely believed to be a key factor of influence on worker/organization performance. In this paper we study major theories about motivation in medical care workers and hospitals, and critically review related empirical evidence. This study follows the historical development of health care system reforms in our country, and provides relevant reform recommendations for health policy-makers.

The methods employed include: 1) a systematic literature review; 2) expert consultations.

The results are as follows: 1) The determinants of motivation of medical care workers can be grouped into seven major classes: work itself, relationships at work, workplace conditions, opportunities for personal development, pay/rewards, management practices, and organizational policies. 2) The method of compensation or payment has an important influence on the behaviour of medical care workers. 3) There is a big gap with some other nations and regions in the motivation of medical care workers. 4) Most medical care workers in public hospitals are not satisfied with their current working conditions. 5) Raising wage levels improves the initiative and efficiency of most medical care workers dramatically. 6) A wide range of motivational mechanisms exist, from psychological to financial incentives. 7) Motivational problems include: incentives systems have not been constructed systematically; the salary system is outdated; medical care workers are poorly compensated for their work; salary differences are not well balanced; `red tape' demotivates workers; and, there is an apparent income gap in comparison with other countries.

Policy recommendations include: 1) The motivation and restriction mechanism for medical care workers in public hospital should follow the principles of legitimacy, equity and stability. 2) Distribution systems and other supporting policies for medical care workers in public hospitals should be improved. 3) Medical care workers should be given independent rights in their work. 4) The skills of medical care workers should be carefully matched with their position. 5) The compensation mechanism in public hospitals should be standardized and perfected. 6) The government should increase investment in public hospitals, and raise fees to reflect the real labour value of medical care work. 7) A performance assessment system and reasonable `floating' mechanism should be established. 8) A reasonable salary system should be established, which reflects the balance between efficiency and equity of distribution. 9) The working environment should be improved for medical care workers in public hospitals, and a harmonious relationship between doctors and patients established in medical care services. 10) `Management with humanity' should be fostered.