중소병원 의사직 성과급제 도입 및 운영 관련요인

Abstract

[한글]이 연구는 중소병원의 의사직 성과급제의 도입과 정착을 위해 성과급제 도입과 목적 달성, 의사직 만족여부와 관련된 요인을 분석하고자 전국의 500병상 미만의 중소병원 994개 병원을 대상으로 우편설문조사를 시행하였다. 전체 조사대상 병원 중 142개 병원(14.3%)이 응답하였으며 빈도분석, 카이제곱 검정과 다중 로지스틱 회귀분석을 실시하였다. 그 주요 결과는 다음과 같다.

첫째, 전체 응답 병원 중 56개(39.4%) 병원에서 의사직 대상으로 성과급제를 도입하였다. 의사직 성과급제는 대도시에 위치한 병원, 300병상 이상, 수익대비 전체 인건비가 50% 이상인 병원에서 많았다.

둘째, 의사직 성과급제는 보상 주기가 매월인 경우가 매분기 이상인 경우에 비해 많았다.

셋째, 성과급제에 대한 의사직의 만족여부는 병원의 소재지가 대도시인 경우, 수익대비 전체 인건비가 50%이상인 경우, 성과급제의 운영기간이 5년 이상인 경우가 많았다.

이 연구는 응답률이 낮아 전체 중소병원을 일반화하기에는 어려움이 있고 경영진을 대상으로 설문조사하여 주관이 개입될 수 있는 여지가 있는 등의 제한점은 있으나 전국의 중소병원을 대상으로 의사직 성과급제 도입 및 운영 관련요인을 분석하고자 한 최초의 연구라는 것에 의의가 있으며. 비재무적 관점을 포함한 종합적인 성과평가를 위한 향후 연구가 지속적으로 이루어져야 한다.

결론적으로 효율적인 성과급제 개발은 중소병원 각각의 경영환경에 적합하고 생산성을 향상시킬 수 있는 경영진의 노력이 필요하다. 아울러 이를 바탕으로 국가적으로 의료기관의 대다수를 차지하며 큰 파급력을 가진 중소병원들의 의사직 성과급제 도입과 정착을 위한 다각적인 정책도 모색되어야 할 것으로 사료된다.

[영문]This research aimed to investigate the current situation of introduction of physician incentive compensation in small to medium sized hospitals, and to analyze relevancy of those related factors thereto, taking whether or not introduced physician incentive compensation, and whether or not accomplished the objectives, and whether or not satisfied with physician jobs as dependent variables, while taking general characteristics of hospital and operation method of physician incentive compensation as independent variables.

To test this, 994 small to medium sized hospitals having less than 500 beds, excluding the clinics of less than 50 beds, national and public hospitals, and rehabilitation hospital, were selected and asked to fill out mail questionnaire survey. Among them, 142 clinics (14.3%) replied.

Data and information were analyzed using the statistical program, SPSS 12.0 for windows, and Frequency Analysis, Chi-Square Test, and Multiple Logistic Regression were conducted. Results therefrom are as follows:

First, among 142 respondents, 56 clinics (39.4%) introduced the physician incentive compensation. Results from analysis of whether or not introduced physician incentive compensation and the relevancy between general characteristics of hospital revealed that there was statistically more significance in the hospitals that located in the bigger city, that had more than 300 beds, and that total personnel expenses occupied more than 50% of revenue.

Second, results from analysis of relevancy between general characteristics of hospital and accomplishment of objectives of physician incentive compensation indicated that there were no statistically significance, however, the results of analysis of the operation method of physician incentive compensation showed that there were more cases of accomplishing the objectives of the physician incentive compensation when the cycle of compensation was every month than when it was not.

Third, results from analysis of relevancy between whether or not satisfied with the physician incentive compensation and general characteristics of hospital revealed that there were statistically significant number of hospitals, especially when the hospital was located in the larger city, when total personnel expenses occupied more than 50% of total revenue, and in case of satisfaction when the operation method of physician incentive compensation was longer than five years.

In this research, there were some difficulties in generalization of all small to medium sized hospitals because of low response ratio and a few number of subject hospitals to this research, and, in addition, there were limits that a questionnaire survey was conducted targeting the managements of hospitals, so then there were possibilities that their subjective opinions might be involved, etc. However, this research shall be meaningful in the aspect that this was first research conducted in order to analyze those related factors to physician incentive compensation and its operation targeting small to medium sized hospitals throughout the nation.

It is necessary to exert efforts, especially from the level of managements in order to develop the physician incentive compensation that fits into management environments of each small to medium sized hospital, and that would lead to improvement of productivity as well as for the purpose of fair and efficient operation of the physician incentive compensation and also researches in connection with comprehensive performance evaluation should be conducted continuously in coming years.

In addition, based on such works, it is thought that a policy for the purpose of settling down such physician incentive compensation in the small to medium sized hospitals that occupy majority portion of medical institutions nationwide, and that are very influential should be pursued in a diverse manner.