Ahetov A.A., Orazkulov
M.O., Amangaliev D.B.
Central clinical
hospital of Medical centre Operating of RK President’s deal, Almaty
TO THE QUESTION OF
IMPROVEMENT OF THE DIFFERENTIATED COMPENSATION OF MEDICS
In the conditions
of expansion of administrative and economic independence of the medical
organizations, transferring their to the legal status of the state enterprises
on the right of economic maintaining, joint-stock companies, increases value of
improvement of the differentiated compensation of medics [1,2]. And an
ideological basis of its formation has to have the clear understanding of that
the salary has to be earned, instead of to be appointed.
It is known that
the salary of medical workers of health care consists of 2 components - basic
and additional [3].
The basic unit of
a salary is formed on the basis of an official tariff rate, surcharges for high
qualification, continuous length of service, special working conditions,
professional harms, established by the Government of RK.
Unlike basic, the
additional salary consists of extra charges for an individual contribution of
the worker to the general results of work of the medical organization and the
awards paid to workers over the main salary, for material encouragement for the
reached successes in work and stimulation of their professional growth.
Thus, if the
basic unit of a salary is guaranteed by Government resolutions, orders MH of
RK, additional - is made according to regulations of Authorized body and
provisions on the compensation, accepted directly in the medical organizations.
In these
conditions as practice shows, use of the developed model of the differentiated
compensation of employees of the hospital, stimulating function of a salary
gradually is leveled and there is a need of its continuous improvement.
The essence of
system of compensation used in hospital is that to a basic unit of a salary,
increases additional, charged on the coefficient of intensity of work (CIW),
and also the awards, given out according to the order established by authorized
body. Thus differentiation of an additional salary, the sizes of
"ciws" is formed on the basis of the general measure of an assessment
of an individual contribution to collective results of work, irrespective of
specifics of activity of division.
Meanwhile, the
contents, volumes, structure and the end results of activity of employees of
policlinic, a hospital, and diagnostic, auxiliary medical and economic
divisions are various and application of uniform methods of differentiation of
an additional salary objectively doesn't reflect an individual collective
contribution of each worker to the end results of activity of division of
hospital.
Therefore
important is to develop for same according to the content of work of divisions
system of estimated criteria and the end results of individual and collective
activity which would reflect quality, intensity and productivity of work.
The review of
special literature and the practice of using of methods of differentiation of
additional compensation of medics show that here are used: various indicators:
Individual Performance Factor (IPF); coefficient of a labor contribution (CLC);
coefficient of intensity of work (CIW); work effectiveness ratio (WER),
coefficient quality of work (CQW), etc.
However it is represented
that the indicator name, and its contents is important not. In this regard it is necessary to
distinguish determination of values of coefficients and distribution methods.
Thus the system of indicators by means of which coefficient size is defined,
can be distributed on three groups: 1) establishing basic the coefficient size;
2) raising the coefficient size; 3) lowering the size of coefficient (fig. 1).
Numbers of basic
indicators of formation of coefficient treat: size of a tariff rate of the worker;
fulfilled time; amounts of completed work (number treated, number of the
operated patients, number of the executed visits, calls, laboratory, and tool
researches); level of quality on system of an assessment operating in hospital.
And in the list of the indicators
increasing coefficient can be carried:
- Improvement of quality of work to
comparison with an average and earlier reached level;
- Performance of work of temporarily
absent workers;
- Expansion of a zone of service;
- Realization of the measures
directed on restriction of unproductive expenses of time and means,
expendables; rational and more effective use of the medical equipment and
equipment;
- Realization of the measures
directed on restriction of duplication at diagnostics; introduction of
effective clinical technologies, surgeries, the techniques accelerating
recovery of patients, and also – on reduction of average terms of
hospitalization, improvement of quality and treatment outcomes;
- Use of safe methods of anesthesia,
increase in a share of the operations made under an endovideoobservation;
decrease in frequency of complications in time and after operation; reduction
of terms of restoration of functions of an organism;
- Development of new, more effective
methods of prevention, laboratory, tool diagnostics, complex treatment and
medical rehabilitations of patients;
It is only approximate list of
indicators which can be used at determination of the size of the raising
coefficient. However, "the" indicators which are most reflecting specifics
of their activity have to be developed for each division, each category of
workers.
On the other hand, it is possible to
include in the list of the indicators lowering coefficient:
- Non-performance (not in full, it
is low-quality) workers functional and functions;
- non-performance of the established
standards of loading on reception in policlinic, at home, when carrying out
consultations, laboratory, tool and clinical research; plans on effective use
of koyechny fund; according to the income from paid medical services and at
implementation of the state order of MH of RK;
- violations of production
discipline (defects under the authority of registration and reporting
documentation; mistakes when using existing clinical protocols of diagnostics,
treatment and medical rehabilitation of patients; non-performance of
instructions and separate tasks of the management of division);
- Low innovative activity;
unwillingness to introduce effective methods of clinical activity, especially
after training; unethical behavior at relationship with patients and
colleagues, and also non-compliance with the principles of corporate
solidarity;
- violation of a daily routine and labor discipline
(delay for work and premature going
away from work; ignoring of
all-hospital actions; participations in scientific and practical conferences,
production meetings; to public work; assumption of cases of alcohol intake and
smoking on a workplace. );
- Violations of safety measures and
labor protection rules when using the medical equipment and the equipment.
It is thus
important to achieve that the system of quantitative and quality standard of
work, shouldn't be bulky and labor-consuming, and raising and lowering
indicators are well measurable quantitatively; simple, clear and to reflect
their interrelation with the end results of work.
Thus, it is
possible to conclude that use of the given methodical approaches to
differentiation of an additional salary of medical workers allows to provide
big objectivity and justice when forming economic motivations of workers to
achievement of the best end results of work: to raise stimulating role of a
salary in the solution of the current and perspective tasks connected with
implementation of obligations to the state, and providing high level of
competitiveness.
List of references:
1. Collective forms of the
organization and compensation in healthcare institutions//the Collection of
standard and legal documents. - M - 2001.
2. Litvinenko L.Ya. Balandin G. I.
New forms of the organization and work incentives in health care. Barnaul. -
1999.
3. Shipova V. M. Rationing of work
of the medical personnel. – M - 2007.
Annotation
In work new
methodical approaches to differentiation of an additional salary of medical
workers are shown. Authors presented Model of differentiation of a salary of
the medics which use will allow to provide big objectivity and justice when
forming economic motivations of workers to achievement of the best end results
of work: to raise stimulating role of a salary in the solution of the current
and perspective tasks connected with implementation of obligations to the
state, and providing high level of competitiveness.
Keywords:
medical workers, salary, technique, model.
