台灣醫院醫師薪資制度調查

The principal purpose of this study is to understand and investigate the pattern and structure of hospital-based physician-compensation arrangements, and further, to investigate the differences between such arrangements as practiced by public and private hospitals. In addition, we intend to investigate the differences in the hospital-accreditation status for various Taiwanese hospitals, namely medical centers, regional hospitals, and district teaching hospitals. We conducted a cross-sectional survey in 1998. A structured self-administered questionnaire was mailed to appropriate representatives of the 120 target hospitals. ? The findings are as follows: 1) The response rate was 75%. 2) The most popular compensation arrangements is the mixed base-salary plus performance pay for public hospitals and mixed base-salary plus physician fee for surveyed private hospitals. 3) Most of the hospitals surveyed, whether public or private, have made the variable portion of the compensation exceeding 50% of physician’s total compensation. 4) The variable portion is determined mainly by the volume of a physician’s service according to the reimbursable items of the national health insurance scheme, although public hospitals appear to take more factors other than service volume into account. 5) Private hospital tend to use guaranteed salary for new-entry physicians, the less-profitable specialties, and residents. By contrast, public hospitals provide little guaranteed salary for the above-mentioned physicians. 6) Private hospitals, as compared to public hospitals, tend to modify physician-compensation arrangements more rapidly according to any changes in the reimbursement method of health insurance schemes. In conclusion, current hospital-physician compensation arrangements focus mainly upon a physician-incentive program, itself based upon volume of services.