[Willingness and preferences of actual service suppliers regarding cancer screening programs: a multi-center survey in urban China].
Shi JfMao AySun ZxLei HkQiu WqHuang HYP. DongHuang JwJun ZhuLi JLiu GxWang DbBai YnSun XjLiao XzRen JsGuo LwL. LanQi ZhouLi YangSong BbDu LbLing ZhuWang JlLiu YqYang RenLiqiang MaiQin MfY-Z ZhangZhou JySun XhWu SlQi XieLou PaBofeng CaiLi NK ZhangJie HeMeixia Dai
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Abstract:
Objective: From the perspective of actual service suppliers regarding cancer screening, this study aimed to assess the long-term sustainability of cancer screening programs in China. Methods: Based on a Cancer Screening Program in Urban China (CanSPUC), our survey focused on all the hospitals, centers for disease control and prevention (CDC) and community service centers across 16 provinces in China which participated in the programs between 2013 and 2015. All the managers (institutional/department level) and professional staff involved in the program were interviewed using either paper-based questionnaire or online approach. Results: A total of 4 626 participants completed the interview. It showed that the main gains from providing screening service emphasized promotion in social value (63.6%), local reputation (35.9%), and professional skills (30.6%), whereas difficulties encountered included inadequate compensation (30.9%) and discordance among information systems (28.3%). When the service remuneration amounts to about 50 Chinese Yuan per screening item, those professional staff self-reported that they would like to work overtime. More than half (63.7%) of the staff expressed willingness to provide routine screening service, the main expectations were to promote their reputation to the local residents (48.7%) and to promote professional skills (43.1%). Those who were not willing to provide screening services were worried about the potential heavy workload (59.8%) or being interfered with their routine work (49.8%). Further detailed results regarding the different organization types and program roles were presented in the following detailed report. Conclusions: Findings of gains and difficulties showed that if cancer screening is expected to become a long-term running, incentive mechanism from the program, external promotion and advocacy as well as capacity building should be strengthened; furthermore, rewards to staff's screening services should be raised according to the local situations. Results regarding the "willingness to provide service" showed that management of the program should also be strengthened, including information system building and inter-agency and inter-department coordination at the government levels.目的： 基于癌症筛查实际供方角度，从工作人员主观感受及意愿层面评价癌症筛查项目的可持续性。 方法： 2014－2015年，基于城市癌症早诊早治项目，在16个省份项目点选取2013－2015年所有承担项目的医院、CDC和社区卫生服务中心，采用纸质问卷和网络调查开展访谈，对象包括宏观管理人员、具体项目管理人员和一线工作人员等。 结果： 最终完成访谈4 626份，访谈对象总体认为参加项目的最大收获在于社会价值感的提升（63.6%）、当地影响力（35.9%）及专业技能提升（30.6%）等；最大困难在于社会物质激励不够所致工作积极性低（30.9%）、信息采集口径不一致（28.3%）、部门间协调（24.4%）和机构间沟通衔接困难（23.5%）等。当单项筛查服务劳务补偿约50元时，工作人员会考虑加班工作。63.7%的受访者有长期筛查服务意愿，主要原因：可通过项目提升个人/团队在当地影响口碑（48.7%）、通过项目提升个人/团队专业技能（43.1%）等；无服务意愿者主要担心工作量超负荷（59.8%）、对日常工作的干扰（49.8%）等。 结论： 收获与困难相关结果提示，若要长期可持续性开展癌症筛查工作，建议加强项目内荣誉激励、对外宣传及专业能力建设，根据具体情况提高劳务补偿。服务意愿结果则提示，应从政府和领导层面加强信息化建设及机构/部门间协调，机构内应合理协调筛查项目与日常工作。.Keywords:
Remuneration
The main objective of this paper is to examine the relationship between directors’ remuneration and Corporate Social Responsibility (CSR) for listed firms in Malaysia. All financial data such as firm size, performance and leverage can be collected from Thomson Reuters DataStream while directors’ remuneration and CSR disclosures were collected from annual reports. 377 samples of listed firms on Bursa Malaysia were collected from year 2014 to 2016. The results of this study show that increase director’ remuneration motivates the directors to perform higher CSR. The CSR practices should benefit people and firms. Therefore, more benefits gained by public and firms from CSR should not be compensated with low directors’ remuneration. The results also show that firm size and leverage have positive relationship with CSR. This study can be extended using other measurements of CSR such as Global Reporting Initiative (GRI), human rights and environmental reporting which could give new insights on the relationship between CSR and directors’ remuneration.
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A postal questionnaire survey was conducted comparing the workload and remuneration of part-time women principals in group practices in the Northern and Oxford regions. Part time was defined as receiving less than a full profit share at parity. Of 501 women principals 308 (62%) responded of whom 146 (47%) were part-time. Respondents were asked to record aspects of workload over a four-week period for themselves and their full-time partner who did the most sessions within the practice. The results showed that although two-thirds of the part-timers had 50% or less of a full profit share, part-time principals overall did about 76% of the daytime clinical work (surgeries and home visits) done by their full-time partners, excluding specialized clinics. The lower the profit share the wider this discrepancy. Although 33% of the respondents did not out-of-hours work, the remainder did more than their profit share would indicate. Twenty per cent of the 116 principals with 40% or more of a full profit share and 57% of the 30 principals with less than 40% of a full profit share felt that their share was unfair. Lack of involvement in practice business and feeling that opinions did not carry equal weight were associated with feelings of unfairness.
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All UK medical schools are revising their curricula following the General Medical Council recommendations to increase general practice involvement in undergraduate education. However, workload in general practice has increased in recent years, raising questions about its ability to maintain, let alone extend, its educational activities.The aim of this study was examine whether recent changes in general practice have affected delivery of practice-based undergraduate education and to assess the extent to which practices will be able to increase their involvement in teaching.A postal questionnaire survey was conducted of the lead clinical teachers and their partners in the practices to which students from Leicester Medical School had been attached in the last 2 years.The questionnaire was completed by 32 out of the 39 lead teachers and 134 of the 150 partners, an overall response rate of 88%. There was widespread support for departmental teaching requirements, but only 17 lead teachers (44%) felt that the suggested reduction by 25% of patients seen per session while teaching was feasible. A total of 14 lead teachers (47%) felt that the ability of their practice to deliver high-quality teaching had declined since 1990. Altogether, 113 (87%) of all doctors in teaching practices felt that time pressures had increased during this period, and 139 (88%) felt that present levels of remuneration were inadequate. The majority of these doctors felt that general practice was the preferred location for learning generic clinical skills and were interested in participating. Nevertheless, most were not prepared to increase their involvement in teaching under present arrangements.Practice-based teachers appreciate the need for quality teaching, remain enthusiastic about teaching and are, in principle, willing to take an increased teaching load. However, recent changes have made delivery of teaching more difficult, and if an expansion in practice-based teaching is to occur, more realistic levels of funding and support are a prerequisite.
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Clinical Practice
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In the UK, under present Whitley Council Regulations for payment for out-of-hours pathology services, there is a complex relationship between the number of requests received, the time taken to analyse each request, and the number of calls for which payment may be claimed for work done. At a fixed average analysis time, the rate of increase of remuneration slows down as workload increases until at higher workloads remuneration falls. The introduction of methods with a shorter average analysis time to improve the clinical service increases remuneration disproportionately. We suggest that a fixed sessional payment would be a better way of funding the service.
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Performance-based remuneration system has come into use widely in the affiliated institiutions of the Ministry of Health of the Republic of Turkey since 2004.In this system, all working personnel benefit from extra pay whereas only the activities performed and finalized by physicians are scored.The activities conducted by non-physician personnel including nurses are not scored.This study intends to determine nurses' views concerning the performance-based remuneration system and its effects.The questionnaire developed by researchers for this purpose was responded by 149 nurses working in a public hospital in the province of Konya (Turkey).According to the findings, the performance-based remuneration system increases the workload of nurses, forces nurses to fulfill the duties that are not included in their job description, makes physicians financially more privileged, has negative effects on the quality of patient care and the relationships between nurse-physician, nurse-patient, nurse-family and causes nurses to experience professional burnout syndrome.The majority of nurses (80.5%) want the direct performance-based remuneration system that is applied to physicians to be also applied to nurses.
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Delphi Method
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Objective
To learn the remuneration and pay expectations of doctors, for practical basis of the dynamic salary adjustment mechanism for doctors.
Methods
A questionnaire survey was made in October-November of 2017, on the remuneration level of 20 public hospitals in Zhejiang province and influencing factors. The survey covered such aspects as remuneration level, pay satisfaction, expected pay and pay constitutes. The data so acquired were subject to descriptive statistics.
Results
The remuneration of residents, attendings, associate chief physicians and chief physicians at these hospitals averaged 135 000, 187 000, 245 000, and 324 000 respectively in 2016. 60.1% of the doctors held the value of technical service, workload, performance appraisal and academic titles as key components for doctors′ remuneration appraisal in the future.
Conclusions
It is recommended to optimize doctors′ remuneration structure as guided by knowledge-based value, establish a dynamic adjustment mechanism based on social average pay and reasonable price relations, to conduct scientific performance appraisal, enhance resource use efficiency, and reform the current performance system, so as to realize the value of doctors.
Key words:
Hospital, public; Remuneration; Influencing factor; Zhejiang province
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Salary
Performance appraisal
Value (mathematics)
Questionnaire
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Detailed information about workload and sources of remuneration for radiologists at a large tertiary-care teaching hospital was reviewed for the calendar year 1991 as part of an assessment of medical professional resources. Radiologists at this facility worked an average of about 50 hours per week. When the intensity of the cases was taken into consideration, there was only a small variation among individual radiologists in terms of workload and income earned for the group. Ninety-three percent of the radiologists' remuneration came as payment for clinical patient care. The radiologists were poorly remunerated for the time they spent teaching, conducting research and performing administrative duties, but this low level of remuneration was partially compensated by the activity of senior residents, who did some work without supervision.
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Tertiary care
Patient Care
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Section (typography)
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The aim of the study was to identify the factors having an impact upon nursing work and to use the results to inform strategic planning of the Queensland Nurses Union.In 2001 and 2004, a study was undertaken to gather data on the level of satisfaction of nurses with their working life. This paper reports the 2004 results on workload, skill mix, remuneration and morale. Where applicable, the results are compared with 2001 data.A questionnaire was mailed to 3000 Assistants-in-Nursing, Enrolled and Registered Nurses in October 2004. All participants were members of the Queensland Nurses Union. The results are reported in three sectors - public, private and aged care. A total of 1349 nurses responded to the survey, a response rate of 45%.Nurses in the 2004 study believed: their workload was heavy; their skills and experience poorly rewarded; work stress was high; morale was perceived to be poor and, similar to 2001, deteriorating; the skill mix was often inadequate; and the majority of nurses were unable to complete their work in the time available. Nursing morale was found to be associated with autonomy, workplace equipment, workplace safety, teamwork, work stress, the physical demand of nursing work, workload, rewards for skills and experience, career prospects, status of nursing and remuneration.Overall the findings of the study are consistent with those determined by the 2001 survey.The findings of this study indicate the importance of factors such as workplace autonomy, teamwork, the levels of workplace stress, workload and remuneration on nursing morale. The data also indicate that workplace safety and workplace morale are linked. These findings provide information for policy makers and nurse managers on areas that need to be addressed to retain nurses within aged care, acute hospital and community nursing.
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