绩效管理与晋升机制能否提高基层卫生人员工作动机——相对剥夺理论视角下分配公平感的中介作用分析  

Can Performance Management and Promotion Mechanisms Boost the Work Motivation of Primary Health Staff:Analysis of The Mediating Role of Perceived Distributive Justice from The Perspective of Relative Deprivation Theory

作　　者：王德龙 陈徽音 姚可鑫 巩金昊 赵世超 王颖 马慧芬 Wang Delong(School of Public Administration,Shandong Normal University,Jinan,P.R.China)

机构地区：[1]山东师范大学公共管理学院,山东济南250358 [2]山东第一医科大学医药管理学院 [3]山东中医药大学管理学院

出　　处：《中国卫生事业管理》2024年第6期656-661,共6页Chinese Health Service Management

基　　金：国家自然科学基金青年项目“工作动机视角下基层卫生机构公益性导向的平衡激励机制研究”(72204150);山东省2023年度深化医改研究课题“工作特征模型视角下基层卫生人员激励机制的优化路径研究”(YGY2023023)。

摘　　要：目的:从相对剥夺理论视角出发,分析基层卫生人员对绩效管理与晋升机制的感知,探究绩效管理与晋升机制如何通过分配公平感的中介作用影响工作动机。方法:于2021年2~6月,采用多阶段整群抽样,对山东省三市的18家社区卫生服务中心和20家乡镇卫生院的基层卫生人员进行问卷调查和个人深入访谈,共计回收有效问卷870份,访谈175人。对问卷数据采用描述统计、相关分析和多元线性回归等方法进行分析;对访谈资料借助定性分析软件进行编码。结果:绩效管理和晋升机制的4个维度得分为:考核规范性3.39±0.910分、考核应用性3.38±1.153分、晋升机会3.35±0.770分、晋升标准3.12±0.963分。多元线性回归结果显示,4个维度均对分配公平感有显著影响,共能解释其42.1%的变异,但仅有晋升机会对工作动机有显著影响(β=0.103,P<0.05)。分配公平感在晋升机会和工作动机之间起部分中介作用,但其只能解释工作动机0.4%的变异。访谈中有人员表示,当前基层存在考核规范性不足、考核结果应用性不强、晋升机会有限、晋升标准不明晰等问题。结论:绩效管理和晋升机制对基层卫生人员工作动机的影响有限,且分配公平感的中介作用只得到部分验证。应通过打破论资排辈的晋升文化、适当拉开收入差距、引入民主决策机制、优化考核结果反馈等措施,提升分配公平感,强化绩效管理与晋升机制的激励作用。Objective To analyze the primary health staff's perception on performance management and promotion mechanisms from the perspective of relative deprivation theory,and explore how performance management and promotion mechanisms affect work motivation through the mediating role of perceived distributive justice.Methods Multi-stage cluster sampling method was used to conduct questionnaires and in-depth interviews with the primary health staff in 18 community health service centers and 20 township hospitals of Shandong Province.Data were analyzed with descriptive analysis,correlation analysis and multiple linear regression.Results The scores of four dimensions of performance management and promotion mechanism were as follows:assessment normalization 3.39±0.910,assessment application 3.38±1.153,promotion opportunity 3.35±0.770 and promotion standard 3.12±0.963.The results of multiple linear regression showed that all four dimensions had a significant impact on perceived distributive justice,accounting for 42.1%of the variation,but only promotion opportunity had a significant impact on work motivation(β=0.103,P<0.05).Perceived distributive justice plays a partial mediating role between promotion opportunities and work motivation,but it can only explain 0.4%of the variation in work motivation.There were problems like poor assessment standardization,weak application of assessment results,few opportunities for promotion,and vague promotion standards in primary medical institutions.Conclusion The effect of performance management and promotion mechanisms on work motivation of primary health staff is limited,and the mediating effect of perceived distributive justice can only be partially verified.It is suggested to improve the perceived distributive justice and strengthen the incentive effect of performance management and promotion mechanism by breaking the promotion culture based on seniority,properly widening the income gap,introducing collective decision-making mechanism and optimizing the feedback of assessment resul

关 键 词：绩效管理 晋升机制 工作动机 相对剥夺理论 分配公平感 

分 类 号：R197[医药卫生—卫生事业管理]