Human Resources Management

Effect of Performance-Related Pay of Hospital Doctors on Hospital Behaviour: A Case Study From Shandong, China

With the recognition that public hospitals are often productively inefficient, reforms have taken place worldwide to increase their administrative autonomy and financial responsibility. Reforms in China have been some of the most radical: the government budget for public hospitals was fixed, and hospitals had to rely on charges to fill their financing gap. Accompanying these changes was the widespread introduction of performance-related pay for hospital doctors, termed the “bonus” system. While the policy objective was to improve productivity and cost recovery, it is likely that the incentive to increase the quantity of care provided would operate regardless of whether the care was medically necessary.

Health Workforce Challenges: Lessons from Country Experiences

This report is aimed at policy makers both in developing country governments and in international agencies. It was a key input to the second meeting of the High Level Forum on the Health Millennium Development Goals held in Abuja in December 2004. It was written to raise awareness of a looming crisis in human resources for health confronting most countries in sub-Saharan Africa, and to help serve as a catalyst for action to avert this crisis.