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From Salary to the Performance-Based Remuneration of Russian Physicians: How Motivation at Work is Changing

Author

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  • Sergey Shishkin

    () (National Research University Higher School of Economics)

  • Aleksandr Temnitsky

    () (National Research University Higher School of Economics)

Abstract

This paper examines changes in the motivation of physicians at work since the start of the salary reforms in 2008. These reforms included a shift from a fixed salary system to performance-based remuneration and an overall increase in salaries. The data of six surveys of health workers from 2007–2016 were used to reveal physician’s motives at work and to track the changes during this period. The changes were minor, and the directions of these changes were contrary to the expected strengthening of financial motivation at work: the importance of earning money is no longer primary. The share of doctors willing to work more and better on the condition of linking salary with labour contribution did not increase. In contrast, almost 66% of physicians believe that they are working at a high level of quality and performance.The majority of physicians desire an increase in the base salary, not the performance-based part. Doctors who receive bonuses for the intensity, quality and performance of their work, and those who have a higher salary overall also wish to see a higher base salary. This is a clear indication that they wish to strengthen the protective function of the base salary rather than to have increased opportunities for earning money

Suggested Citation

  • Sergey Shishkin & Aleksandr Temnitsky, 2017. "From Salary to the Performance-Based Remuneration of Russian Physicians: How Motivation at Work is Changing," HSE Working papers WP BRP 08/PSP/2017, National Research University Higher School of Economics.
  • Handle: RePEc:hig:wpaper:08/psp/2017
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    File URL: https://wp.hse.ru/data/2017/03/27/1169928539/08PSP2017.pdf
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    References listed on IDEAS

    as
    1. Elise Huillery & Juliette Seban, 2014. "Performance-Based Financing, Motivation and Final Output in the Health Sector: Experimental Evidence from the Democratic Republic of Congo," Sciences Po publications 2014-12, Sciences Po.
    2. Junui Shen & Kazuhito Ogawa & Hiromasa Takahashi, 2014. "Examining the Tradeoff Between Fixed Pay and Performance-Related Pay: A Choice Experiment Approach," Review of Economic Analysis, Digital Initiatives at the University of Waterloo Library, vol. 6(2), pages 119-131, December.
    3. Scott, A & Schurer, S & Jensen, P H & Sivey, P, 2008. "The Effects of Financial Incentives on Quality of Care: The Case of Diabetes," Health, Econometrics and Data Group (HEDG) Working Papers 08/15, HEDG, c/o Department of Economics, University of York.
    4. Franco, Lynne Miller & Bennett, Sara & Kanfer, Ruth, 2002. "Health sector reform and public sector health worker motivation: a conceptual framework," Social Science & Medicine, Elsevier, vol. 54(8), pages 1255-1266, April.
    5. Chandler, Clare I.R. & Chonya, Semkini & Mtei, Frank & Reyburn, Hugh & Whitty, Christopher J.M., 2009. "Motivation, money and respect: A mixed-method study of Tanzanian non-physician clinicians," Social Science & Medicine, Elsevier, vol. 68(11), pages 2078-2088, June.
    6. Franco, Lynne Miller & Bennett, Sara & Kanfer, Ruth & Stubblebine, Patrick, 2004. "Determinants and consequences of health worker motivation in hospitals in Jordan and Georgia," Social Science & Medicine, Elsevier, vol. 58(2), pages 343-355, January.
    7. Abigail Barr & Magnus Lindelow & Pieter Serneels, 2005. "Intrinsic motivations on the development frontline: Do they exist? Do they endure?," Economics Series Working Papers GPRG-WPS-033, University of Oxford, Department of Economics.
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    More about this item

    Keywords

    health care; physicians; salary; performance based remuneration; motivation at work; incentives.;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J08 - Labor and Demographic Economics - - General - - - Labor Economics Policies
    • J31 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Wage Level and Structure; Wage Differentials

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