研究目的

分析我国疾病预防控制机构人员薪酬保障和激励机制建设现状，结合激励影响因素分析，提出针对性的优化建议，为完善我国疾病预防控制机构人员激励制度提供理论支持和实证依据。

研究方法

（1）文献法和专家咨询法，分析疾病预防控制机构人员薪酬保障及激励政策，并制定和完善调查问卷、座谈及访谈提纲，为后续研究奠定基础。

（2）实地调研法，在东部、中部和西部地区各选择1个省份，各省调查省、市、县（区）级疾控中心各1个，共9个机构（按东中西依次编码为E、C、W，省市县通过数字1、2、3体现），调研时间为2024年8月-11月。具体方法包括：①问卷调查法：向机构发放《机构基本信息调查表》了解机构的人员流入和流出情况、收支情况、人员薪酬情况；向疾病预防控制中心人员发放问卷，调查调研人员对激励的感知情况，共收回有效问卷855份，激励框架由激励因素和激励效果两部分构成，均通过李克特5点量表进行测量，采用成熟量表或精简后纳入问卷，各维度均通过信度检验（Cronbach's α＞0.8）。②座谈法：面向疾病预防控制中心的领导、财务和人事部门工作人员开展，了解机构的薪酬保障、激励制度现状和改进建议。③半结构式访谈：采用方便抽样，开展一对一的半结构式访谈，访谈对象为疾病预防控制中心的业务人员，了解被访谈人员对疾控中心激励的感受与看法，共访谈24人。

（3）数据分析方法：①采用均值、标准差等描述性分析介绍人员薪酬保障和激励制度的基本情况。②采用独立样本t检验比较不同性别工资收入及激励的差异，采用单因素方差分析（ANOVA）描述工作特征等多分类变量对工资收入、激励因素及激励效果的影响，采用Spearman或Pearson相关分析方法分析激励因素对激励效果的影响。③采用OLS回归分析人员激励的影响因素；④再采用模糊集定性比较分析（fsQCA）分析激励因素如何相互作用而共同影响激励效果，并基于此方法探索可能的“成功案例”和“失败案例”的组态，为激励制度完善提供参考。

结果

一是政策层面，我国疾控中心薪酬保障制度经历了职务等级工资制、结构工资制、事业单位工资分类管理和岗位绩效工资制的历史演变进程，地方在疾控中心薪酬保障及激励机制的探索主要包括三大类：“两个允许”政策、地方政府增加财政投入和专业技术类公务员。

二是机构层面：（1）人员变动：2019-2023年，9个机构里西部区属疾控中心W3在五年平均离职率最高（10.33%），东部区属疾控中心E3、中部县属疾控中心C3和西部市属疾控中心W2人员非常稳定，近五年没有离职的情况，其它机构五年离职率低于4%；（2）疾控体系高质量发展背景下的各项具体制度落实：①岗位绩效工资制：9个机构中仅3个机构（东部省属E1、东部市属E2和中部省属C1）在机构内部实施了绩效工资分配与工作量或贡献有效挂钩的制度，其它机构都没有较好贯彻岗位绩效工资制。②“两个允许”政策：9个机构中有3个机构实施了社会化服务并可以用于人员分配(E1、E2和C1)，2个机构实施了社会化服务但不能用于人员分配（W1、W3），其它4个机构未开展相关举措。③科研经费管理：9个机构中2个机构将横向课题按科研项目管理规定实行经费管理，其它机构未实施相关制度。④人才引进与人才典型管理：4个机构有高层次人才相关制度（E1、E2、E3、C1)，1个机构（W1）实施了校园引才计划。⑤卫生防疫津贴：9个机构中没有机构有效落实了最新的卫生防疫津贴政策。

三是个体层面，本研究基于工作要求-资源理论，构建了疾病预防控制机构人员激励路径模型，前因变量划分为两类：工作资源维度（薪酬保障、成就发展、社会支持、工作特征）与工作要求维度（工作负荷），结果变量聚焦于工作投入（积极行为）与离职意愿（消极结果）。结果显示，总分按5分计，中间值为3，调研机构成就发展均分3.34，社会支持均分3.64，薪酬保障均分为2.93，工作负荷均分3.10，工作特征均分3.33，工作投入人员均分2.93，离职意愿人员均分2.22。单因素分析结果显示，不同机构级别人员之间的离职意愿具有统计学意义（P＜0.0001）。多因素分析结果显示成就发展、社会支持、薪酬保障和工作特征对工作投入具有正向影响，工作负荷对工作投入具有负向影响。成就发展、社会支持和工作特征水平与离职意愿呈负相关，工作负荷与离职意愿呈正相关（P＜0.05）；薪酬保障与离职意愿的相关性统计学不显著（P=0.445），市级和县区级机构离职意愿显著高于省级（均P<0.001）。

结论

要高度重视薪酬保障在人员激励中的作用，目前疾控中心人员对薪酬保障的满意度偏低，但它对人员工作投入具有重要影响，应当要严格落实疾控机构的财政保障，结合地方情况积极落实推进目前疾控体系改革中涉及的“两个允许”政策、科研经费管理政策、卫生防疫津贴补贴政策，把人才队伍建设放在更高的位置进行资源保障。

离职意愿受多重因素影响，薪酬保障并非决定性因素，要留住优质人才必须多管齐下，完善机构职称晋升体系，重视人员的培训培养，打通职业成长通道，体现疾控工作和疾控中心人员个人的社会价值。

Objectives

To analyze the current status of salary security and incentive mechanism development for personnel in China's Centers for Disease Control and Prevention (CDCs), identify influencing factors of motivation, propose targeted optimization recommendations, and provide theoretical support and empirical evidence for improving incentive systems for CDC personnel.

Methods

(1) Literature review and expert consultation were used to analyze CDC salary security and incentive policies. These informed the development of questionnaires, discussion outlines, and interview protocols for subsequent research stages.

(2) Field investigation was conducted in one province each from Eastern (E), Central (C), and Western (W) China. Within each province, one provincial (coded 1), municipal (2), and county-level (3) CDC was surveyed (total n=9 institutions: E1, E2, E3; C1, C2, C3; W1, W2, W3). Data collection occurred from August to November 2024 using: Specific methods included: ① Questionnaire survey: The "Institution Basic Information Questionnaire" was distributed to institutions to understand personnel inflow/outflow, revenue/expenditure, and personnel salary status; Questionnaires were distributed to CDC personnel to investigate their perceived motivation. A total of 855 valid questionnaires were collected. The motivation framework consisted of motivation factors and motivation outcomes, both measured using a 5-point Likert scale. Mature scales or refined versions were incorporated into the questionnaire, and all dimensions passed reliability testing (Cronbach's α > 0.8). ② Discussion method: Conducted with CDC leadership, finance, and human resources department personnel to understand the institution's salary security, current incentive system status, and improvement suggestions. ③ Semi-structured interviews: Conducted using convenience sampling, involving one-on-one semi-structured interviews with CDC operational staff to understand their feelings and views on incentives. A total of 24 people were interviewed.

(3) Data analysis methods: ① Descriptive analysis was used to introduce the basic situation of personnel salary security and the incentive system. ② Independent samples t-test was used to compare differences in salary income and motivation by gender; One-way ANOVA was used to describe the impact of multi-categorical variables such as job characteristics on salary income, motivation factors, and motivation outcomes; Spearman or Pearson correlation analysis was used to analyze the impact of motivation factors on motivation outcomes. ③ OLS regression analysis was used to analyze the influencing factors of personnel motivation; ④ Fuzzy-set Qualitative Comparative Analysis (fsQCA) was then used to analyze how motivation factors interact to jointly influence motivation outcomes, and based on this method, explore possible configurations for "successful cases" and "failure cases" to provide references for improving the incentive system.

Results

First, at the policy level, China's CDC salary security system has undergone a historical evolution from the position grade salary system, structural salary system, classified salary management for public institutions, to the post-based performance salary system. Local explorations in CDC salary security and incentive mechanisms mainly fall into three categories: the "Two Permissions" policy, increased financial investment by local governments, and specialized technical civil servant classification.

Second, at the institutional level: (1) Personnel changes: From 2019-2023, among the 9 institutions, the western county-level CDC (W3) had the highest average five-year resignation rate (10.33%). The eastern county-level CDC (E3), central county-level CDC (C3), and western municipal-level CDC (W2) personnel were very stable, with no resignations in the past five years; the resignation rates of other institutions were below 4% over five years. (2) Implementation of specific systems under the background of high-quality development of the CDC system: ① Post-based performance salary system: Only 3 institutions (eastern provincial E1, eastern municipal E2, central provincial C1) implemented a system within the institution where performance salary distribution was effectively linked to workload or contribution; other institutions did not implement the post-based performance salary system well. ② "Two Permissions" policy: Among the 9 institutions, 3 implemented socialized services that could be used for personnel distribution (E1, E2, C1), 1 implemented socialized services but could not use them for personnel distribution (W1, W3), and the other 4 institutions did not implement relevant measures. ③ Research funding management: Among the 9 institutions, 2 managed horizontal projects as research projects; other institutions did not implement relevant systems. ④ Talent introduction and exemplary talent management: 4 institutions had systems for high-level talents (E1, E2, E3, C1), 1 institution (W1) implemented a campus talent recruitment program. ⑤ Epidemic prevention subsidies: None of the 9 institutions effectively implemented the latest epidemic prevention subsidy policy.

Third, at the individual level, this study constructed a CDC personnel motivation pathway model based on the Job Demands-Resources theory. Antecedent variables were divided into two categories: job resource dimension (salary security, achievement/growth, social support, job characteristics) and job demand dimension (workload). Outcome variables focused on work engagement (positive behavior) and turnover intention (negative outcome). The results showed that, with the total score calculated on a 5-point scale and the midpoint being 3, the mean scores were: achievement/growth 3.34, social support 3.64, salary security 2.93, workload 3.10, job characteristics 3.33, work engagement 2.93, turnover intention 2.22. Univariate analysis results showed that turnover intention differed significantly among personnel from different institution levels (P < 0.0001). Multivariate analysis results showed that achievement/growth, social support, salary security, and job characteristics had a positive impact on work engagement, while workload had a negative impact. Achievement/growth, social support, and job characteristics levels were negatively correlated with turnover intention, while workload was positively correlated with turnover intention (P < 0.05); the correlation between salary security and turnover intention was not statistically significant (P = 0.445). Turnover intention was significantly higher in municipal and county-level institutions than in provincial institutions (both P < 0.001).

Conclusion

Salary security plays a crucial role in motivation，which significantly impacts work engagement. Therefore, robust fiscal guarantees for CDCs are essential. Local implementation of key reforms is urgently needed, including the "Two Permissions" policy, improved research funding management, and updated epidemic prevention subsidies. Prioritizing talent development requires enhanced resource allocation.

Turnover intention is multifactorial; salary security alone is not decisive. Retaining talent requires a multi-pronged approach: improving professional promotion systems, strengthening training and development, facilitating career progression, and recognizing the social value of CDC work and personnel.