Abstract:Objective Understanding the current status and influencing factors of mutual recognition of magnet-ic resonance imaging(MRI)examination results among tertiary public hospitals in Zhengzhou City.Methods A ques-tionnaire survey was conducted among physicians at tertiary Grade A public hospitals in Zhengzhou.Statistical de-scriptions of the indicators were performed,followed by one-way analysis of variance and binary logistic regression analysis.Results Doctors showed high recognition of MRI results mutual recognition at 55.63％,with moderate rec-ognition at 23.77％.Insufficient image clarity,poor timeliness,and inadequate completeness of examination reports were the primary reasons for low recognition levels.Hospital type,age,and professional title differences were the main factors influencing doctors' recognition of MRI results mutual recognition.Conclusion The mutual recognition of MRI examination results has shown overall positive progress.The next step should focus on improving the clarity,timeliness,and completeness of MRI reports,as well as enhancing young physicians' acceptance of mutually recog-nized MRI findings.

Abstract:Accurately reflecting the value of Traditional Chinese Medicine (TCM) within emerging health-insurance payment models has become pivotal.Analyzing Zhejiang Province's TCM medical insurance payment reform from a"three-medicine"synergy perspective:reviewing regulations and practices revealss challenges with DRG payment systems,including inadequate adaptation to TCM,insufficient weighting for minor surgical procedures,undervaluation of TCM service items,and outdated pricing standards for herbal medicine prescriptions.Drawing on experiences from Shanghai,Guangdong,and other regions,it proposes solutions such as refining TCM diagnostic groupings,adjusting weighting factors,improving pricing mechanisms,and implementing dynamic updates for herbal medicine costs.By optimising the payment architecture,it aims to enhance both accessibility and therapeutic effectiveness of TCM services,thereby offering policy guidance for the high-quality development of TCM and its deeper integration into the modern healthcare system.

Abstract:Objective Based on the expectation theory framework,design a scientifically reasonable surgical performance evaluation plan,optimize the doctor incentive mechanism,and improve the hospital's surgical related performance operation and management level.Method Through in-depth interviews with insiders,it fully explored the existing problems in surgical performance evaluation.Based on this,it constructed a"four-level,nine-grade"performance scheme based on the clustering of surgical difficulty index and the calculation of performance ratio.It tested the effectiveness of the new scheme by calculating the Karensky-Harabasz index and within-cluster sum of squares for the new and old schemes,and designed a questionnaire to consult clinical departments.Result Simulations showed that the scheme could more reasonably distinguish and compensate for surgeries with different resource consumption and difficulty levels,which helped to exert the guiding role of performance and effectively improve the hospital's ability to perform high-difficulty surgeries,while also helping clinical departments form a sense of resource control.Conclusion When conducting surgical performance evaluation,it is necessary to balance the expectations of medical staff in clinical departments with the needs of hospital performance operational management.Through reasonable scheme setting,application of supporting control measures,and timely dynamic adjustments,appropriate incentives can be achieved,providing a more scientific path for hospital surgical performance management.

Abstract:Objective To assess the implementation,key barriers,and underlying drivers of the mutual recognition policy for medical examination and test results in the Yangtze River Delta and to propose targeted countermeasures for optimizing the coordinated development of regional medical integration.Methods A total of 29 people from health and wellness departments,clinical testing centers and medical institutions in relevant regions were interviewed in depth through literature analysis,expert symposiums and interviews with key insiders.Based on the cross-boundary governance theory and Van Meter-Van Horn model as the analytical framework,the policy documents and interview data are integrated and analyzed.Results Revealed core issues:the lack of a leading agency,insufficient technical resources,an absence of authoritative guarantees,and a deficit in incentives.Conclusion Establish a provincial joint meeting mechanism to unify standards,jointly build a data sharing platform with sufficient technical and financial resources,set up a cross-provincial quality control alliance that operates in a substantive manner to strengthen quality assurance and responsibility definition,and promote the"dual insurance"mechanism that combines medical insurance incentives with professional liability insurance.

Abstract:The concept of"active health"emphasizes the collaboration between individuals and the medical system,multi-stakeholder coordination,enhancement of health management capabilities,continuous implementa-tion of self-health actions,control of major risk factors,and effective prevention of chronic diseases.Large public hospitals are the primary providers of healthcare services.The application of the active health concept to chronic disease management relies on the technical support and promotion from large hospitals.Guangdong Second Provincial General Hospital built a active health service model and integrating the active health philosophy,chronic disease prevention and treatment integration practices are carried out in terms of organizational management,resource integration,service innovation,and technological advancement.

Abstract:With the advent of the big data era,are facing new opportunities for high-quality development,while their digital construction is also facing severe challenges.Analyze the current development status of through the establishment of a traditional Chinese medicine service system,personnel structure,and management status,and explore the problems in the top-level design and infrastructure construction of digital construction in traditional Chinese medicine hospital.It is recommended that collaborate to develop digital construction standards and specifications,promote digital transformation of business processes,facilitate data sharing and reuse,establish a digital diagnosis and treatment resource platform for renowned traditional Chinese medicine practitioners,and carry out technological innovation based on data mining to promote high-quality development of the hospital.

Abstract:Objective To optimize the surgical performance grading system by utilizing the K-means clustering algorithm,thereby enhancing the precision and scientific validity of the grading.Method The methodology involves determining the K value through a combination of the silhouette coefficient,WCSS,and hospital management requirements,with further verification conducted using the Calinski-Harabasz index and the Davies-Bouldin index.Subsequently,cluster analysis is performed on surgical data based on the K values determined for each surgical level and the SDI values of individual surgeries,to elucidate the distribution characteristics of each surgical level and refine traditional surgical grading.Result The K-means clustering algorithm can further subdivide the original surgical classification into four levels with nine grades,facilitating scientific classification of surgeries and providing a more accurate foundation for surgical performance management and evaluation.Conclusion Hospitals should adopt a more scientific surgical performance grading method to differentiate resource consumption among surgeries of the same level within the four-level classification,offering guidance for rational performance allocation and control,and driving the refinement of hospital performance management.

Abstract:Objective By systematically reviewing and summarizing the current status and existing issues of surgical performance grading and evaluation in China,it provides reference for the construction of a surgical performance grading and evaluation system that aligns with the reform direction of public hospital salary systems,reflects the labor value of medical personnel,and promotes the optimization of resource allocation.Method Based on existing policies,literature,and practical experience,SWOT analysis is used to clarify the external opportunities and threats,internal strengths and weaknesses in the current classification and evaluation of surgical performance in China.Result A standardized system for surgical performance grading and evaluation that meets management needs has not yet been established.External policy evolution and technological progress,as well as internal resource allocation efficiency and personnel motivation,provide impetus for optimizing surgical performance grading and evaluation.However,reform also faces pressure from external policy changes,peer competition,institutional differences and internal conflicts of interest,incremental costs,and execution deviations.Conclusion In the future construction of surgical performance grading and evaluation system,the comparability of results can be improved by strengthening standardization construction,using scientific methods to achieve comprehensive evaluation,deepening the application of grading results to optimize performance allocation,and promoting information technology construction and talent cultivation.

Abstract:Objective Taking the key specialties of a tertiary general hospital in Shanghai as the research object,evaluating the development status of each subspecialty under the guidance of the concept of unbalanced develop-ment,analyzing the dilemmas and reasons currently faced by its disadvantaged subspecialties and proposing the de-velopment strategy in a targeted manner to provide a basis for optimizing the construction of hospital subspecialties.Methods Semi-structured interviews were conducted with relevant informants through purposive sampling,and the-matic framework analysis was applied to organize the data,and then quantitative data and qualitative information were combined to analyze the current situation and dilemmas of the development of disadvantaged subspecialties.Results At present,some of the disadvantaged subspecialties are facing the problems of uneven allocation of re-sources,insufficient service capacity,insufficient refinement of departmental management and lack of coordination and cooperation.Conclusion Hospitals and disciplines should adjust the allocation of resources to support the con-struction of disadvantaged subspecialties;clarify the division of tracks between subspecialties and set subspecialty main goals by disease types;cultivate the characteristics of disadvantaged subspecialties and shape their develop-mental advantages;optimize the internal staffing structure of some subspecialties and improve the management structure;and promote the positive interactions between subspecialties to strengthen coordination and cooperation.

Abstract:Objective Establish an evaluation index system for the extension of services from urban hospitals to county-level hospitals,quantitatively evaluate the extension of services from urban hospitals to county-level hospitals,and improve the service and management capacity of county-level hospitals.Methods Through literature research and on-site case research,the evaluation indicators were selected,experts were selected from hospital managers,government departments,and scientific researchers to carry out expert consultation,and the weights of indicators at different levels were calculated by analytic hierarchy process on the basis of quantitative expert consultation.Results A three-level index system was established,including 6 level-1 indexes of system collaboration,organizational collaboration,professional collaboration,clinical collaboration,resource collaboration,and normative collaboration,15 level-2 indexes and 47 level-3 indexes.The mean value of the authority coefficient(Cr)of the two rounds of experts was 0.79,the coordination coefficient of expert consultation was 0.199 in the first round and 0.369 in the second round,and the difference between the two rounds of coordination coefficient test was statistically significant(both P＜0.05).Conclusion The evaluation index system of extending services from urban hospitals to county-level hospitals has a theoretical and practical basis,with rigorous process and reliable results,which provides a quantitative evaluation system for promoting the sinking of high-quality resources and improving the capacity of county-level hospitals.

Abstract:The Artificial Intelligence(AI)-based auxiliary imaging report quality control system can address is-sues inherent in traditional manual quality control,such as low efficiency,inconsistent standards,poor accuracy,and outdated management.With the construction goals of full-dimensional quality control,high-efficiency review,full-process standardized management,and real-time accurate traceability management,the system adopts a"da-ta layer-technology layer-application layer"architecture.It integrates PACS/RIS/HIS data with AI technology,and significantly improves core performance compared with the traditional methods.It enhances the precise manage-ment capabilities of hospitals and departments,contributes to the high-quality development of hospitals and depart-ments,and holds considerable application value.

Abstract:Addressing the challenge of over one billion people worldwide suffering from mental disorders and the uneven distribution of medical resources under traditional mental healthcare service models that struggle to meet current demands,it demonstrates the practical value of"Internet Plus Mental Health"in reducing stigma,enabling proactive prevention,and achieving cost reduction with efficiency gains.It explores three critical tensions in its development:technical(digital divide and access barriers),usability(communication distortion and functional fragmentation),and systemic(policy lag and data silos).It proposes a three-dimensional development pathway across the "ecology-technology-model"layers:at the ecological level,implementing data sharing and medical insurance support;at the technical level,promoting age-friendly design and AI ethical review;and at the model level,expanding medical consortiums and community digital health stations,thereby providing actionable pathways for advancing mental health service development.

Abstract:Objective Based on the Technology Acceptance Model,by analyzing the current status of the development of smart healthcare for the elderly,the effects of technology usefulness,perceived usefulness and perceived ease of use on elderly patients willingness to use smart healthcare were studied.Methods A survey questionnaire was designed with the help of a mature scale from previous studies.A random sampling method was used to select 1 200 elderly patients aged 65 and above in the Guangdong-Hong Kong-Macao Greater Bay Area as the survey subjects.The data were analyzed using SPSS 29 software and SPSS PROCESS.Results The three key variables of technology availability,perceived ease of use and perceived usefulness all had a significant positive impact on the willingness of elderly patients to use smart healthcare.The digital literacy of elderly played a moderating role between technology usefulness and willingness to use,while the digital divide of the elderly played a moderating role between perceived ease of use,perceived usefulness and willingness to use.Conclusion Optimizing the design of smart healthcare for the elderly,strengthening the digital literacy training of elderly patients,accessing smart healthcare security technology,and bridging the digital divide of elderly patients can provide a feasible solution for the development of smart healthcare for the elderly in the Guangdong-Hong Kong-Macao Greater Bay Area.

Abstract:Objective It was aimed to analyze outpatient and inpatient utilization of self-paid and outsourced items in public healthcare institutions in Shanghai and its association with patient evaluation of medical cost rationality.Methods By conducting questionnaire surveys among outpatients and inpatientsin public healthcare institutions in Shanghai in 2023,patient utilization of self-paid and outsourced medicine,devices and testsin medical care was analyzed.Multilevel logistic regression models were adopted to analyze the influence of patients' self-paid and outsourced medicine,devices and tests on their identification rate with regard to"hospital medical care cost is reasonable".Results In 2023,the rates of outpatient and inpatient utilization of self-paid and outsourced medicine,devices and tests were less than 10％,7％,and 4％,respectively,in public healthcare institutions in Shanghai.The identification rates with regard to"hospital medical care cost is reasonable"in outpatients and inpatients were 84.86％and 95.75％,respectively.Additionally,self-paid and outsourcedmedicine and testscould reduce the identification rate with regard to"hospital medical care cost is reasonable"in outpatients,while self-paid and outsourced medicine and devices could decrease this rate in inpatients.Conclusion Public healthcare institutions should be value-oriented and reduce unnecessary patients' self-paid and outsourced medicine,devices and tests.

Abstract:Based on the PDCA-SDCA dual cycle management theory,a hospital complaint management path-way was systematically constructed.To address issues such as delayed response to complaints,fragmented pro-cesses,and poor interdepartmental coordination,it clarified responsibility distinction,categorized complaints and determined their priority levels,defined response time limits,and developed standardized complaint handling manu-als to regulate operational requirements at each stage,thereby optimizing the complaint guidance system.By estab-lishing a three-level response mechanism,formulating standardized operating procedures,implementing tiered training and quality control systems,and optimizing a performance-associated reward and punishment system with routine training guidance,a standardized four-step process"categorization-response-handling-feedback"was cre-ated.The PDCA-SDCA dual cycle management method effectively shortened the response time to complaints and the closed-loop cycle,improved the one-stop resolution rate and overall patient satisfaction for complaints,and fa-cilitated a shift in hospital complaint management from passive reaction to proactive prevention and systematic im-provement,providing a practical basis and reference for continuous enhancement of medical service quality.

Abstract:To facilitate secure and efficient circulation and sharing of disease-specific datasets while realizing data value,It employs a linear classification method from the business application perspective.The datasets are categorized into four classifications:basic data,clinical data,follow-up data,and bioinformatics data.For data fields within each category,hierarchical data classification standards for disease-specific datasets were established alongside stratified management strategies.This framework enables secure and efficient data utilization while safeguarding patient rights and privacy,thereby realizing data element value.It provides both reference frameworks and practical experience for classified grading and stratified management of disease-specific data.

Abstract:Objective Based on the background of China's tiered healthcare system,it conducts an in-depth analysis of the impact of personal income levels on residents' willingness to seek initial treatment at primary care facilities,providing scientific evidence to optimize resource allocation and improve tiered healthcare policies.Methodss Using data from the 2023 China Social Governance Survey(CSGS),a binary logistic regression model was constructed.A stratified analysis method was employed to examine the direct effect of personal income levels on the willingness to seek primary care at the community level,as well as the moderating effect of household registration status between the two variables.Additionally,heterogeneity tests were conducted based on income sources.Results (1)Personal income levels have a significant negative impact on the willingness to seek primary care(P＜0.01),with lower-income groups showing a higher willingness to do so;(2)Household registration status exerts a significant moderating effect on the relationship between individual income levels and residents' willingness to seek primary care at community health centers;(3)Heterogeneity analysis indicates that the negative effects are particularly pronounced among groups with wage-based,business-based,and transfer payment-based income.Conclusion It reveals that higherpersonal income has a clearnegative impact on the willingness to utilize primary care at the local level.This effectvaries dependingon thesourceof income.It also finds different patternsbetween citiesand rural areas.To helppeople usehealthcaremore sensibly,different policies are needed to improve primary healthcare services.In addition,medical resources should be better arranged to match the unique features of city and rural household registration systems,to effectively guide residents in seeking appropriate medical care.

Abstract:Objective To establish an indicator system for value-based payment access targeting Traditional Chinese Medicine(TCM)-advantaged diseases,thereby conducting constructive exploration for deepening reforms in TCM medical insurance payments methods.Methods Through literature research method,a preliminary indicator pool for value-based healthcare payment access of"overstrain stranguria"was drafted.The Delphi method was employed to solicit indicators,and Kendall's W coefficient was used to assess expert consensus.Results Through three rounds of consultation,5 primary indicators,8 secondary indicators,and 14 tertiary indicators were finalized.The coefficient of variation was＜0.15,and Kendall's W coefficient was 0.62.Conclusion A preliminary value-based payment access indicator system for"overstrain stranguria"has been established,demonstrating high scientificc rigor and reliability.This system provides an effective tool and scientific basis for reforming TCM medical insurance payment methods and implementing value-based payment approaches.

Abstract:Objective Focusing on optimizing surgical performance grading evaluation methods,this approach aims to provide a core quantitative tool for refining surgical grading and performance assessment through cross-catalog matching of procedures and the development of a scientifically sound,quantifiable Surgical Difficulty Index(SDI).Method The"two-step matching method"is employed to correlate the in-hospital surgical catalog with the national surgical catalog and CCHI,thereby obtaining comprehensive data for surgical evaluation.Additionally,based on the Balanced Scorecard approach,dimensions for calculating the Surgical Difficulty Index(SDI)are established.The Delphi method is utilized to determine the weights of each dimension,leading to the formulation of an SDI calculation model.This model enables the integration and quantification of cross-directory and cross-standard data.Result Through matching,the in-hospital surgical catalog is aligned with CCHI in various forms.Raw data is collected from five dimensions:manpower consumption,time consumption,technical difficulty,risk level,and cost consumption.These data undergo standardization processing.By combining the weights of each dimension,SDI values for surgeries are obtained,achieving a preliminary comprehensive and scientific evaluation among different surgeries.Conclusion Traditional surgical grading methods are no longer adequate for current performance management needs.It is imperative to refine surgical grading based on matching results and SDI values.This approach will facilitate a comprehensive evaluation of surgical resource consumption,the formulation of performance plans and management measures,guiding departments to enhance technology,optimize resource allocation,and ultimately achieve high-quality sustainable development.

Abstract:Objective To evaluate the evolution of outpatient and inpatient service volumes in county-level hospitals from 2008 to 2023,and to forecast trends for 2024-2030 using a Long Short-Term Memory(LSTM)network.Methods Data on outpatient visits and hospital admissions in county-level hospitals were compiled;compound annual growth rates,fixed-base growth rates,and year-on-year growth rates were calculated.Per capita health expenditure,GDP per capita,proportion of elderly population aged ≥65 years,and population density were included as control variables.An LSTM network model was constructed for forecasting.Results Since the new round of health care reform,service volumes in county-level hospitals have continued to increase but with agradual slowdown in growth,and inflection points have occurred due to external policy adjustments and public health emergencies.The regional distribution of service volumes has become more balanced.Forecasts indicate that overall service volumes will continue to grow slowly,with a structural divergence in their share of the national total.Conclusion Under the context of health care reform,county-level hospitals have entered a stage of slower aggregate growth and intensified structural differentiation.Development should shift from extensive expansion to connotative improvement,with emphasis on strengthening service capacity,enhancing institutional resilience,and advancing refined demand-side management.