Abstract:Objective To analyze the current development of smart operating room in Chinese public hospitals and explore the challenges in the development process.Methods It interviewed hospital officers related to operating room and smart operating room solution providers.In addition,a questionnaire survey was conducted among the people who are in charge of operating rooms in 162 hospitals across the country to investigate the construction and functional use of smart operating rooms within their hospitals.The questionnaire results were organized and analyzed.Results The relevant functional modules of smart operating rooms have been applied to some extent in the surveyed hospitals.The medical information inter-connectivity has a high penetration rate,with a coverage rate of 92％.In terms of the integration of software and hardware in the operating room,the vital signs and anesthesia information system has a relatively high application rate,with 87％of hospitals achieving electronic recording.However,the coverage rate of Artificial Intelligence early warning function is low.The application rate of high-end equipment such as surgical robots is low.In terms of operating room operation and management optimization,there is a certain ability to automate surgical processes.Conclusion Smart operating rooms have developed to some extent in medical institutions in China,but there are still shortcomings in technology and management,and further intelligent improvement is needed.

Abstract:It focuses on innovating governance problem for management of"one hospital with multiple campuses"in public hospitals.It systematically analyzes shared problems of"one hospital with multiple campuses"with a deep dive into the 16-year management practices of The First Affiliated Hospital of Chongqing Medical University.Through strategic repositioning,organizational restructuring,and innovative resource integration,the research illuminates the structural characteristics and operational logic of system governance for"one hospital with multiple campuses"under policy constraints and practical needs.By addressing the"resource dilution trap"and"management entropy dilemma",it aims to provide a theoretical framework and practical guidelines for public hospitals to optimize governance systems,enhance overall operational efficiency and achieve synergistic development.

Abstract:Objective To evaluate the medical service efficiency of county-level comprehensive public hospitals in Sichuan Province for 2023,and propose evidence-based recommendations for enhancing operational efficiency and promoting high-quality development.Methods Data Envelopment Analysis(DEA)was utilized to assess the operational efficiency of county-level public general hospitals.Malmquist index model was applied to examine temporal efficiency changes during 2022-2023.Spatial autocorrelation analysis was conducted to identify geographical clustering patterns of medical service efficiency across prefecture-level divisions in Sichuan Province.Results Revealed an average comprehensive efficiency score of 0.865 among surveyed hospitals,with only 35 institutions(21.60%)achieving DEA effectiveness.The total factor productivity index is 0.913 during the study period.Spatial analysis identified positive spatial autocorrelation(Moran's I=0.846,P＜0.05),with Ziyang and Zigong municipalities exhibiting distinctive high-low clustering patterns.Conclusion The findings indicate suboptimal medical service efficiency in Sichuan's county-level public hospitals during 2023,marked by progressive efficiency deterioration and widespread input redundancy.Strategic recommendations include paradigm shifts in hospital management,accelerated adoption of medical technological innovations,enhanced inter-regional collaborative mechanisms,and optimized resource allocation strategies to drive sustainable quality improvement in county-level healthcare institutions.

Abstract:Objective Based on the TOE model,to analyze the driving and restraining forces i in the digital development of primary healthcare institutions.Methods Based on the TOE model,the data obtained from literature analysis and key informant interviews were subject coded,and the dynamic resistance factors in the development of digital technology-enabled primary health care institutions were systematically sorted out from three dimensions of technology,organization and environment.Results The main technical driving force for the development of primary health care institutions enabled by digital technology was the rapid development of digital information technology,the main organizational driving force was the government's incentive policies,and the environmental driving force was the increasing diversification of patients'health needs.The main technical obstacles to the development of digital technology-enabled primary medical institutions include information islands and information security risks,the main organizational obstacles include imperfect policy system,inadequate financial support,inadequate digital capacity of primary medical staff,and the main environmental obstacles are the low recognition of patients.Conclusion The development of primary health care institutions enabled by digital technology faces more resistance and less driving force,so all parties should strengthen the integration and application of digital technology,enhance the multi-dimensional collaborative path of policy-fund-talent,and enhance patients'recognition of primary health care digitalization.

Abstract:Objective To explore the changes in physicians'diagnostic and treatment behaviors before and after the implementation of the Diagnosis-Related Group(DIP)reform,providing evidence for healthcare payment reform.Methods It selected a tertiary hospital in W City,Shandong Province,as a sample and analyzed indicators of physicians'diagnostic and treatment behaviors using an interrupted time series analysis.Results The differences were statistically significant on the trend changes in the increased number of hospitalizations and decreased average hospitalization expenses in surgical departments.The overall average length of stay decreased but not significantly.Although the hospital CMI increased,its trend change decreased significantly.The CMI of internal medicine departments increased,while that of surgical departments decreased.Conclusion The DIP payment reform has a structural impact on the service volume of internal medicine and surgery,driving resources towards surgery.The potential risk of patient deferral needs to be vigilant.DIP reform effectively controls cost growth but is accompanied by a decrease in the difficulty of admitted cases,highlighting the need to balance controlling medical cost growth with incentives for admitting severe cases.Changes in the average length of stay reflect differences in efficiency responses across departments,with improved efficiency evident in surgical departments,while optimization of internal medicine processes still needs to be strengthened.

Abstract:Objective Analyze the impact of fiscal input intensity on medical expenses under different measurement methods.Methods Using provincial panel data from 201 0 to 201 9,an empirical analysis was conducted using econometric methods.Results The proportion of fiscal subsidy income in the total revenue of medical and health institutions,input per bed,and input per doctor can all significantly reduce medical expenses;and there are lag effects and regional heterogeneity in the impact on medical expenses.Conclusion The impact of fiscal input intensity on medical expenses under different measurement methods is related to many factors such as regional economic conditions and the level of health resource allocation.It is suggested to establish a fiscal input mechanism that links the government,the market and medical insurance,and implement fiscal input methods based on local conditions according to the economic environment and resource allocation of each region.In addition,it is necessary to improve the dynamic adjustment mechanism of fiscal input to optimize government resource allocation and improve the performance of fiscal funds.

Abstract:Objective In order to summarize the implementation problems and suggestions of entrusted manage-ment projects between municipal hospitals and suburban hospitals in Beijing.Methods Through literature research and focus group interviews,more than 50 person in charge of municipal hospitals,district hospitals,and relevant departments of relevant district-level governments were interviewed.Results A comprehensive understanding of the 1 0 entrusted management projects in Beijing,some of which have signed the second phase of the contract,sorted out the problems and suggestions for further optimization from the aspects of the government governance re-lationship of the entrusted management projects,the indicators of the agreement contract,the calculation of the entrusted management cost,the support of the local government where the entrusted management hospital is lo-cated,and the foundation and personnel of the entrusted management hospital and the personnel assigned by the entrusted management hospital.

Abstract:Objective To investigate the current status,challenges,and improvement strategies for implementing tumor diagnosis and treatment performance indicator target management in a district of Beijing.Methods A qualitative study was conducted using semi-structured interviews with 33 staff members from 1 1 medical institutions providing oncology services in the district.Interview data were coded through thematic analysis.Under the framework of Actor-Network Theory,implementation was analyzed across four dimensions:actor identification,translation,obligatory passage points,and network stability/conflicts.Results The District Tumor Quality Control Center organizes annual on-site supervision and inspection,quarterly self-inspections and random checks,and monthly monitoring indicator data collection,effectively promoted practitioners'voluntary compliance with guidelines and standards.These measures standardized and homogenized diagnosis and treatment practices across institutions while improving indicator performance.However,unmet target values were primarily attributed to tumor patients'individualized treatment needs and inconsistent acceptance of assessment indicators among physicians.Conclusion The standardized and homogeneous management requirements for tumor diagnosis and treatment stand in both contradiction and unity with the heterogeneity of cancer patients and the variations among hospitals,departments,and physicians.

Abstract:Objective Construction of homogeneous evaluation index system of medical quality in clinical departments of"one hospital with multiple campuses"in pulich hospitals.Methods Based on the Donabedian model,the initial evaluation index pool was developed using literature review.Delphi expert consultation was employed for evaluation index screening,and the Analytic Hierarchy Process was used to determine indicator weights.Results The response rates for both rounds of consultation were 1 00%,with authority coefficients of 0.91 and 0.90,respectively.The Kendall's W coefficients for importance scores in the two rounds were 0.21 and 0.22,while the availability scores improved from 0.14 to 0.22,all statistically significant(P＜0.001).The evaluation system comprises three dimensions(structure,process,outcome),six primary indicators,1 2 secondary indicators,and 37 tertiary indicators.Key monitoring areas include quality monitoring and improvement(0.1 52 6),quality outcomes(0.264 9),and patient safety and satisfaction(0.345 5).Conclusion In the construction of"one hospital with multiple campuses",it should focus on strengthening the construction of patient safety and satisfaction,quality outcome,quality monitoring and improvement,and refine the management of medical quality homogeneity in multiple hospitals.

Abstract:China has entered a new development stage of building a"Digital China",where Traditional Chinese Medicine(TCM)is facing a historic opportunity to transition from an empirical paradigm to a data-driven model.It refines the conceptual framework of digital TCM,examines the evolution of China's digital TCM policy system,and draws insights from the digital development experiences of traditional medicine in Japan,South Korea and other regions.A five-pronged high-quality development pathway is proposed,integrating"infrastructure consolidation,organizational implementation,technological breakthroughs,process reengineering,and quality control innovation."This approach aims to drive comprehensive upgrades in TCM services,research,and governance through data empowerment,offering a Chinese blueprint for the global digital transformation of traditional medicine.

Abstract:As an important support for accelerating the expansion of high-quality medical resources and achieving balanced regional distribution,the construction of National Regional Centers,needs to fulfill the public welfare responsibility of basic medical services and fully participate in the performance evaluation of public hospitals,accelerating the establishment of a high-quality development model that focuses on connotation.It introduces the achievements of a certain National Regional Center in building a refined management mechanism for performance evaluation and achieving a three-level jump under the"homogenization construction"construction model,which systematically constructs six dimensions including"establishing the organizational system framework""top-level designing of development strategies""innovating talent introduction and cultivation paths""improving monitoring and evaluation mechanisms""linking medical recordcoding quality control",and"adjusting performance incentive plans"and provides suggestions for further construction.

Abstract:Objective To investigate the current status of satisfaction with collaborative governance of imaging resources in county-level medical consortia,identify the main influencing factors,analyze the differences in satisfaction across various demographic characteristics,and propose data-driven optimization path for governance.Methods A cross-sectional survey design was employed to collect data from 320 medical staff across 30 county-level medical consortia member units in Zunyi City,Guizhou Province.The questionnaire covered satisfaction with collaborative governance and its influencing factors.Data analysis was performed using t-tests,one-way analysis of variance,and multiple linear regression.Results Type of medical and health institution and educational level influenced satisfaction with collaborative governance,staff from county hospitals and those with a bachelor's degree or above reported higher satisfaction score.Multiple linear regression results indicated that institutional uniformity,information system integration,and organizational trust had positive effects on satisfaction(β=0.1 86,0.1 27,and 0.1 90,P＜0.01),while effectiveness of incentive mechanisms showed no significant effect(P＞0.05).Conclusion Efforts should focus on strengthening institutional standardization,promoting information system integration,and fostering organizational trust.Governance measures should be stratified and optimized according to different medical and health institutions and personnel characteristics to improve the efficient integration and collaborative service capacity of imaging resources in county-level medical consortia.

Abstract:Objective To study the settlement of high-rate cases in the year-end final accounts of medical insurance,and the factors affecting the comprehensive settlement rate,and improve the reform of medical insurance payment methods.Methods The medical insurance final accounts of a hospital in 2023 were described and statistically analyzed.2 test and Mann-Whitney U test were used to compare the difference between high rate cases and normal rate cases,and linear multiple regression was used to explore the influential factors affecting the comprehensive settlement rate.Results The settlement rate of resident medical insurance was lower than that of employee medical insurance,the settlement rate of high rate cases was lower,and the allocation rate of some low weight high rate cases was negative,and the hospital did not get reasonable compensation.Compared with the normal rate,the proportion of acute and critical cases in high rate cases is higher,and the cost and time consumption are higher.The factors influencing the comprehensive settlement rate are high rate limit,settlement point value,cost ratio,total medical cost,benchmark points and reimbursement ratio in descending order.Conclusion Under the current policy,the high rate cases have not been reasonably compensated.The medical insurance department should work out the identification standard and settlement method of high rate cases scientifically and reasonably together with medical institutions.

Abstract:Objective To evaluate the comprehensive effectiveness of implementing a Multi-Disciplinary Treatment(MDT)green channel policy for geriatric hip fracture patients in a public tertiary grade A hospital,and to explore the practical challenges and corresponding solutions during its implementation.Methods A difference-in-differences model was employed to analyze multidimensional changes in key indicators between the intervention and control groups before and after policy implementation.Results The average preoperative preparation time in the intervention group was shortened by 3.49 days(β=-3.49),and the incidence of complications decreased by 1 1%(β=-0.1 1),contributing to better clinical outcomes.Economically,total medical costs,patients'out-of-pocket expenses,and pooled medical insurance expenditures decreased,while the proportion of medical service revenue increased,conclusively demonstrating the policy's substantial benefits.Conclusion This policy achieved a triple-win scenario for hospitals,insurers,and patients,demonstrating comprehensive benefits across social,medical,and economic dimensions.As an evolving and optimizable model,it holds strong potential for widespread application in orthopedic clinical practice.

Abstract:The development of"one hospital with multiple campuses"serves as a crucial strategy for large public hospitals to expand high-quality medical resources and achieve balanced distribution.Drawing on the organizational life cycle theory,it examines the standardized nursing management practices at Chongqing Medical University Affiliated First Hospital's"One Hospital,Four Branches"model.Through the initial establishment,growth,and maturity period,it innovatively establishes a phased approach to standardized nursing management.The findings summarize practical implementation outcomes,offering actionable recommendations with significant reference value for healthcare institutions.

Abstract:Objective To analyze the reasons for inter-provincial patient referral in Heilongjiang Province's counties from a doctor's perspective,and to provide theoretical support for enhancing primary healthcare capacity,improving medical insurance fund efficiency,and promoting the implementation of the hierarchical diagnosis and treatment system.Methods Using purposive sampling,a semi-structured in-depth interview was conducted with 31 doctors from county-level hospitals.Based on grounded theory used NVivo 1 2 Plus software for word frequency analysis and three-level coding to build a theoretical model of the reasons for inter-provincial patient referrals.Results Through coding analysis,1 7 subcategories and 7 overarching categories were identified,overarching categories includes medical resource levels,economic factors,social relationships,external influences,individual characteristics,medical cognition,service experience,and institutional environment.Central contributing factors included the obsolescence of medical equipment and the inadequate diagnostic and therapeutic capacities of county-level healthcare institutions.Conclusion The inter-provincial referral behavior of patients is influenced by multiple factors.It is recommended to strengthen the construction of grassroots specialties,enhance the service capacity of county-level hospitals,improve the differentiated reimbursement mechanism of medical insurance,strengthen doctor-patient communication,promote rational medical treatment,and promote the effective implementation of hierarchical diagnosis and treatment.

Abstract:Objective To investigate the status of provincial center for healthcare quality management in mental health across China.Methods A self-designed questionnaire was used to survey the basic information,institutional systems,and medicine quality control practices of provincial-level psychiatric medicine quality control centers.Results Except for the Tibet,provincial-level psychiatric medicine quality control centers have been established in 30 provinces,with 35 healthcare institutions responsible for their operation.Among these,20(57.1%)institutions had dedicated staff,and 14(46.7%)received special financial support from authorities in 2024.Conclusion The organizational framework for provincial-level psychiatric medicine quality management has been preliminarily established,though regional disparities persist in personnel and funding support.Further policy reinforcement and resource allocation remain necessary to strengthen the system.

Abstract:Objective To explore the key influencing factors of medical quality homogenization in"one hospital with multiple campuses"of public general hospitals and to construct an optimization mechanism model for its management.Methods Grounded theory was applied in semi-structured interviews with 30 staff from six tertiary grade A public general hospitals in Chongqing from March to April 2025.The interview data were systematically sorted,coded,and integrated.Results Based on 30 interview transcripts,178 initial concepts,107 preliminary categories,26 main categories,and 7 core categories were summarized,and a homogenization management optimization mechanism model for"one hospital with multiple campuses"medical quality in public general hospitals was constructed.Conclusion Public general hospitals should prioritize seven critical dimensions to achieve homogeneous medical quality management across multiple campuses:party-building leadership,human resource allocation,logistical support,information technology infrastructure,medical quality management systems,multiple areas coordination,and homogeneity performance.This is to achieve high-level"one hospital with multiple campuses"homogenized management of medical quality,diagnostic and treatment levels,and degree of satisfaction.

Abstract:Objective A comprehensive evaluation was conducted on the homogeneity of medical quality in"one hospital with multiple campuses"of a tertiary grade A hospital in Chongqing,providing a reference for improving the homogeneity of medical quality in"one hospital with multiple campuses".Methods Based on the index system of homogeneity of medical quality in"one hospital with multiple campuses",the entropy weighted TOPSIS method was employed to calculate the weights of each evaluation indicator and rank the homogeneity of medical quality across various specialties in the hospital.The RSR method was further used to categorize and rank the homogeneity of medical quality among the hospital's specialties.Results The trend of the entropy weight TOPSIS method and RSR method analysis results is basically consistent,with 1 0 specialties(52.6%)ranking in the"good"or"relatively good"level.Conclusion The systematic construction of"one hospital with multiple campuses"with"integrated construction,homogeneous management,and differentiated development"in a tertiary grade A hospital has achieved initial results.The overall homogenization level of medical quality in each specialty is good,but there are still specific differences.Hospitals should establish a strategy of medical quality homogenization of"one hospital with multiple campuses"based on specialty differences,with a focus on the homogenization level of resource allocation,systems and norms.

Abstract:Objective Examine the spatial distribution of medical service efficiency in public Traditional Chinese Medicine Hospitals.Methods Utilize the super-efficiency Slack-Based Measurement model for service efficiency measurement and the Dagum Gini coefficient to assess efficiency gaps across four regions.Apply exploratory spatial data analysis to analyze spatial distribution characteristics.Results The efficiency of medical services in these hospitals is generally low with notable regional disparities,displaying a spatial concentration pattern favoring southern regions.Conclusion To improve efficiency,hospitals must enhance their autonomy and internal structures.Additionally,addressing regional disparities is crucial;high-efficiency regions should radiate and lead to the sharing of quality medical resources,thereby reducing the north-south efficiency gap.