Abstract:Grounded in the Healthy China strategy,it employs integrated healthcare service theory,collaborative governance theory,and symbiosis theory to systematically analyze the conceptual connotation of medical-preventive integration within county-level medical communities and clarify its seven-dimensional framework of medical-preventive integration.These dimensions encompass resource integration,management integration,information integration,team integration,service integration,assessment integration,and cultural integration.The study delineates its three-phase dynamic evolution characterized by"interaction,coordination,and symbiosis"and outlines future development paths:constructing an intelligent integrated platform,delivering continuous services across the prevention-treatment-rehabilitation continuum,and fostering a multi-stakeholder collaborative governance framework.The findings provide both theoretical foundations and policy recommendations to support the high-quality development of medical-preventive integration in county-level medical communities.

Abstract:The key to strengthen the construction of county medical communities in China is multidimensional synergy.Based on the SFIC model,it deeply analyzes the collaborative dilemmas of county medical community in China from four dimensions:initial conditions,catalytic leadership,institutional design and collaborative process.Specifically,it is manifested as the differentiation of values among the main entities within the county medical community,the uneven catalytic leadership of each levels and entities,vertical and horizontal institutional fragmentation and weak coupling among stakeholders to collaborate.Based on typical regional experiences,for the current dilemma of collaboration in county medical community,it proposes aoptimized paths for the collaborative evolution of tightly integrated county medical community in China.

Abstract:Objective Analyzing the distribution of policy attention in policy documents concerning county-level medical community at the provincial level in China,provides insights for enhancing the governance effectiveness and service capacity of these consortiums.Methods Guided by policy instrument theory,it conducted coding and quantitative analysis of county-level medical community policy documents from all provinces(autonomous regions and municipalities)in China using NVivo 11 software.Results The policy instrument structure showed imbalance:environmental,supply-side,and demand-side instruments accounted for 42.2%,36.4%,and 21.2%respectively.Organizational management and human resource support received the highest attention,while innovation environment optimization and performance evaluation mechanisms were significantly inadequate.Pilot regions achieved progress through resource integration and institutional innovation,the overall development trend is positive.Conclusion Optimizing policy attention allocation is key to enhancing county-level medical community effectiveness.Recommendations include strengthening systemic synergy among policy instruments,increasing application of demand-side tools,and formulating differentiated policies based on regional heterogeneity to improve governance capacity and service delivery.

Abstract:Objective To systematically identify the problems in the clinical use management of medical devices in medical institutions,analyze their severity and rank them,so as to provide a basis for optimizing management strategies.Methods Eighty-two relevant literatures from CNKl,Wanfang and Vl P databases from 2015 to 2025 were selected as the research objects.The literature content analysis method was used to extract and summarize the problems,and a structured problem list was constructed.The severity index calculation formula was used to quantitatively evaluate the severity of the problems.A problem system was constructed based on the"structure-process-result"theoretical framework.Results A total of 48 categories of issues were identified.Among them,the top three in terms of severity ranking are as follows:the relevant systems within medical institutions are imperfect,unscientific,or not fully implemented;the technical skills of maintenance personnel are outdated;and medical staff are unable to use medical devices correctly.Conclusion ln response to the core problems in the clinical use management of medical devices,it is necessary to improve the institutional system,build a professional maintenance talent team,and establish a hierarchical and classified training system for medical staff.

Abstract:Medication reconciliation plays a key role in improving patient medication safety,reducing inappropriate polypharmacy,and promoting the high-quality development of pharmaceutical services.Compared to advanced international guidelines,China's medication reconciliation service standards have deficiencies in areas such as definition and process design,and multidisciplinary team building.There is a need to establish a comprehensive medication reconciliation effect evaluation index system,develop pharmacist-led multidisciplinary teams,promote the advancement of artificial intelligence and big data technologies,and strengthen outpatient and community medication reconciliation coverage,thereby contributing to the high-quality development of pharmaceutical services in China.

Abstract:Objective To analyze the focus and shortcomings of provincial-level digitalization policies for Traditional Chinese Medicine(TCM),and to provide references for improving relevant policies.Methods A three-dimensional analytical framework—comprising"digitalization policy coverage-economic level-TCM development level"was constructed to quantitatively analyze provincial TCM digitalization policy documents issued over the past five years.Results A total of 750 policy items were extracted.Among them,digital applications accounted for the largest proportion(58.13%),while digital governance(26.53%)and digital infrastructure(15.33%)were relatively less emphasized.Two-dimensional analysis revealed that 48.4%of provinces had both low economic levels and low digital policy coverage,while 45.2%had both low TCM development levels and low policy coverage.Multiple linear regression result showed a positive association between digitalization policies coverage and TCM development level,with no significant correlation to economic level.Conclusion Most provincial TCM digitalization policies prioritize application while neglecting governance and infrastructure.There is a need to strengthen talent development and standard system construction,The extent of policy coverage is closely related to the level of TCM development,indicating the need to enhance top-level policy design,Provincial policies vary in focus and can be categorized into three types:industry-driven,technology-driven,and demand-driven.

Abstract:The traditional medical quality management model has many problems,such as excessive reliance on experience,poor coordination among departments,and lagging supervision,innovating medical quality management models has become an essential issue for the high-quality development of hospitals.A tertiary Grade A general hospital built a"data element multiplier"ecological chain for medical quality management,and established a complete closed-loop management system for medical quality management under the"Internet plus"model.Finally,the mobile medical quality management platform was built.Jointly driven by"Internet plus"and"data element multiplier",the level of lean management has been significantly improved,providing practical reference for hospitals at the same level.

Abstract:Objective To identify the thematic dimensions and analyze the strengths and weaknesses of inpatient experiences based on reviews of inpatient experience comments,and to propose improvement suggestions.Methods Open comments provided by inpatients at a tertiary hospital in Beijing between January 2023 and June 2024 were analyzed using sentiment analysis,LDA topic model and I PA analysis.Results The average sentiment score for all comments was 3.50,indicating overall positivity.LDA identified 1 1 themes.The dominant factors influencing inpatient experience were nurse service,doctor service,and diet,while sanitation and discharge settlement were identified as weak factors.Privacy protection,facilities,and bed resources were noted as areas for improvement,with accompaniment,access control,care worker services highlighted as maintenance factors.Conclusions The overall inpatient experience is positive.However,there is a need to maintain core competitive advantages of medical services while further enhancing tangible experiences related to sanitation and facilities.Additionally,efforts should be made to strengthen the accessible experience of discharge settlement and bed resources.

Abstract:Objective To explore the construction of a scientific and reasonable performance appraisal and evaluation system for clinical department heads in public hospitals,so as to provide reference for improving the operational efficiency and medical service quality of hospitals.Methods Preliminary construction of the indicator system through the literature research method,using the Delphi method to conduct two rounds of correspondence with 13 experts in related fields,screening and revising the performance appraisal evaluation indicators,and establishing the final indicator system.Results Formation of a performance appraisal and evaluation system for heads of clinical departments that includes 7 one-vote veto indicators,4 first-level indicators,19 medical and 24 surgical second-level indicators and 3 plus indicators,with the authority coefficients of the two rounds of expert consultation at 0.89 and 0.90,and the harmonization coefficients at 0.504 and 0.630,respectively,and with good results in consistency tests for indicators at all levels.Conclusion The performance appraisal and evaluation system for clinical department chiefs has good science and feasibility.It has played a positive role in promoting the connotative construction of the hospital and improving the management efficiency of the hospital,and can provide a reference for hospital management practice.

Abstract:Objective Itproposes a WISN staffing demand model for clinical physicians to address the challenge that current physicians staffing standards fail to meet the operational needs of general hospitals.Methods Collect the 2023 annual operation data of a tertiary general hospital,using inpatient visits and surgeries as benchmarks to measure the workload demands of physicians in internal medicine and surgery,respectively.Additionally,integrate non-clinical workloads of physicians and the workload of resident physicians in standardized training to address the limitation of traditional models that focus solely on clinical tasks.Results The good applicability and robustness of the model in practical applications are verified through model comparison and sensitivity analysis,accurately reflecting the demand for physicians.Conclusion The model accurately reflects the workload of physicians in general hospitals,providing a quantitative estimation formula for physicians staffing.It has broad applicability and significant potential for wider adoption.

Abstract:Objective To explore the application of cognitive interview in the development of Experience Scale of Patient Sense of Gain.Methods Purposive sampling method were used to select 13 inpatients of a tertiary grade A hospital in Xi'an,14 outpatients from a community health service center in Guangzhou,and 14 inpatients of a tertiary hospital in Guangzhong from February to April 2023 as the interviewees.The measurement tool was the preliminary version of Experience Scale of Patient Sense of Gain which was preliminary phase of research results of the group.Three rounds of cognitive interviews were conducted to explore the respondent'sunderstanding towards the items of the scale.The collected data were analyzed by thematic coding and the items of the scale were revised by the results of interviews and group discussion.Results After the first round of interviews,eight doubtful items were discussed and revised;after the second round of interviews,three doubtful entries were discussed and revised;and after the third round of interviews,all the interviewees were able to correctly understand the scale.Conclusion Cognitive interviews can provide insights into the target population's understanding of Experience Scale of Patient Sense of Gain,effectively addressing the problems of understanding differences between the developer and respondent in the process of the scale development,thus improving the accuracy of the scale.

Abstract:Objective To construct a comprehensive evaluation model for physician promotion in tertiary hospitals,which is systematic,scientific and operational.Methods Based on the physician competency model,a multi-level evaluation index system was constructed through literature review,policy analysis,and Delphi method.A simulation assessment was conducted using the CRITIC-TOPSIS method on 22 clinical physicians from a tertiary general hospital in Sichuan Province.Results The final evaluation model,established after two rounds of Delphi consultation,consisted of 4 first-level indicators,10 second-level indicators and 33 third-level indicators.The expert authority coefficient was 0.776,and the Kendall's W coefficients for the two rounds were 0.386 and 0.348(P＜0.01),respectively.The weights for clinical practice,teaching,research,and ethical conduct were 49.44%,18.82%,20.13%,and 11.61%,respectively.Simulation score results show that,the average relative proximity values of case physicians to be promoted to senior,associate senior,and intermediate titles were 0.50,0.43,and 0.39,respectively.Conclusion The model demonstrates scientific validity and reliability for evaluating physician promotion to intermediate and senior professional titles.Five supporting recommendations are proposed:talent development,standard optimization,health information system management,communication and feedback mechanism,and performance enhancement.

Abstract:Objective To evaluate the efficacy of the venous thromboembolism(VTE)digital risk prevention and control platform based on whole-process closed-loop management for the quality management of VTE in Peking University Shenzhen Hospital.Methods The data of 360 718 hospitalized patients from 2021 to 2024 were collected to analyze the rate of VTE risk assessment,the proportion of VTE intermediate and high-risk patients,the rate of VTE prophylaxis implementation(physical/pharmacological),and the VTE outcome indexes,and the differences between groups were verified using the Cochran-Armitage χ2 trend test.Results The VTE initial risk assessment rate,the implementation rate of VTE physical prophylaxis,and the rate of VTE pharmacological prophylaxis all showed an upward trend;the incidence rate of hospital correlated VTE,and the incidence rate of VTE in hospitalized surgical patients all showed a downward trend.Conclusion The establishment of the VTE digital risk prevention and control intelligent platform can effectively improve the level of standardized prevention and treatment of in-hospital VTE and the efficacy of quality management,and provide a digital management paradigm for the implementation of the national healthcare quality and safety improvement goals and the monitoring indicators of surgical quality and safety improvement actions.

Abstract:Objective To explore the coupling mechanism between medical surge response resources and the spread of secondary risks during public health emergencies,as well as the effectiveness of relevant interventions.Methods Based on complex network theory,a dual-layer network model of medical resources and secondary events was constructed.The interactive feedback between medical resource status and secondary event risk,as well as the effects of network structure,were analyzed through MATLAB simulations,REPAST agent-based modeling,and mean-field analysis.Results Simulation and prediction results show that an increase in first-layer resource-deficient nodes significantly raises the activation rate and transmission speed of secondary events,while the clustering and spread of secondary events in the second layer,in turn,intensify resource depletion,creating a negative feedback loop.Mean-field analysis indicates a nonlinear positive correlation between the adequacy of medical resources and the likelihood of secondary events.Network structure analysis reveals that when the average node degree exceeds 8,resource allocation efficiency improves markedly.Conclusion There exists a dynamic coupling and bidirectional feedback relationship between medical resource status and secondary event risks.Enhancing the flexible allocation and responsiveness of medical resources,improving multi-sectoral collaborative monitoring and coordinated regulation,optimizing network connectivity and coordination mechanisms for resource distribution,and establishing dynamic monitoring and tiered early warning systems are key strategies for strengthening the resilience of healthcare systems and effectively containing the spread of secondary events.

Abstract:Objective To identify the key factors affecting the risk of medical surges and their coupling relation5 ships,providing strategic support for medical institutions to optimize risk management and emergency governance.Methods 17 influencing factors were determined based on WSR theory,and an expert scoring method was employed to assess the impact strength among the factors.The DEMATEL method was applied to calculate the centrality,cau5 sality,influence,and being influenced degrees of the influencing factors.The ISM method was used to construct a hierarchical structure of the influencing factors related to medical surge risks,thereby revealing the connections and interaction mechanisms among these factors.Results Seven critical influencing factors were identified,including the crisis decision-making capacity and leadership effectiveness of emergency managers,the completeness of the emer5 gency system and dynamic execution capabilities,and the cross-departmental coordination mechanism and com5 mand collaboration efficiency.Deep driving factors and coupling pathways were also revealed.Conclusion The risk of medical surges exhibits multi-factorial coupling cascade effects;attention should be directed towards the construc5 tion of mid-to-deep level mechanisms such as information systems,institutional frameworks,and organizational management,to enhance targeted capabilities and systemic resilience in risk governance.

Abstract:Objective Exploring the components of complex scenarios of healthcare surges triggered by major epidemics to provide a theorical basis for building resilience in healthcare organizations.Methods A hybrid analysis method is used to summarize macro-meso-micro multi-level and multi-source heterogeneous information,extract the elements of complex scenarios of medical surge and evaluate the rationality.Fault Tree Analysis method is used to clarify the logical relationship between various scenario elements and construct scenario reasoning paths.Results 10 scenario states,11 disaster-bearing,24 emergency management and 23 scenario results are summarized and extracted to form the key elements of complex surge scenarios.Among them,M4 expansion and coordinated scheduling of key positions,B2 conventional drug inventory emergency/insufficient core treatment drugs,B emergency medical material transportation breakage,S3 disease symptom spectrum shift to severe disease,R13 prevention and control awareness laxity,and M5 media information dissemination management are the key driving factors that promote a major turning point in the scenario.The most positive scenario result is the orderly operation of the medical service system,and the most negative scenario result is the paralysis of the medical service system.Conclusion Medical institutions need to improve emergency plans based on the complex evolution scenarios of medical surges and agile governance capabilities targeting key turning points,focus on dynamically expanding and scheduling personnel in key positions,strengthen material rotation and reserve mechanisms,maintain smooth emergency logistics channels,and improve efficient management of media and public opinion,so as to comprehensively improve overall resilience.

Abstract:Objective To systematically identify the scenario elements of unconventional hospital infection outbreaks and provide a theoretical framework for preventing and resolving unconventional hospital infection outbreaks.Methods The literature related to unconventional hospital infection outbreaks was searched,and the text was preprocessed by Chinese word segmentation technology,and the element categories were condensed layer by layer based on the three-level coding of grounded theory.Results A total of 122 initial concepts,52 initial categories,13 sub-categories and 4 main categories were extracted disaster causing factors,disaster bearers,disaster environment,and emergency activities,and the action types:disaster factors driving the causal chain,disaster bearers bearing the mediating conduction,disaster environment exerting moderating effects,and emergency activities had two-way feedback.Conclusion The four-dimensional scenario factor action type model constructed breaks through the traditional one-way causal framework and provides a qualitative theoretical framework for factor association for the prevention and control of hospital infection outbreaks.

Abstract:Objective To define the conceptual connotation and characteristics of medical surges,and to construct a theoretical analysis framework for responding to medical surges based on complex networks.Methods By systematically reviewing relevant domestic and international research and practices,and from the perspective of complex networks and interdisciplinary integration,it analyzed the concept connotation,characteristics and comprehensive analytical framework of medical surges.Results The concept and connotation of medical surges were defined,and six major characteristics were summarized:sudden and surging congestion,overload spillover,stage recurrence,complex network and multi-dimensional collaboration,dynamic nonlinear multi-path evolution,and cascading amplification.A theoretical analysis framework was developed,encompassing four dimensions("risk and vulnerability coupling-complex surge scenario characterization-complex risk network chain drive-network dynamic collaboration capacity assessment and construction"),multiple hierarchical levels("macro-level healthcare system-meso-level hospital department functional systems-micro-level resource elements system"),and multiple scales("Wuli-Shili-Renli").Conclusion The proposed conceptual connotation,characteristics,and multi-dimensional,multi-level,and multi-scale theoretical analysis framework provide new perspectives and theoretical support for advancing the theoretical system of medical surges,guiding healthcare institutions to respond scientifically to surge impacts,and enhancing system resilience and network dynamic collaboration capacity.

Abstract:Objective To analyze the impact of medical insurance payment method reform on the efficiency of health services in China and provide empirical evidence for optimizing payment policies.Methods Using panel data from 31 Chinese provinces from 2012 to 2022,it measured health service efficiency with super-efficiency SBM model,assessed the effects of payment reforms using a staggered DID model,and analyzed the heterogeneous impacts of health informatization levels and health resources.Results DRG payment method reform increased health service efficiency,while no evidence was found that DIP payment method reform improved efficiency.Heterogeneity analysis showed that DRG payment method reform effects were not significantly influenced by health informatization levels or bed resource distribution,where as DIP payment method reform's negative effects were positively moderated in regions with higher informatization or abundant bed resources.Conclusion DRG payment method reform can improve the efficiency of healthcare services.It is recommended to accelerate the promotion of the DRG payment method system.Regarding the reform of the DIP payment system,it is recommended to improve the DIP scoring settlement mechanism,strengthen refined disease management,optimize hospital information system construction,enhance the medical insurance information platform and medical record quality control system,in order to improve hospital management levels and service efficiency.

Abstract:Objective To systematically evaluate the service efficiency and its differences among different types of medical institutions in Guangdong under the background of DRG payment reform,and to provide reference for optimizing regional medical insurance payment policies.Methods Using data from the Comprehensive Evaluation and Analysis Report on DRG Inpatient Medical Services in Guangdong Province in 2023,it compared the service efficiency differences among different types of medical institutions in Guangdong under the background of DRG payment reform,employing the length of stay consumption index,cost consumption index,and drug and consumable cost consumption index as research indicators.The Kruskal-Wallis H test was used to compare the service efficiency differences among different types of medical institutions in Guangdong,and linear regression analysis was applied to explore the relationship between the cost consumption index and the drug and consumable cost consumption index.Results There were statistically significant differences in the length of stay consumption index,cost consumption index,and drug and consumable cost consumption index among different types of medical institutions in Guangdong(P＜0.05).For the same disease group,the average length of hospital stay in Traditional Chinese Medicine hospitals is longer;the average hospitalization costs and drug expenditure per visit in tertiary public general hospitals are higher;while the average length of hospital stay and average hospitalization costs per visit in secondary public general hospitals,maternal and child health care hospitals,and county people's hospitals are relatively lower.Conclusion It needs to establish a quantitative management mechanism based on the DRG indicator system,improve dynamic adjustment and incentive policies for medical insurance payments,and optimize TCM-specific DRG grouping and payment standards,in order to systematically promote the reform of medical insurance payment methods.