Abstract:How to fully reflect the technical labor value in medical services is a key issue in deepening the medical and health system reform.Following to the principle of"socially necessary labor",it theoretically expounds the connotation characteristics and determining factors of the technical labor value,and constructs a multi-dimensional analysis framework that includes the characteristics of service items,technical labor input,and service quality levels.Among them,technical labor input is the basic dimension,including acquisition of knowledge and skills and actual labor consumption.The characteristics of service items and the level of service quality are taken as the adjustment dimensions,respectively reflecting the technical complexity and risk of service items with the core elements including time consumption,technical difficulty and risk degree,and the utility of service output with diagnosis and treatment quality&safety and service satisfaction as the core elements.The analytical framework of this determining factor provides theoretical support for the quantitative measurement of the technical labor value in medical services and the reform of the medical service price and salary system.

Abstract:Compiling and making good use of medical service price indices can enhance the coordination between medical service prices and the level of economic development.Against the backdrop of the key tasks of deepening medical reform,it introduces the significance of compiling the medical service price index.Based on a review of the requirements at the national level for compiling the medical service price index,and in combination with the application practice of the dynamic adjustment plan of medical service prices in typical regions for the medical service price index,it gains inspirations for improving and operating the dynamic price adjustment mechanism in various regions:compile a medical service price index and incorporate it into the dynamic adjustment assessment index system of medical service prices;make good use of the medical service price index,strengthen horizontal comparisons,and promote reasonable price connections among adjacent regions.

Abstract:Objective:To address issues such as lagging price adjustments for special medical services,regional imbalances,and insufficient collaboration among multiple stakeholders.Methods:Constructing an SFIC moded adjusted by special medical service price adjustment to analyze the collaborative governance elements and challenges faced by the dynamic adjustment of special medical service prices.Corresponding policy recommendations were proposed.Results:According to the SFIC collaborative governance model,the dynamic adjustment of special medical service prices in China faces issues such as regional resource imbalance,lack of patient trust,regulatory vacuum caused by fragmented management,cost distortion resulting from dual failures,and inconsistent objectives among stakeholders that hinder the achievement of collaborative consensus.Suggestion:Targeted solutions are proposed from optimizing starting conditions,strengthening leadership,improving institutional implementation,and facilitating collaborative feedback.A dynamic adjustment mechanism of"institutional track+market track"dual track system is proposed to form a collaborative governance implementation path of"fiscal collaboration promotes public welfare,technical coordination enhances oversight,economic zone interconnection fosters regional synergy,and comprehensive policies maximize shared benefits",providing feasible solutions for the dynamic adjustment of special medical service prices.

Abstract:To explore how to implement progressive reforms in internal control systems during mergers and reorganizations while preventing and controlling operational risks in public hospitals.Through literature review and analysis of internal control practices in sample hospitals,it explores a"three-step"framework for internal control development(system integration,scenario reconstruction,and digital empowerment)has been established.Therefore,the mergers and reorganization of public hospitals in prefecture-level cities should establish an internal control construction path suitable for the development of the hospital according to the actual situation of the hospital,so as to help reduce the financial risk,enhance the operation ability and improve the management level of the hospital.

Abstract:Objective:It examines how health financing and related factors,including development assistance for health and innovative health financing tools,effect on life expectancy amid high public debt and debt distress in low-income countries,and analyze the role of innovative financing instruments.Methods:Global panel data were used to construct a fixed-effects model to assess the effects of health financing,income,trade openness,government corruption,and population growth on life expectancy,and mediation analysis was performed.Results:Health financing,income,trade openness,and government corruption had significant positive effects on life expectancy,while population growth had a significant negative effect.Mediation analysis showed that governance corruption reduced the effectiveness of health financing,producing a negative indirect effect that accounted for 2.1%of the total effect.Although innovative financing instruments such as debt swaps and pandemic bonds can provide additional resources to the health sector,their effectiveness was weakened by corruption in resource allocation and financing environments.Conclusions:Strengthening health financing is essential to improving population health,but governance corruption undermines efficiency and limits the sustainability of innovative financing tools.It is recommended that policymakers enhance governance and transparency while promoting the application of debt swaps and pandemic bonds to improve global health outcomes under debt constraints.

Abstract:It aims to develop a post-investment risk management mechanism for government bonds applicable to public hospitals,focusing on debt repayment capacity and strengthening forward-looking risk early warning,so as to effectively enhance the debt risk prevention and control level of public hospital construction projects.Using scenario analysis and case study methods,asset evaluation is integrated into the post-investment management process of government bonds,achieving a deep integration of debt repayment capacity orientation with the asset characteristics of hospitals.An innovative"Risk Graded Classification and Closed-Loop Management"model is proposed.Based on asset evaluation results,projects are categorized into high,medium,and low risk levels.Corresponding differentiated risk management strategies are designed,covering three aspects:asset restructuring and optimization,operational improvement and revenue enhancement,and financial and debt optimization.A"monitoring-early warning-disposal-feedback"management closed loop is established.The risk management mechanism anchored in asset evaluation provides a systematic and operable tool for post-investment management of government bonds.It helps public hospitals improve their debt repayment capacity and project management proficiency,while guiding multiple stakeholders,including hospitals,fiscal departments,and regulatory agencies,to enhance post-investment risk management for government bonds.

Abstract:Objective:To study the cost accounting and the cost structure of high-frequency nursing service items in the ICU,in order to provide a reference for formulating scientific and reasonable medical service pricing standards.Methods:The activity-based costing was used to calculate the activity-based cost and total cost of nursing service items.The specific steps included dividing the operation process,determining cost drivers and resource consumption,and cost accounting and analysis.Results:Ten nursing service items,including intravenous transfusion,endotracheal intubation nursing,and endotracheal suctioning,were included.The actual cost of each item ranged from 23.95 yuan to 46.82 yuan.The actual cost of all items was higher than the current charging standards.Among the 10 nursing service items,labor costs accounted for the highest proportion(50.94%to 71.85%),followed by indirect costs(13.14%to 27.72%),medical material costs(2.52%to 15.71%)and fixed asset depreciation(8.03%to 10.40%).Conclusion:There is a significant gap between the current medical service price norms and the actual costs,which reveals that the current medical service pricing mechanism underestimates the technical difficulty,risk level and actual resource consumption of nursing services,resulting in a deviation between the current charging prices and the actual value of service items.In the future,reasonable value realization and resource allocation can be promoted by establishing a scientific and reasonable pricing mechanism.

Abstract:Objective:Based on the hospital management perspective,it aims to compare the economic performance of conventional manual injection versus automated high-pressure injection systems in coronary interventional procedures,and to assess costs and resource utilization efficiency to inform clinical and managerial decision-making.Methods:Cost and time data from cardiac catheterization laboratories in sample hospitals in 2023 were collected through on-site surveys,key informant interviews,and expert consultation.Time-Driven Activity-Based Costing(TDABC)was used to estimate the costs of coronary angiography(CAG)and percutaneous coronary intervention(PCI),and the distribution of cost components were analyzed to provide evidence for optimizing the resource allocation.Results:The per-case total costs of CAG and PCI using manual injection were 2 802.56 yuan and 13 348.45 yuan,respectively;corresponding costs using automated high-pressure injection were 2 700.00 yuan and 13 587.92 yuan.Consumables constituted the largest share of total costs,followed by equipment and labor.Conclusions:Automated high-pressure injection improves procedural efficiency,optimizes resource allocation,and reduces labor costs,aligning well with cost-containment requirements under DRG-based payment systems.

Abstract:Conventional pharmacoeconomic evaluation pathways face issues such as implicit neutrality concerns,excessive model complexity,and variability of outcomes.To better support management decision-making,it is necessary to propose a more transparent and neutral pharmacoeconomic evaluation method.Based on pharmacoeconomic principles,it introduces a structured evaluation framework that independently conducted and presented components such as clinical efficacy analysis,economic value analysis,and drug cost analysis.A hypothetical case study was employed for illustration.Structured pharmacoeconomic evaluation offered a more transparent,neutral,and understandable alternative to conventional methods,with the potential to better inform and support healthcare management decisions.

Abstract:Building an efficient and lean operation management system has the core issue to promote the high-quality development of public hospitals.Taking the Cleveland Clinic,a benchmark of global medical operation,as an example to systematically analyze its core advantages such as the mission-driven strategy of"patient-centrism",the lean management framework,the data-driven indicator system,the technology-empowered innovation and the synergistic team mechanism.In combination with the domestic policy orientation and social background,and in view of the key difficulties such as the disconnection of the management,the lack of digital application,the imbalance of talent incentive and the low efficiency of cross-departmental collaboration,it proposes the optimization paths such as constructing the mission-strategic system,implementing the data lean management model,deepening the digital empowerment,cultivating the synergistic team culture and perfecting the full-cycle talent training and incentive,aiming to provide theoretical reference and practical guidance for domestic hospitals to achieve the coordinated improvement of medical quality,patient experience and operation efficiency.

Abstract:On January 9,2025,the China-ASEAN Medical Regional Procurement Platform,guided by the National Healthcare Security Administration and developed by local authorities,was officially launched in Fangchenggang,Guangxi.The establishment of this platform is deeply rooted in the long-standing cooperation between China and ASEAN in political,economic,and health-related fields.However,the platform's implementation still faces multiple challenges.Based on a review and analysis of existing literature and data,it clarified the institutional foundations underpinning the launch of the platform,examined the current development of the ASEAN pharmaceutical market,and revealed its unmet therapeutic needs and potential entry opportunities.Nevertheless,Chinese pharmaceuticals still encounter various policy barriers when entering ASEAN markets,including those related to registration,inspection,procurement and distribution,local protectionism,and Halal certification,all of which increase the time and cost of market entry.It is recommended to ensure the platform's efficient operation and intended effectiveness,accelerate the establishment of regulatory coordination mechanisms in areas such as drug registration,inspection,procurement,and distribution in China and ASEAN.

Abstract:Objective:To analyze the"triangular dilemma"arising from conflicting objectives and counterproductive incentives among the finance department,medical insurance department,and public hospitals during public hospital reforms,and to explore the theoretical logic and fiscal pathways toward"systemic synergy".Methods:Based on property rights theory,incentive compatibility principles,and systemic coordination theory,a theoretical model of"dilemma analysis,role reshaping,pathway construction"was developed and analyzed through literature review and policy deduction.Results:The"triangular dilemma"stems from the government's improper fulfillment of property rights responsibilities and distorted systemic incentive structures.As both the property rights holder and"meta-governor"of the system,the finance department must transcend simple compensatory funding.Its role should be elevated through establishing a foundation for coordination via performance-based compensation,activating coordination momentum through strategic purchasing empowerment,and building coordination safeguards by constructing information platforms,thereby guiding the system toward public welfare objectives.Conclusion:Realizing the public welfare nature of public hospitals hinges on the fiscal department's transformation from"direct operator"to"system architect".Through sophisticated mechanism design,this shift will foster a community of shared destiny among the three parties-aligning objectives,complementing functions,and ensuring incentive compatibility.

Abstract:Objective:To analyze the basic public health service efficiency in Bijie City,Guizhou Province,and provide empirical evidence for improving its operational efficiency.Methods:A three-stage DEA model was used to conduct a static analysis of the efficiency of basic public health services in Bijie from 2020 to 2024,and the Malmquist index was used for dynamic analysis.Results:After excluding the influence of environmental variables and random interference factors,the overall efficiency of Bijie City,Qianxi County,Jinsha County,and Weining County improved year by year,while the remaining seven districts and counties remained completely effective in DEA(TE=PTE=SE=1.000).The average total factor productivity of basic public health services in Bijie City from 2020 to 2024 was 0.918.Conclusion:The overall efficiency of basic public health services in Bijie City is relatively good,but regional differences are more obvious,mainly constrained by management capabilities,technological progress,and resource allocation structure.It is recommended to improve the service efficiency from pooling resource allocation,refined management,and promoting the technology application efficiency.

Abstract:Objective:It aims to analyzes the influencing factors of diabetes outpatient costs and conduct case grouping,providing references for chronic disease outpatient cost management and deepening of the medical insurance system.Methods:Outpatient medical insurance claims data of diabetic patients in Lanzhou during 2022-2023 were retrospectively analyzed.Univariate analysis and multivariate linear model were applied to explore the factors affecting outpatient medical cost.A decision tree model was applied for outpatient case grouping,followed by evaluation and cost estimation of the case combinations.Results:A total of 14 038 valid data were included.The outpatient medical cost for diabetes is associated with patient gender,ethnicity,age,type of diabete(P＜0.05).The E-CHAID decision tree model identified 9 case combinations,with Combination 9 having the highest number of cases and Combination 3 the lowest;Combination 4 had the highest standard cost,and Combination 3 the lowest.The coefficient of variation values for all case combinations were close to 1,reduction in variance values of 0.978,and related weight values ranging from 0.30 to 1.33.Conclusion:The core factors influencing the outpatient medical cost for diabetes patients are medication,diagnostic tests,and patient age.Grouping outpatient cases based on a decision tree model yields good results,with strong homogeneity within groups and heterogeneity between groups,and significant differences in cost standards across different combinations.It is recommended to strengthen the control of outpatient medical costs for diabetes,promote the development of a diversified outpatient payment system,collaboratively optimize chronic disease diagnosis and treatment protocols,and standardize electronic medical record documentation,so as to alleviate the economic burden on patients and advance the reform of outpatient medical insurance systems.

Abstract:Against the backdrop of public hospitals generally facing multiple challenges such as the requirements for high-quality development and the pressure of refined operation,exploring a scientific and effective performance management system based on the work score mechanism has become a key link in driving the sustainable development of hospitals.The performance management based on the work score mechanism implemented by Peking University First Hospital Taiyuan Hospital is a systematic practice of localized and institutionalized innovation of the core concepts of the Resource-Based Relative Value Scale(RBRVS).Based on an analysis of the limitations of the traditional performance management model,it takes Peking University First Hospital Taiyuan Hospital as a case,systematically expounds the implementation path of performance management under the work score mechanism,quantitatively analyzes its implementation effects in terms of medical quality,operational efficiency and cost control,and puts forward in-depth suggestions for key links such as the setting of work scores and the secondary distribution mechanism,aiming to provide references for the optimization of performance management and the high-quality development of public hospitals.

Abstract:Objective:To analyze the equity and spatial characteristics of community health human resource allocation in Guangzhou from 2018 to 2023,providing empirical evidence and decision-making references for optimizing the distribution of primary health human resources in Guangzhou and similar megacities to enhance service capacity and equity.Methods:Based on data from the 2018 Guangzhou Health and Family Planning Statistical Yearbook,the 2019-2023 Guangzhou Health Statistics Yearbooks,and the 2018-2023 Guangzhou Statistical Yearbooks,the Gini coefficient,Theil index,and Moran's I were used to comprehensively evaluate the human resource allocation in Guangzhou's community health centers.Results:The total human resources in Guangzhou's community health centers showed steady growth.Equity in allocation based on population was better than that based on geographic area.Global Moran's I was significantly positive and rose,showing strengthened spatial clustering;a"core-periphery"polarization pattern formed.Conclusion:While the total volume of human resources in Guangzhou's community health centers has increased,significant spatial distribution inequities persist.It is recommended to incorporate geographic accessibility into resource allocation standards to promote spatial equity in health human resource distribution.

Abstract:Objective:The interrelationship among weight,magnification,and patients'Out-of-Pocket(OOP)within the DRG payment system were analyzed to provide empirical evidence for optimizing the DRG payment policy and reasonably controlling patients'medical burden.Methods:The data of 46 342 patients who were successfully enrolled and paid through DRG in a tertiary hospital of Wuhan from 2023 to 2024 were utilized.After conducting a correlation analysis,a moderation effect model,a grouped linear regression model,and a quantile regression model were constructed to explore the relationships among these three elements.Results:Partial correlation analysis after controlling for confounding factors showed that the three elements were significantly correlated.The multiple played a significant positive moderating role in the relationship between weight and OOP.As the multiple increased,the positive impact of weight on OOP grew explosively.The size of the quantile regression coefficient showed a significant increasing trend as the quantile increased.The impact of weight on OOP was the strongest at the 90%quantile point of OOP(P＜0.01).Conclusion:In DRG payment,there is a close relationship among weights,case multipliers,and OOP.Weights establish the cost benchmark,while case multipliers cause the actual costs to fluctuate above and below this benchmark,and the combined effect of these two factors ultimately determines the level of the patient's economic burden.

Abstract:Establishing a high-quality and efficient pediatric medical service system is a crucial task for accelerating the development of Healthy China and safeguarding the healthy growth of children.Currently,China's children's medical services still face structural challenges such as uneven resource allocation,inefficient coordination mechanisms,and insufficient health management.Taking Fujian Province as an example,it systematically analyzes the prominent problems in its pediatric medical service system in terms of regional resources,hierarchical diagnosis and treatment,and full-cycle health services.Based on the practices of National Regional Children's Medical Centers,it proposes a systematic optimization path centered on"strengthening core leadership,promoting resource integration,transforming service models,and improving support mechanisms".The aim is to drive the transformation of the children's medical service system from a disease-centered to a health-centered model,providing practical references for promoting the high-quality development of children's medical services.

Abstract:Objective:To analyze the internal composition and changes in hospitalization costs for the elderly patients with noncommunicable chronic diseases(reffed as chronic disease)in Guangdong,and to predict the trend of these costs.Methods:The hospitalization data of elderly patients with chronic diseases in Guangdong from 2019 to 2023 were collected.Structural variation analysis and grey correlation analysis were employed to study the proportion,variation,and correlation degree of various components of hospitalization expenses.A Grey GM(1,1)model was constructed to predict the average hospitalization expenses per case.Results:From 2019 to 2023,the average cost per hospitalization for the elderly patients with chronic diseases in Guangdong showed a declining trend.The largest component of hospitalization costs was medical service fees.The most significant negative structural change was ob-served in drug revenue,while the most significant positive change was shown in examination and laboratory test fees.Medical service fees,total medical insurance payments,and out-of-pocket payments exhibited a high degree of association with total hospitalization costs.The GM(1,1)model predicted that the average cost per hospitalization for elderly patients with chronic diseases would continue to decline from 2024 to 2030.Conclusion:From 2019 to 2023,the average hospitalization expenses per case for elderly patients with chronic diseases in Guangdong Province decreased steadily,and the expense structure tended to be optimized.It is essential to sustain cost-containment measures for chronic conditions among the elderly to maintain a reasonable and gradual reduction in hospitalization ex-penses.Efforts should also focus on further refining the cost composition of chronic disease hospitalizations and enhancing oversight of key cost components.

Abstract:The high-quality development of the biopharmaceutical industry requires a new productivity theory for guidance.Based on a deep understanding of the theoretical essence and contemporary significance of the new quality productive forces,it systematically elaborates on the issues and challenges faced by China's pharmaceutical industry.It offers an in-depth analysis of the current obstacles and barriers that constrain the development of new quality productivity in the pharmaceutical sector.Furthermore,it proposes policy recommendations for deepening healthcare system reform,establishing new production relations that align with the needs of the industry,creating institutional mechanisms conducive to the development of new quality productivity in pharmaceuticals,and improving mechanisms that support the growth of innovative drugs and medical devices.