Abstract:Objective To investigate the current situation of effort-reward imbalance,career resilience,and perceived organizational support among physicians in public hospitals,and to explore the impact of effort-reward imbalance on career resilience and the mediating role of perceived organizational support between them.Methods A total of 660 physicians from five secondary and tertiary public hospitals in a central province were selected as survey respondents,and were surveyed using General Information Questionnaire,Effort-Rewardl mbalance Scale,Perceived Organizational Support Scale,and Career Resilience Scale.Data analysis and testing were performed using the SPSS PROCESS macro plugin.Results Effort-reward imbalance negatively predicted career resilience(β=-0.076,P＜0.05).Perceived organizational support played a fully mediating role in the effect of effort-reward imbalance on cognitive resilience(β=-0.049,P＞0.05)and behavioral resilience(β=-0.047,P＞0.05),and played a partially mediating role in the effect of effort-reward imbalance on emotional resilience(β=-0.137,P＜0.001).Conclusion Perceived organizational support is a mediating variable between the effort-reward imbalance and career resilience of physicians in public hospitals,and hospital administrators can reduce the effort-reward imbalance and enhance career resilience of physicians by reducing the load on physicians,enhancing the sense of acquisition,and establishing a multidimensional support system.

Abstract:Technological innovation is pivotal to the core competitiveness of public hospitals and safeguarding national health.As a tool of new-quality productive forces,digital technology holds significant importance for hospital technological innovation.It constructs a framework based on embeddedness theory,examining the manifestations,bottlenecks,and pathways of digital technology embedded in the transformation of scientific and technological achievements within public hospitals across four dimensions:structure,function,relationships,and cognition.While digital technology drives quality and efficiency improvements in public hospitals,it also faces challenges such as structural fragmentation and inadequate coordination mechanisms.Public hospitals need to build an integrated digital medical ecosystem,unleash the multidimensional effectiveness of digital technology,create a deeply integrated network of medical care,research,and production,and consolidate the foundation for digital medical innovation.

Abstract:Objective Developing a localized scale of Patient Sense of Gain Experience for healthcare institutions based on value co-creation theory.Methods Building upon preliminary research,a three-round delphi consultation was conducted with 27 experts.The response rate,authority coefficient,and Kendall's W coefficient were employed to evaluate the reliability of the consultation process.Results The response rates were 77.14%,92.59%,and 100.00%across three rounds,with authority coefficient is 0.88.Expert consensus significantly improved:Kendall's W coefficient for dimensions increased from 0.125 to 0.271,and for items from 0.179 to 0.322(P＜0.01),while coefficients of variation decreased progressively.The finalized scale comprises 2 levels(micro and macro),8 dimensions,and 31 items.Conclusion This expert-consensus-based scale serves as a standardized measurement tool for healthcare institutions to optimize services and for health administrative departments to evaluate medical reforms.Further validation of its psychometric properties through large-scale studies is warranted.

Abstract:Based on the background of performance monitoring,taking the surgery department of a tertiary grade-A hospital as the research object and exploring the practical path and implementation effect of intensive allocation of medical resources.In response to the structural obstacles in resource allocation,the imbalance between supply and demand of bed resources,the insufficiency of service continuity,and the insignificant effect of the performance command stick in the surgery department of the hospital,the hospital promoted the"static and dynamic combination"bed resource optimization allocation mechanism through the hospital regular meeting system,established a multi-mode linkage diagnosis and treatment process combination transformation of"pre-hospitalization+one bed for the whole hospital+day care",promoted the construction of specialized disease centers,and improved the performance incentive mechanism of"basic and advanced"in parallel.At the same time,it implemented the"one theme per month"quality and safety special action to ensure medical quality and medical safety.The practical results show that the surgery department has significantly improved the efficiency and capacity of medical services under the premise of ensuring medical quality and safety.

Abstract:As the mainstay of the medical service system,the technological innovation capabilities of public hospitals directly impact medical quality and public health standards.Promoting holistic,full-chain,and highly efficient collaborative governance for technological innovation in public hospitals is crucial.Drawing upon collaborative governance theory,it systematically analyses the developmental challenges facing scientific and technological innovation in public hospitals across three dimensions:macro,meso,and micro.Consequently,it proposes optimisation strategies including advancing holistic governance,reshaping clinically-oriented evaluation systems,fostering innovation communities,and refining incentive mechanisms.These measures aim to enhance the collaborative efficacy of scientific and technological innovation within public hospitals,thereby propelling the high-quality development of healthcare services.

Abstract:Currently,most medical institutions have not standardized the management of off-label drug use.Using the theory of total quality management,the management system and implementation rules for off-label drug use were jointly formulated with multiple departments of the hospital.The implementation process and quality control of each link were clarified,which has effectively enhanced clinical awareness of off-label drug use and regulated the behavior of off-label drug applications.

Abstract:Objective Analyze China's medical insurance payment reform since the new healthcare reform,current policy landscape and shortcomings,and provide references for refining the reform.Methods Using ROST CM 6 software to systematise national-level policy documents on payment system from 2009 to 2024,it identified the major payment methods and established a Policy Modeling Consistency(PMC)index system to quantitatively evaluate and compare major payment methods.Results Diagnosis-Related Groups(DRG)and Diagnosis-Intervention Packet(DIP)payment methods were the most frequently-referenced payment methods,indicating their central role in China's medical insurance reform agenda.PMC evaluation showed a higher policy quality for DIP(mean index=6.25)compared to DRG(mean index=5.76).Conclusion Since the new healthcare reform,policy iterations had driven the establishment of a diversified composite payment system.Medical insurance payment method reforms had entered a phase of precision development.As the two primary payment methods,the number and frequency of DIP payment policies were lower than those of DRG payment policies,but their policy quality surpassed that of DRG payment policies.Both DRG and DIP shared challenges including short-term policy orientation,limited stakeholder perspectives,and insufficient incentives.The findings suggested to strengthen the combined use of DRG/DIP with other payment methods in the policy implementation of medical insurance payment approaches reform.

Abstract:It conducts a systematic study on the development of DCMCs,constructing an analytical framework from three dimensions:connotation deconstruction,transformation pathway,and advancement mechanism.DCMCs,are characterized by"service integration,evidence-based management,and digital drive,"achieving paradigm shifts in developmental impetus,collaboration modes,and health service delivery.In terms of the transformation pathway,it emphasizes the synergistic advancement of technological adaptation,organizational transformation,and policy support:technologically,focus should be placed on aligning supply and demand to avoid blind construction;organizationally,it is necessary to build data-driven service models,process reengineering,and structural adjustments;policy-wise,top-level design,resource guarantees,and cross-departmental coordination should be strengthened.In terms of the advancement mechanism,it proposes digital governance and digital capabilities as the twin engines.Governance mechanisms are designed to mitigate technical risks,regulate personnel behavior,and balance organi-zational interests,while the enhancement of digital operational capabilities and digital dynamic capabilities facilitates the continuous evolution of the healthcare consortium from tool application to ecological collaboration.

Abstract:Objective Through a systematic review and quantitative analysis of 199 policy texts related to performance salary in primary health care institutions in China from 2009 to 2024,the purpose of this paper is to reveal the evolution context and text characteristics of the policy,and to explore the improvement direction of the current policy.Methods Based on the three-dimensional analytical framework combining policy tools,policy objectives and policy diffusion stages,the single-dimensional and multi-dimensional interactive analysis of performance salary policy items in primary health care institutions was carried out by content analysis.Results The use of policy tools was dominated by supply-oriented tools(44.45%),supplemented by demand-oriented tools(32.87%),and environment-oriented tools were the least(22.68%).Among the policy objectives,"improving long-term incentive mechanisms"accounted for the highest(30.67%),while"enhancing public service levels"represented the lowest(9.43%).The number of policy documents across three diffusion stages increased progressively,demonstrating a gradual and hierarchical diffusion pattern.Conclusion It is suggested to further optimize the internal and external structure of policy tools,emphasize multidimensional objectives coverage and alignment,address variations across diffusion stages.Additionally,strengthen the two-dimensional integration of objectives and tools,and encourage local governments to innovate policies based on local conditions.

Abstract:Objective To analyse the focal points and limitations of China's healthcare science and technology innovation policies,offering insights for future policy refinement.Methods It conducted a quantitative analysis of national-level healthcare science and technology innovation policy documents issued between 2012 and 2024.Using a two-dimensional analytical framework comprising the policy tools dimension and the innovation value chain dimension was employed to conduct quantitative analysis.Results Analysis of 50 policy documents revealed that supply-type,environment-type,and demand-type policy tools accounted for 39.88%,46.87%,and 13.25%respectively in the X-dimension.In the Y-dimension,policies addressing the research and development,production and application,industrialization and marketization stages of the innovation value chain constituted 46.78%,37.36%,and 15.86%respectively.And the difference in the distribution of the use of different types of policy instruments along the innovation value chain dimensions is statistically significant(P＜0.01).Conclusions China's healthcare science and technology innovation policy is characterized by an imbalance in the structure of tools,poor connection between the stages of the innovation value chain,and insufficient policy synergies,it is recommended to optimize the balance of tools,strengthen the whole chain of support,and promote the dynamic combination of policies in order to enhance the effectiveness of innovation and the transformation of results.

Abstract:Against the backdrop of national medical insurance payment reform,it focuses on the incentive mechanism of Traditional Chinese Medicine(TCM)DRG payment in Zhejiang Province.By sorting out policy texts,integrating operational data of the authors'hospital and medical insurance settlement information,it systematically analyzes the practical effects of Zhejiang's combined policies of"TCM DRG grouping+TCM treatment rate incentive+outcome-based payment".It finds that there are currently problems of insufficient incentives such as undervaluation of TCM DRG groups and overspending of integrated Chinese-Western medicine cases.In response to these problems,it proposes optimization suggestions such as constructing a"two-dimensional evaluation model"to identify undervalued DRG groups,establishing a classification and price comparison relationship between TCM and Western medicine DRG groups,and improving the outcome-oriented dynamic adjustment mechanism,aiming to provide reference for improving TCM-friendly medical insurance payment policies.

Abstract:Driven by the background of national policies promoting the high-quality development of public hospitals and the application of"Artificial Intelligence+Healthcare",from the perspective of innovation diffusion theory,it takes the innovation promotion path of the large-model medical record writing system at the First Affiliated Hospital of Anhui Medical University as a case study.It analyzes the innovation characteristics and dissemination channels,proposes an innovation optimization framework that includes the optimization of innovation characteristics,integration of communication channels,and hospital system support.It systematically explores the pathways for promoting technological innovation in public hospitals,providing a new perspective on the innovation promotion mechanism.

Abstract:Objective The strategic human resource management(SHRM)model in clinical departments enables flexible changes in staffing and division of responsibilities based on practical needs,giving employees more autonomy and opportunity for initiative in their work.This method attempts to increase employeesinnovative engagement and stimulate their innovation capacities.Methods A questionnaire survey was done among 281 clinical department staff from a tertiary infectious disease hospital in Beijing.Fuzzy-set Qualitative Comparative Analysis was applied to study the influence of clinical SHRM on organizational ambidextrous innovation capability,providing practical insights for developing innovative behaviors among clinical staff.Results Two main pathways emerged"Absorption-Driven Deficiency"and"Development-Oriented Absorption Gap"with a total of four primary configurations identified for increasing ambidextrous innovation capability.Human resource absorptive capacity and development capability were identified as core conditions.Certain conditions in the configurations showed substitutability in influencing innovation capability.Conclusion Specialized infectious disease hospitals'clinical departments must explore innovative development paths suited to their context.They need to enhance human resource management by promoting multi-ability coordination.Striking a balance between external talent recruitment and internal employee development is crucial.Also,staff innovation potential can be unlocked via training and planning.

Abstract:Aiming at the problems of insufficient collection and weak quality management of Traditional Chinese Medicine(TCM)diagnosis and treatment data,it constructs a standardized dataset covering the whole process of diagnosis and treatment for TCM dominant diseases to improve medical quality and efficacy evaluation.The main contents include the upgrading of TCM-characteristic information systems,the construction of intelligent platforms,unification of data standard,the collection of key diagnosis and treatment data,and standardized clinical pathways.These modules realize the standardized collection and structured storage of key data such as patients'basic information,diagnosis and treatment records,medication schemes,and efficacy follow-up.The above measures can effectively improve the standardization level of diagnosis and treatment for TCM dominant diseases,providing data support for the inheritance and innovation of TCM and clinical efficacy evaluation.

Abstract:Objective Through social network analysis,to build a collaborative policy network of organizational sectors in the high-quality development of public hospitals,analyzes the interaction status of collaborative networks,and providing insights for the efficient advancement of high-quality development in public hospitals.Methods Central,Shandong Provincial,and Weifang Municipal governments were selected as representatives of three tiers of government departments.Policy documents issued by central,provincial,and municipal governments from 2021 to 2024 concerning the high-quality development of public hospitals were screened at each target level.Quantitative analysis was conducted using social network analysis.Results In the high-quality development of public hospitals,the coordinated policy network among departments at the target tiers—central,Shandong,and Weifang—has emerged as the core driver.This network demonstrates broad horizontal coordination across departments,with subordinate departments playing a significant role in collaboration.However,communication channels within the network remain limited,and vertical coordination among departments lacks sufficient depth.Conclusion To increase the density of collaborative policy networks in the organizational sector,It is necessary to further expand the action parts and communication channels of the departmentally collaborative policy network,emphasize the practical role of subordinate organizational departments in the implementation of policy,develop tolerance and incentives mechanism,and give full play to the integrational power of the Health Commission and the Leading Group,eventually form a collaborative network,which interacts well with the top and bottom.

Abstract:Objective It aims to identify the key factors influencing patient satisfaction with public internet hospitals,providing empirical evidence to support service process optimization,quality improvement,and policy design.Methods A total of 400 valid responses were collected from patients nationwide who had used public Internet hospital services.It employed the Best-Worst Scaling method to design a survey covering six core service attributes:online consultation system,online consultation content,service provider,response waiting time,communication style,and payment method.A logit regression model was used to evaluate the impact of each attribute on patient satisfaction.Results Patient satisfaction was mainly influenced by response waiting time and payment method reimbursement ratio.In addition,user characteristics such as age,frequency of using public Internet hospitals,and Internet proficiency exhibited heterogeneous effects on satisfaction preferences.Conclusion The key to improving the service quality of public Internet hospitals lies in enhancing response timeliness and optimizing medical insurance reimbursement mechanisms.Furthermore,promoting personalized services can help improve the overall patient experience.The findings provide practical reference for advancing the high-quality development of"Internet Plus Healthcare".

Abstract:Objective Comprehensive evaluation of scientific and technological innovation in China's public hospital.Methods A sample of people's hospitals from 31 provincial-level administrative regions across China was selected.Based on 2023 data,an evaluation indicator system was constructed across four dimensions:innovation factors,infrastructure,institutional environment,and value creation.The CRITIC method was employed to determine evaluation indicator weights,while the RSR method was used for comprehensive evaluation and tier classification.Results The top three weighted indicators in the evaluation framework are number of national-level postdoctoral research stations,number of research management departments,and number of national and provincial/ministerial-level key laboratories.The WRSR of the 31 hospitals ranged from 0.052 to 0.537,exhibiting a normal distribution overall but with significant variation.The tiered classification results showed that only two hospitals were in Tier 5(Excellent),with most hospitals falling into the intermediate level.Conclusion Significant regional and inter-hospital disparities exist in the scientific and technological innovation capabilities of China's public hospitals,with research platforms and management mechanisms serving as key drivers.Recommendations include establishingregional coordination mechanisms to narrow innovation capability gaps;advancing the digitalization of scientific and technological innovation to optimize the allocation of research resources;creating two-way feedback mechanisms to accelerate the transformation of research outcomes;and strengthening deeper integration between hospitals and academic institutions to foster a collaborative innovation ecosystem.

Abstract:Person-centered Pharmaceutical Care constitutes a critical anchor in shaping China's integrated health service system during the 15th Five-Year Plan.Guided by the Gothenburg Model,It identifies three theoretical pillars:effective pharmacist-patient communication,standardized service protocols,and evidence-based decision-making frameworks.Through stakeholder interviews,the research prospectively delineates critical policy dimensions for implementing person-centered integrated service transformation.Finally,it proposes three supporting strategies-cultivating supportive policy environments,optimizing pharmacist training systems,and establishing cross-departmental governance frameworks.

Abstract:Objective To systematically review the application models,practical outcomes,and influencing factors of Artificial Intelligence(AI)in improving diagnostic homogenization within medical consortia,providing references for optimizing AI's deployment,policy formulation,and future research.Methods To search relevant literature in both Chinese and English databases such as CNKI,Wanfang,PubMed,MEDLINE,and Web of Science,combining keywords including"Artificial Intelligence","Medical Consorti","Diagnostic Standardization",and"Hierarchical Diagnosis and Treatment".Results AI primarily enhances diagnostic accuracy,consistency,and efficiency in medical consortia particularly in radiology,pathology,and electrocardiography through models such as remote diagnostic centers and clinical decision support systems.However,its effectiveness is constrained by multiple factors,including algorithm vulnerability,data quality,as well as organizational management and user acceptance.Conclusion Artificial intelligence serves as a powerful technological lever for promoting diagnostic homogenization in medical consortia.Future research should prioritize effectiveness evaluation in real-world clinical settings and optimization of human-AI collaboration models.Additionally,it is imperative to establish an AI clinical application evaluation and regulatory framework tailored to China's healthcare context,ensuring the technology can safely and effectively enhance healthcare equity and accessibility.

Abstract:Objective Based on the classical healthcare quality management SPO theory,it explores the specific scenarios,implementation approaches,and management requirements for Artificial Intelligence(AI)-assisted medical record generation.Methods It employed the content analysis method to systematically sort out 25 cases of artificial intelligence-assisted medical record generation implemented in domestic medical institutions.It summarized the existing experience and,in combination with the current legal system,explored the management needs.Results At present,there are practical cases of AI-assisted medical record generation in both outpatient and inpatient medical record scenarios.Implementation approaches vary significantly across different AI technologies with corresponding resource investments.AI-generated medical records require mandatory verification and confirmation by healthcare professionals.A solution utilizing Large Language Models for extracting medical quality management indicators is feasible.Conclusion AI-assisted medical record generation represents a developmental opportunity for enhancing healthcare quality management.