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Objective:To evaluate the new compensation mechanism for primary healthcare institutions in Zhejiang province, in terms of fairness, performance, incentive mechanism and sustainability in pilot areas.Methods:Evaluation indicators were constructed based on stakeholder theory, fairness theory, expectation theory and sustainable development theory.Focus group interviews were conducted with stakeholders and quantitative data were collected through questionnaires. Meanwhile, the financial compensation, income and expenditure and work equivalent data were collected from such institutions of the four pilot areas, with quantitative data subject to descriptive analysis.Results:This study found the reform used reasonable proportion of funds allocated(the proportion of basic salary for employees was lower than 50%)and adjustment factors(1.0-1.8)of different primary healthcare institutions to guarantee the fairness of the reform; the increase of work equivalents(the per capita work equivalents of medical staff in pilot counties had increased from 38.435 million in the previous year to 42.590 million work equivalents)reflected the performance outcomes of the reform. The incentive and sustainability of the reforms were the weak parts. These were mainly due to the fact that the internal distribution system of primary healthcare institutions failed to make corresponding reforms.Conclusions:The reform of the compensation mechanism based on the equivalent method has changed medical staff′s perception of the distribution of funds. The principle of" more pay for more work" and the use of information technology to capture work equivalents have improved the enthusiasm of primary medical staff and the operational efficiency of these institutions, thus, making reform generally scientific and reasonable.
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Objective@#To evaluate the new compensation mechanism for primary healthcare institutions in Zhejiang province, in terms of fairness, performance, incentive mechanism and sustainability in pilot areas.@*Methods@#Evaluation indicators were constructed based on stakeholder theory, fairness theory, expectation theory and sustainable development theory.Focus group interviews were conducted with stakeholders and quantitative data were collected through questionnaires. Meanwhile, the financial compensation, income and expenditure and work equivalent data were collected from such institutions of the four pilot areas, with quantitative data subject to descriptive analysis.@*Results@#This study found the reform used reasonable proportion of funds allocated(the proportion of basic salary for employees was lower than 50%)and adjustment factors(1.0-1.8)of different primary healthcare institutions to guarantee the fairness of the reform; the increase of work equivalents(the per capita work equivalents of medical staff in pilot counties had increased from 38.435 million in the previous year to 42.590 million work equivalents)reflected the performance outcomes of the reform. The incentive and sustainability of the reforms were the weak parts. These were mainly due to the fact that the internal distribution system of primary healthcare institutions failed to make corresponding reforms.@*Conclusions@#The reform of the compensation mechanism based on the equivalent method has changed medical staff′s perception of the distribution of funds. The principle of" more pay for more work" and the use of information technology to capture work equivalents have improved the enthusiasm of primary medical staff and the operational efficiency of these institutions, thus, making reform generally scientific and reasonable.
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Objective To investigate expression and regulatory mechanism of phosphatase and tensin hemology deleted on chromosome ten gene (PTEN) and cyclooxygenase-2 (COX-2) in human myeloid leukemia cells.Methods Thirty patients was collected from the First Hospital of Baoding and Second Affiliated Hospital of Hebei Medical University,including 10 chroni myeloid leukemiac (CML)patients in chronic phase (CML-CP),10 CML patients in blast crises (CML-BC) and 10 normal controls.The recombinated adenovirus containing green fluorescent protein (GFP) and PTEN ( Ad-PTEN-GFP) or empty vector (Ad-GFP) was transfected into human CML K562 cells.The growth of K562 cells and cell adhesion ability was observed by 3-[4,5-dimethyl-2-thiazolyl]-2,5-dip (MTF) assay; PTEN and COX-2 messenger ribonucleic acid (mRNA) levels were detected by real-time fluorescent relative-quantification reverse transcriptional PCR (FQ-PCR).PTEN and p-Akt protein levels were detected by western blot,and COX-2 protein were measured with cytochemical staining.ResultsThe mRNA expression levels of PTEN in CML-BC patients (0.022 ±0.021 ) were lower than CML-CP patients (1.134 ± 1.124) and normal control ( 1.059 ±0.595).The mRNA expression levels of COX-2 in CML-BC patients (0.761 ±0.418) were higher than CML-CP (0.211 ± 0.158) and normal control (0.165 ± 0.152).The growth of K562 cells was suppressed markedly,and the maximum growth inhibition rate was 38.67％ ± 4.30％ after transfected with PTEN gene,which was higher than Ad-GFP group (5.34％ ±0.31％,t =13.39,P ＜0.01 ).COX-2 mRNA expression levels in Ad-PTEN-GFP(0.013 ± 0.001 )were significantly lower than Ad-GFP group (0.199 ±0.018) and untransfected group (0.217 ± 0.021,F =499.45,P ＜ 0.01 ),and p-Akt as well as COX-2protein were also down-regulated after K562 cells transfected ( MOI =200) with wild type PTEN in three days.ConclusionPTEN may inhibit proliferation and adhesion ability of leukemia cell in myeloid leukemia via down-regulating COX-2 expression.