Investigation and analysis of information disclosure status and willingness of public hospitals based on social supervision / 中华医院管理杂志

Objective:To investigate the status and willingness of information disclosure based on social supervision in tertiary and secondary public hospitals, so as to provide reference for expanding information disclosure content.Methods:By using stratified cluster random sampling method, 66 tertiary public hospitals and 126 secondary public hospitals in 6 provinces were selected for questionnaire survey in April 2021. Thirty-one indicators in 3 categories and 5 groups were selected to obtain the information disclosure status and willingness. Chi-square test, variance analysis and paired t-test were used to conduct difference analysis. Results:The indicators with higher disclosure rates in public hospitals were drug prices and medical service price adjustments (93.9% in tertiary hospitals and 92.1% in secondary hospitals) and medical insurance reimbursement policies and compensation processes (90.9% in tertiary hospitals and 86.5% in secondary hospitals), while the indicators with lower disclosure rates were case fatality rates in low-risk groups (24.2% in tertiary hospitals and 26.2% in secondary hospitals), proportion of special needs medical services (27.3% in tertiary hospitals), and average daily outpatient visits per practitioner (27.3% in tertiary hospitals and 26.2% in secondary hospitals). The indicators that public hospitals thought could be disclosed at a higher rate were drug and medical service price adjustments, medical insurance reimbursement policies and compensation processes, and prices and medical insurance reimbursement of commonly used drugs and major medical consumables, while the indicators that were thought to be disclosed at a lower rate were some medical service safety indicators and hospital financial indicators.For all indicators, the percentage that the hospitals thought could be disclosed was higher than the percentage that had been disclosed.Conclusions:At present, China′s secondary and tertiary public hospitals have a low rate of disclosure about medical service efficiency, medical service safety, statistical summary cost and financial indicators. However, except for some medical service indicators and financial related indicators, the hospitals′ information disclosure willingness is relatively high, and the scope of information disclosure can be expanded in an orderly manner in steps.

Information Disclosure in Informed Consent

@#Informed consent has been recognised as an essential part of clinical practice, giving ethical and legal legitimacy to medical intervention. There is no universal standard on the amount and type of information that a patient is entitled to and needs to be adequately disclosed. This article proposes nine information that will assist the doctor in providing adequate information for a patient to evaluate whether to authorise medical intervention. The recommended information are: (i) diagnosis, prognosis and its uncertainties; (ii) nature of proposed medical intervention; (iii) the expected benefit of proposed medical intervention; (iv) the potential risk of proposed medical intervention; (v) alternative to proposed medical intervention; (vi) progress of proposed medical intervention; (vii) opportunity for a second medical opinion and to seek further details; (viii) costs of proposed and alternative medical intervention; and (ix) the person responsible for implementing medical intervention.

Analysis and Suggestions on Main Measures of Risk Management in National Drug Sampling and Testing / 中国药学杂志

OBJECTIVE: To analyze the main measures of the drug quality and safety risks management in the national drug sampling and testing, and provide reference for improving the drug sampling and testing after listing. METHODS: Using retrospective research methods to analyze the effects of the deadline management, special item (special topic) sampling and testing, serious quality risk disposal mechanism, nonserious quality risk warning mechanism, information disclosure on drug quality and safety risk management during the national drug sampling and testing in 2014-2019. RESULTS: A series of measures improved a timely, efficient and complete closed-loop response chain of risk identification-disposal-disclosure. CONCLUSION: The main measures can help reduce public drug safety risks and have good demonstration and guiding significance for local drug sampling and testing. It is recommended to continuously improve the risk management mechanism, such as learning from the US and EU drug regulatory experience, strengthening the sampling and testing of vaccines, imported drugs and consistency evaluated drugs, and personalized designing test and research strategies.

Current Status Analysis and Suggestions on the Results Disclosure of Drug Sampling and Testing in China / 中国药学杂志

OBJECTIVEP: To provide a reference to improve the information disclosure of drug sampling and testing. METHODS: Through literature and information disclosure measures research, combined with examples, the historical evolution, disclosure form, disclosure status, and significance of the drug sampling and testing results disclosure in China was analyzed, suggestions was made. RESULTS: AND CONCLUSION: The disclosure of drug sampling and testing results are helpful to improve the government's credibility, protect the public's right to know, deter illegal enterprises and promote the improvement of drug quality. It is suggested that the drug regulatory department learn from the FDA's experience to improve the legal status of information disclosure, strengthen timeliness, transform results, monitor public opinion and remove the enterprise information from public environment after credit repair,and all circles of society correctly understand and rationally treat the information disclosure content, in order to improve the information disclosure of drug sampling and testing and promote the social co-construction and co-governance of drug quality and safety.

Research of Disclosure and Confidentiality of FDA Information in US / 中国药学杂志

OBJECTIVE: To study the content and mechanism of the US Food and Drug Administration (FDA)in balancing information disclosure and confidentiality, and make recommendations for China. METHODS: The design and mechanism of information disclosure and confidentiality balance system has been explored from the development of FDA information disclosure and confidentiality. RESULTS: The United States has a strict legal and regulatory system. New drug application has series measures to ensure FDA balance information between disclosure and confidentiality, such as active disclosure, request for information and non-public information, FDA IT system security plan, CDER expert network information disclosure, review and confirming of confidentiality provisions in FDA published articles or public speeches. CONCLUSION: It is suggested that China introduce the information disclosure and confidentiality clause in upper law, establish information disclosure procedure, and adopt internal information security measures.

Investigation and Evaluation on the Implementation Situation of Financial Information Disclosure Policy for Public Hospitals in Pilot Cities / 中国卫生经济

Objective:To investigate and evaluate the status of financial information disclosure in public hospitals.Methods:Taking the method of policy analysis,descriptive statistics,consult the relevant policy and the hospital website of 200 countries for public hospital reform pilot cities,sum up the change trend and implementation status of public hospital financial information disclosure regulation policy from 2006 to 2017.Results:There were obvious differences in public financial information in public hospitals from various regions,only 130 hospitals(65％) disclosed financial information in the website,the goal of "hospitals in comprehensive reform of all urban public hospitals should disclose financial information to the public by the end of 2016" was not fully achieved,the standardization and comparison of financial information was not high.Conclusion:In order to achieve the goal of "opening the financial information disclosure system to all public hospitals and all regions in China by the end of 2018",it suggested to integrate the existing documents,combined with the beneficial practices in pilot cities,unified public hospital financial disclosure guidelines and perfect supporting measures for policy implementation.

Comparative study of hospital information disclosure between China and the United States / 中华医院管理杂志

Objective To compare the contents of hospital information disclosure in China and the United States, and provide reference to improve hospital information disclosure in China. Methods Systematic collection was made for hospital information disclosure data from government documentation, statistical yearbooks, and hospital website portals like Hospital Compare of the United States and China. By means of inductive method and comparative analysis, hospital's medical services that were openly and freely accessible to the public of the two countries were studied in terms of structural indexes, medical quality indexes and patient experience assessment. Results The disclosed structure indexes of the US were abundant and distinctive. Its disclosed medical service quality indexes include such four diseases as myocardial infarction, cardiac failure, pneumonia and childhood asthma, as well as classification indexes under surgery infection prevention, comprising ten core process indexes and nine outcome indexes. In addition, the US also discloses patient experience survey results of ten aspects. Given the rich hospital information structure openly accessible in China, there lacks medical service quality information for disclosure. The only information directly comparable was the ranking of hospitals and specialties, instead of patient experience results. Conclusions China can learn from the experiences of American hospital information disclosure, establish an easy-to-understand and comparable index system; enrich the disclosure content, and build an authoritative and unified disclosure platform.

The two-level and two-way reporting system of community benefits for non-profit hospitals in the United States / 中华医院管理杂志

Information disclosure is important for the government and society to monitor the fulfillment of social responsibility of hospitals. This paper introduced the existing legislatures of the community benefits information disclosure system for non-profit hospitals in the United States, and analyzed the "two-level and two-way reporting system" of these hospitals, based on facts of California, Illinois and other regions. In the end, the authors put forward inspirations for the development of public hospitals' community benefits system in China as follows. This refers to the establishment of a social responsibility reporting system,stipulating the hospital and its health authority as the entities accountable for disclosure;a two-level/two-way reporting mechanism to improve the integrity of information disclosure;and standardization of information disclosure content and better timeliness and accessibility of information disclosure.

Thoughts on the procurement and management of research-use reagents and consumables in hospitals / 中华医学科研管理杂志

Objective Along with the fast increasing of scientific research capacity,more and more financial funding were available at hospital level,at the same time,the kinds and quantities of the reagents and consumables for scientific research uses are also increased.As a result,procurement risks become a gig concern in hospitals.Thus,how to increase the cost-effectiveness of their financial funds while lowering the risks and hidden troubles are the key issues need addressing urgently.Methods This paper took Beijing Obstetrics and Gynecology Hospital,Capital Medical University as an example,summarized its service conditions of reagents and consumables for scientific research uses in past three years (2014-2016),according to the comparison and analysis of their actual prices with the guiding prices on the same as indicated on the informational procurement platform,to discuss the existing issues and risks.Results Under the current procurement management system of reagents and consumables for scientific research uses,the purchasing price for some items are relatively high.Conclusions This paper specifically proposed some measures and advices on risk prevention and control during the period of transition with the intention to reduce the purchasing cost,increasing the costeffectiveness of the financial funds,and lowering the risks and hidden troubles in procurements.

Status of Social Responsibility Information Disclosure of the Tertiary Hospital in Beijing City / 中国医院管理

The core elements of public hospital social responsibility information disclosure at the present stage is clarified,and the status quo and problems of public information disclosure of public hospitals in Beijing are understood to provide suggestions for hospital social responsibility information disclosure under government perspective.Through using policiometrics,government demand factors and interviewing the officers in hospital or government sector are established,then social responsibility of public hospital related vocabulary consisted in data dictionary are selected,and tertiary hospital sites are investigated to obtain the information and data,finally to do qualitative quantitative descriptive analysis.The hospital website social responsibility information disclosure regulations should be strengthened,hospital disclosure stage be standardized and the hospital disclosure initiative and enthusiasm be improved,and the hospital social responsibility information disclosure content update rate through the web site be increased.

The investment and financing policy dilemma in Public-Private Partnerships of public hospitals and its way out / 中国卫生政策研究

This article reviews the investment and financing policies suitable for the Public-Private Partnerships(PPPs)model in public hospitals and the main practice models, analyzes their dilemma when applied to the public hospitals in public-private partnerships to determine reasonable equipment and facilities, evaluate the value of investment assets in public hospitals, and obtain reasonable return on investment for the cooperation current partnership.Based on this, the study puts forward the way out of the dilemma which is aroused in public hospitals.Forwarded suggestions include the strengthening of the previous feasibility studies regarding the partnership projects and implementation of regional health planning and medical institutions to set the planning requirements;strengthening the assessment of tangible and intangible assets of the PPP projects in public hospitals and to prevent the loss of state-owned assets;and strengthening the financial information disclosure on PPP in public hospitals, protecting the legitimate rights and interests of the staff and maintainance of the public welfare of public hospitals.

Study on the Coordination between Standardization Strategy and Trade Secrets Protection System in Tradi-tional Chinese Medicine / 中国药房

OBJECTIVE:To provide reference for the effective integration of standardization strategy of traditional Chinese medicine (TCM) and intellectual property. METHODS:Through analyzing the conflict between standardization requirement of TCM and intellectual property system,the coordination between TCM standards and intellectual property especially the trade secret rights was explored. RESULTS:The information disclosure of TCM standards and intellectual property strategy especially protec-tion of TCM trade secrets faced confrontation and conflict in system and design. For the suggestions to solve it,one is to reconfirm the role and positioning of the government on the adaption of standardization in public law field;another is to establish coordina-tion principle of information disclosure and confidentiality in private law field,and achieve difference open and moderate open of information. CONCLUSIONS:The TCM standardization is not absolute,the pros and cons is the precondition to solve the conflict between the standardization strategy and trade secret system in TCM in terms of protection of information freedom and secret infor-mation.

Analysis on the interest groups of hospital information disclosure in the United States / 中国卫生政策研究

Through the literature combing the interest groups of hospital information disclosure in the United States, the demand and practice of the main interest groups are analyzed. This paper uses policy maker4. 0 software to further analyze the interests of various interest groups, power and the degree of influence by the policy of hospital information disclosure. The results showed that interest groups involved in hospital information disclosure in the Unit-ed States can be mainly divided into five categories:consumers, employers, health insurance companies, hospitals, and decision makers ( government) . In order to balance the cost-effectiveness of various insurance schemes, health insurance companies choose high-quality service providers to restrict poor-service providers and insurers, and hospi-tals need to use public information to manage and improve health care. In order to monitor and improve the quality of medical services, employers need to weigh various insurance plans, health insurance companies have to measure the service quality of themselves and competitors, and hospitals need to manage and improve the medical quality and in-crease market share. As the largest stake in the hospital information disclosure, the results show that the consumer's position on the hospital information disclosure is low support. From the consumer as a main, although the hospital in-formation disclosure practices but the right to speak and other small powers have a limited participation. Analyzing the of the interest groups of hospital information disclosure in the United States, they all push forward the hospital infor-mation disclosure work to provide evidence to support.

Research on the Impact of Financial Information Disclosure on Public Hospitals / 中国卫生经济

Financial information disclosure was the weak link in public hospitals information disclosure,information provided to outside by hospitals was priority to basic medical information,opaque finance will hinder the reform and benign development of public hospitals.It analyzed the impact on operation management,transparency,and compensation of public hospitals financial information disclosure.It pointed out that published financial information can promote public hospitals' internal control,strenghthen financial work well informed and participation by all staffs,reinforce the external supervision of public hospitals with hardening budget and cost constraints.

Research on System Design of Financial Information Disclosure in Public Hospitals / 中国卫生经济

Based on the comparison of financial information disclosure among public hospitals,enterprises,government and non-profit organizations,it proposed to establish a system framework on public hospitals financial information disclosure framework combined with the guidance of urban public hospital comprehensive reform pilot,including information published main body,object,scope,contents,method,time,form,quality assurance and violations.

A lei de cotas para pessoas portadoras de deficiência nas empresas brasileiras: impacto e possíveis alternativas / The law of quotas for people with disabilities in Brazilian companies: the impact and possible alternatives

O trabalho consiste em uma análise teórica acerca do impacto da legislação que impõe cotas para pessoas portadoras de deficiência em empresas com cem ou mais empregados no Brasil, bem como de algumas soluções legais alternativas: incentivos (incentivos fiscais e comercialização do direito a não contratar) e medidas de regulação pela informação. As referências teóricas do artigo compõem-se de trabalhos sobre a eficácia das normas jurídicas em geral e, em particular, de trabalhos atinentes aos efeitos de custo e cognitivos dessas normas. Considerando-se tratar-se de análise exclusivamente teórica, o trabalho não chega a concluir pela superioridade das demais estratégias de regulação examinadas frente à lei de cotas, limitando-se a chamar a atenção para as possíveis causas do fracasso desta última e para o potencial e os inconvenientes das alternativas aventadas.

This paper consists of a theoretical analysis of the impact of the Brazilian law establishing quotas for people with disabilities in companies with one hundred or more employees, as well as the possible impact of some alternative legal measures: incentives (fiscal incentives and tradable rights) and information disclosure policies. The analysis is based on work regarding the efficacy of legal norms in general, and particularly the literature concerning the cost and cognitive effects of those norms. Given its exclusively theoretical character, the paper does not affirm the superiority of any regulatory strategy over the current law, but draws attention to the likely reasons for the failure of the quota system and for the potential and inconveniences of its proposed alternatives.

Website information disclosure by 80 public hospitals in China and the analysis / 中华医院管理杂志

Objective Studying information disclosure at China' s public hospitals and recommending on information disclosure policies.Methods Collecting and analyzing the websites of 80 public hospitals in five main Chinese cities (Beijing,Shanghai,etc.).Results Information disclosure by these hospitals is found to be identical,with a slight difference in information publicity.By percentage,the information disclosure of hospital profile,department navigation,specialists characteristics,hospital news,health education,and doctor-seeking guidance,is 100.0％,98.3％,95.0％,93.3％,90.0％and 88.3％respectively.The disclosure is found to be lack of general planning,objectivity,timeliness and sufficiency.ConclusionEstablishing the information disclosure system based on mandatory information disclosure,stipulating the content,approach and timing for public hospitals information disclosure.

Intormation disclosure requirements for investigators' financial conflict of interest in clinical trials of United States / 中华医学科研管理杂志

Investigators' financial conflict of interest(COI)in clinical trials may compromise the well-being of subjects and the objectivity and accountability of the research results.Lots of COI policies have been made in US to deal with such issues.This paper analyzed tIle policies governing investigators' financial COIs in clinical trials at the 21 medical schools which received the largest amount of research funds from the NIH.critically reviewed the different requirements of disclosure with the principles of respects for persons,justice,and beneficence.

Access to AE Report in MEDWatch Web Needs Computer Expert and Big Computer / 薬剤疫学

Background : As the consequence of the decision at the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) progress, drug safety information reporting system in Japan is being revised. This has led to inevitable increases in the number of safety reports submitted to the industries and in turn, the Ministry of Health and Welfare (MHW). In 1997, the MHW announced they would publicize this acquired information starting in 1999. In the USA, Food and Drug Administration (FDA) has released safety related information to the public, acquired over the years since 1969, though such means in the Web page of MEDWatch using the internet.<BR>Purpose : (1) To review accessibility of individual adverse experience (AE) reports in MEDWatch through internet, (2) to give advise to other possible Japanese users on the use of it and, (3) to give recommendation to the new system being developed in Japan by the MHW and/or other regulatory agency. <BR>Method : Case study started by using personal computer.<BR>Results : (1) The information cannot be accessible only using personal computers. Computer expert assistance and big computer are needed to access the information. (2) Information from more than a million AE cases is accessible. (3) Searches for information can be organized by pharmaceutical name, event term, patient demographics, and others. (4) The detailed information such as the course of the individual case from which drug causality could be assessed is not accessible. (5) The improvement of system should be needed for easy access such as “quick search”. (6) More “user friendly” system is desired to be developed by the MHW and/or other regulatory agency in Japan which enable easy and full access of the information.

A Study on the Attitude and its Influencing Factors of Cancer Patients towards Information Disclosure / 中国医学伦理学

Objective: To explore the attitude and its influencing factors of patients with cancer towards information disclosure.Methods: 302 patients with cancer were investigated with self-designed questionnaires.Results: The patients' attitudes towards Information Disclosure were significantly affected by the gender,marriage status,personality,duration of cancer information,hospitalization experience and funeral experience,with significant statistical differences﹝P