ABSTRACT
The actor network theory, with reference to systems science, sociology and management science, offers a new perspective for research of the technology-society binary view. This theory as introduced by the authors, analyzed the constituent bodies and their relationship of the operation of the precise medical service system, and studied the translation process of the actor network. The analysis showed that the main factors affecting the operation of the precision medical service system were hospitals, patients, governments, scientific research institutions, technology-based enterprises, and universities, which were suppliers, demanders, managers, funders, and technical supporters of precision medical services. Among them, 82.72%(335/405) of clinicians believed that hospitals were the core actor that affected the operation of precision medical service system. 71.60%(290/405) of the clinicians thought that the training of medical workers was the current focus of the hospital, i. e., the mandatory access point for this actor network. Through training, the accurate medical service ability of medical workers and hospitals can be improved.
ABSTRACT
Objective To summarize the experience of the clinical research network operation mechanism in typical countries,and provide reference for the construction of China's national clinical research network.Methods Literature research method and the inductive analysis method were used to analyze the information on official website and literature materials of the clinical research network in typical countries to summarize their characteristics and experience.Results The clinical research network in typical countries had developed an optimized and efficient operational mechanism,including the development of information platforms,development of tools and templates,streamlined review processes,implementation of membership systems,establishment of sharing mechanisms,and complementary models of clinical centers and research institutes,stable sources of funds,establishing reward and punishment mechanisms,etc.Conclusions China's national clinical research network is still at the initial stage,government should make full use of the information platform,strengthen human resource input,and accelerate the research and exploration of more innovative management mechanisms.
ABSTRACT
Reform of public hospitals is key to the healthcare system reform.This article introduced how Hangzhou implemented such a reform of " Hangzhou characteristics" by referring to the hospital reform framework of the World Bank, and the theoretical achievements and practical experiences of domestic public hospitals′reform.Led by the service concept of " Medicine has its limitations but we have the courage to overcome, service is boundaryless and we must pursue excellence" , Hangzhou has established a public hospital value system of " reorientation to public welfare".The smart healthcare system serves as a focus, to support the delicacy management of the hospitals. The construction of hierarchical medical care system functions as the pillar, to support the coordinated development of hospitals, primary health institutions and public health institutions.This way a public hospital comprehensive reform mode is established featuring " one value system, 2 levels of organization structure, 6 mechanisms, and 19 supporting measures ". Its experiences may serve as reference to streamline hospital internal operation and external cooperation mechanism.
ABSTRACT
Reforms in public hospitals are among the most important improvements in China's health care system over the last two decades. However, the reforms that should be implemented in public hospitals are unclear. Thus, a feasible direction of reforms in Chinese public hospitals is suggested and reliable policy suggestions are provided for the government to reform public hospitals. The data used in this study were mainly derived from a qualitative study. Focus group discussions and in-depth interviews were conducted in Shanghai, Guangdong, and Gansu between May and December 2014. Government funding accounted for approximately eight percent of the total annual revenue of public hospitals in China, and the insufficient government subsidy considerably affects the operation mechanism of public hospitals. However, solely increasing this subsidy cannot address the inappropriate incentives of public hospitals in China. The most crucial step in setting the direction of reforms in public hospitals in China is transforming inappropriate incentives by implementing a new evaluation index system for directors and physicians in public hospitals.
Subject(s)
Humans , China , Focus Groups , Health Care Reform , Health Personnel , Economics , Hospitals, Public , Classification , Economics , Qualitative ResearchABSTRACT
From the perspective of management, the authors established an analysis framework for the option mechanism of this information system, and analyzed the option mechanism of the system in such aspects as organization and management, optional and maintenance management, resources management, and shared interactive management. It is held that a medical insurance information system is already established to cover both rural and urban residents in China, along with a comprehensive operation mechanism. However such a mechanism is still defective in terms of communication mechanism, investment and resources development. It is recommended to make up in terms of improving stakeholders coordination mechanism, building diversified investment and financing mechanism, enhancing data quality, as well as system promotion and application, data sharing and business synergy capabilities.
ABSTRACT
Centering on the reform practice in Sanming featuring a synergistic reform in public health services,medical insurance and medicine production-circulation (Tripartite-sector reform below),this paper focused on the top-level design of the management system in such a reform and its synergistic operation mechanism.The authors probed into the main reasons for its grounding-breaking success and challenges,to pave way for their discussions on the reproducibility and sustainability of the reform.
ABSTRACT
Objective:To empirically evaluate the impact of the reform of separating drug sales from medical services reform on the operation of public hospitals in Beijing. Methods:Taking R hospital as a case study,Twenty-six clinical departments were selected as samples, and the indicators which have significant change after medical reform were analyzed by descriptive statistics,Pairing test,Correlation test and Spearman correlation test. 24 tested indicators included workload,cost and medication behavior. Results:After the Beijing medical reform between May to September 2017,and from May to September 2016, R hospital workload and cost indicators changed in varying degrees. There were differences between the two groups in terms of the internal medicine and surgery,and the medi-cation behavior had no significant change. Conclusion:The effect of Beijing's healthcare reform policy is obvious. R hospital has the trend of decreasing outpatient volume, drug proportion and medical insurance costs. The medical reform policy may have a profound impact on the development of the clinical subject.
ABSTRACT
The paper described efforts made by Guangdong province to achieve a goal of the healthcare reform Serious diseases can be treated within the county.In this reform,the province attempts such operation mechanisms as autonomous type,guided type and trusted type for the purpose of elevating the service capabilities of county-level public hospitals.To this end,four independent operation mechanisms have also been built for talent development,remuneration incentive,specialty development,and cost control.All these efforts aim at encouraging the hospitals to improve service capability and quality.
ABSTRACT
To cement the 5 years’ staged achievement of new medical reform so as finally achieve the objective of medical reform, public hospital would become the aim of reform in the following stage. On one hand , canceling “using drug to supple health care” in public hospitals has came into the crucial stage; on the other hand, the government needed to increase financial input and ensure the implementation of security fund. What was the relation between these two reforms? Therefore , based on the survey of county-level public hospitals in G Province, relationship among government compensation method, hospital public profit operation mechanism and profit-driven operation mechanism were analyzed; besides, different financial insurance mode had different operation efficiency. Because the construction of hospital expense under public profit operation mechanism was more reasonable , the required government insurance fund was less, which only accounted 32.9%of the required fund under the profit-driven operation mechanism. Therefore, the policy suggestions that government need to “buy the mechanism” and “be brave to implement ‘subtraction reform’” were proposed.
ABSTRACT
In this article,the strategy and achievements of the interdisciplinary in recent years in Peking University are summarized.We also discussed the remaining problems in the development of medical science and interdisciplinary as well as how to improve the management system and operational mechanism.
ABSTRACT
The article introduces the concepts of medical social work and its performance evaluation,and reviews relevant researches on medical social work home and abroad.In addition,it proposes an operation mechanism and implementation scheme for the evaluation of medical social work in China.
ABSTRACT
Public hospitals reform is a key roadblock for the ongoing health reform.By means of such experiments as Three openings and three mechanisms,Beijing is practicing a separation of hospital regulation and management and separation of clinic and pharmacy,while building the mechanism of financial subscription for pricing,that of medical insurance adjustment,and that of hospital corporate governance.These measures aim at building a new management structure,operation mechanism and medical service model focusing on quality of care,efficiency and satisfaction.Separation of clinic and pharmacy has lowered drug proportion,average outpatient expense and out of-pocket payment of patients,as well as producing higher patient satisfaction,quality of care and hospital income.Other benefits include better management efficiency indirectly caused by separation of clinic and pharmacy,higher acceptance of the corporate governance,and service model innovation to better serve the people.