Internal audit of Organ Procurement Organization under the requirements of high-quality development / 器官移植

High-quality development is the primary task of building a socialist modern country in an all-round way. Organ donation and transplantation in China are evolving from high-speed growth to high-quality development, which put forward new requirements for the safe, stable and healthy operation of Organ Procurement Organization (OPO). Safety is the foundation and prerequisite for achieving the goal of high-quality development. As an independent and comprehensive department, internal audit should create new achievements in the new era. The department should include OPO and organ donation into the scope of internal audit, shift the emphasis upon the overall development of organ donation. Besides, it should fully consider the actual situation in different places, conduct all-round, objective and fair evaluation, provide evaluation and consulting services for OPO to properly implement organ donation, and give full play to the supervision and prevention role of internal audit.

Gathering Strength and Marching Again, Scaling New Heights Courageously / 中华泌尿外科杂志

2021 is the 100th anniversary of the founding of the Communist Party of China and the 40 thanniversary of the founding of Chinese Urology Association (CUA). In compliance with the "Plan of Healthy China 2030" , we are ready to gather strength to march again, put forward the slogan "Nourishing Elite to Promote Urology, Aiming High to Forge Ahead" , and scale new heights courageously. With training elite urological talents and developing excellent scientific researches and medical projects as the engine, we will promote the rapid development of Chinese urology, and further achieve the lofty goal of leading Asia and catching up with the international community in the 50 th anniversary of the founding of CUA. In order to achieve this ambitious vision, CUA unites the strength of Chinese urologists to work together on six major tasks: leading academics, strengthening research, cultivating talents, enhancing clinical practice, public welfare and international communication. Alliances in urology should cooperate sincerely and work hand in hand to contribute to the prosperity of urology in China.

The effect of the public welfare training of esophageal speech on the psychological condition of the laryngectomees / 中国实用护理杂志

Objective@#To explore the effect of the public welfare training of esophageal speech on the psychological condition of the laryngectomees.@*Methods@#Using experimental research method and convenient sampling method to select 96 laryngectomees as research object by inclusion and exclusion criteria in Hubei province. The public welfare training was used to guide the laryngectomees to learn the esophageal speech. Then, laryngectomees' restoring vocalization, self-rating anxiety and self-rating depression would be assessed in a month before training, a month after training and half a year after training. The results were analyzed by descriptive analysis, chi-square test, F-test and so on.@*Results@#Ninety-six laryngectomees participated in the public service esophageal language training one month before, one month after and half a year after the training. The number of patients recovered completely from 3 to 39 to 72 in the recovery of pronunciation function. There was significant difference in the distribution (χ2=195.579, P < 0.01). The score of anxiety and depression was (54.84±9.19), (47.41±8.16), (42.92±7.16) points and (59.00±8.87), (52.48±8.16), (47.56±7.41) points. There were significant differences (χ2=79.772, 82.705, P<0.01).@*Conclusions@#Most laryngectomees have the different degrees of anxiety and depression after surgery. By carrying out the public welfare training of esophageal speech on laryngectomees, the psychological state of the laryngectomees can be effectively improved.

The effect of the pubLic weLfare training of esophageaL speech on the psychoLogicaL condition of the Laryngectomees / 中国实用护理杂志

Objective To explore the effect of the public welfare training of esophageal speech on the psychological condition of the laryngectomees. Methods Using experimental research method and convenient sampling method to select 96 laryngectomees as research object by inclusion and exclusion criteria in Hubei province. The public welfare training was used to guide the laryngectomees to learn the esophageal speech. Then, laryngectomees′ restoring vocalization, self-rating anxiety and self-rating depression would be assessed in a month before training, a month after training and half a year after training. The results were analyzed by descriptive analysis, chi-square test, F-test and so on. ResuLts Ninety-six laryngectomees participated in the public service esophageal language training one month before, one month after and half a year after the training. The number of patients recovered completely from 3 to 39 to 72 in the recovery of pronunciation function. There was significant difference in the distribution (χ2=195.579, P<0.01). The score of anxiety and depression was (54.84±9.19), (47.41±8.16), (42.92 ± 7.16) points and (59.00 ± 8.87), (52.48 ± 8.16), (47.56 ± 7.41) points. There were significant differences (χ2=79.772, 82.705, P＜0.01). ConcLusions Most laryngectomees have the different degrees of anxiety and depression after surgery. By carrying out the public welfare training of esophageal speech on laryngectomees, the psychological state of the laryngectomees can be effectively improved.

Ethics Struggle of Protection and Sharing in the Construction of Biobank / 中国医学伦理学

At present, the development of biobank in China is still at the initial stage, and there are many problems, such as lack of scientific management and sharing mechanism, insufficient application of transformation and weak sustainable development. Through constructing the ethical challenge of biobank, the author draw out the rights protection claims of biological sample sources, such as the informed consent of samples source and the privacy protection of samples management. In order to achieve the balance between the protection and sharing of biobank construction, we should improve the awareness of privacy protection, take effective means of privacy protection and fully consider and foresee ethical issues after rapid development of technology. Finally, it is pointed out that the principle of public welfare, the principle of fairness in the distribution of results and the predictive principle should be reflected in the transformation of results.

4．History and Future Direction of Academia Clinical Trial Regulation : Lessons of Diovan Affairs and Concerns on Clinical Trials Act / 薬剤疫学

Clinical trials play a crucial role in the development of new medical technologies and optimization of current treatments. Because the results directly affect medical practice, the trials must not be harmful both to the current and future patients, which is ensured by their scientific validity and data credibility. Inversely, fake trials deceive and mislead people, representing serious threats to the public welfare.In 2013, series of misconduct were revealed for Diovan trials, where false results were derived and published, based on made up data. Although futile efforts were devoted to pursue responsibility of relevant researchers and pharmaceutical company, the essential cause was lack of the rule to ensure reliability of clinical studies in academia. Indeed, importance of data credibility, which is a prerequisite of clinical science, was not stipulated in the clinical study ethical guideline, allowing for the spread of studies with poor quality and/or malpractice.Spurred by the Diovan affairs, national arguments tardily took place regarding reliability of academia trials, leading to the implementation of “Clinical Trials Act”. Although the law will improve reliability of academia trials, several concerns exist, as it ignores external consistency and harmonization with other laws. Most seriously, it lacks the mechanism to translate study achievements to the tangible benefits for people.Namely, no matter how good results were obtained by studies under the law, they would not lead to the regulatory approval, due to the lack of link with pharmaceutical affairs law. Then, there rises a doubt on the spirit of law, regarding whether it really aims to improve current medicine. Indeed, the driving force of clinical trial is the hope of medical staffs, to palliate the pain of patients and families, if not this time, but next time in the future. This is the cause of clinical trials, where we must return, in order to reward the heart of medicine and clinical trials, for the improvement of academia clinical trial regulation.

Analysis of main influencing factors for social capital to play in public-private partnership projects in public hospitals / 中华医院管理杂志

Analyzed in this paper are difficult roadblocks for social capital to "break into" public hospital by way of public-private partnership(PPP) projects. To name a few,the public welfare nature and non-profit nature,and sensitive political issues of public hospitals among other factors prevent such capital from directly making profit from the core businesses of these hospitals, hence almost impossible to design a feasible PPP model. Conflicting interest demands among stakeholders might make it a zero-sum game. New profit sources need to be created to cover such problems as insufficient returns on investment and long payback period. The financing risk exposure of social capital, which tends to be high, would push up the hidden debt risks shouldered by local government in question. In addition,there are not yet clear policies for social capital in terms of fiscal subsidy, tax preference and financing. All of these have curbed the"impulse" of social capital to a certain extent,pending better solutions.

The Financing Difficulties and Coping Strategies for the Public Hospitals from the Perspective of Public Welfare / 中国卫生经济

The continued release of demand for medical services had stimulated the development of public hospitals.In the context of insufficient government financial subsidies and inadequate hospital funds,some public hospitals tended to seek market-oriented financing support,but the contradiction between the nonprofit nature of public hospitals and the profitability nature of capital made the process of public hospital financing into a dilemma.Through the analysis of the connotation of public welfare in public hospitals and cases of PPP projects,it found that nonprofit of public hospitals did not completely exclude the profitability of capital,the market competition mechanism that capital profit behavior relied on was a prerequisite for the realization of the public welfare nature of public hospitals.Taking the advantage of market-oriented financing methods on the basis of insisting on the public welfare of public hospitals,the following measures must be taken:firstly,adhere to the government's dominant position in the direction of public hospitals;secondly,while introducing capital,it needed to focus on the reform and innovation of operational mechanisms;thirdly,convert the dividends that belong to the government into continued investment in public hospitals to support the realization of public welfare;fourth,com bined with the local government financial resources based on differentiated financing model.

Reflections on the Development of Public Welfare Connotations in Public Hospitals in China / 中国医院管理

The public welfare of public hospitals is determined by the social attributes of its public sector,which is a manifestation of public welfare in health management.The public welfare of public hospitals is conceptual,which is existed by the specific form,thus affects people's awareness about the public welfare in public hospitals.The paper introduced the concept of public welfare of public hospitals,analyzed the characteristics of public welfare in public hospitals,and summarized the manifestations of public welfare and the intervention policies on public welfare in public hospitals since the reform of public hospitals in China.Then the paper put forward the suggestions on the development path of public welfare in public hospitals.

"Ethical Implication of the National Strategy of ""Healthy China""——From the Perspective of Bioethics" / 中国医学伦理学

Healthy China has been a national strategy,of which ethical implications and values manifest in the following aspects:firstly,it surpassed the instrumental good,resultant good and extrinsic good of medicine and health,and eventually established the ultimate value position of health as objective good,itself good and intrinsicgood;secondly,the strategy provided a good opportunity and atmosphere to develop the health morality and health ethics,which is beneficial to the different social subjects to clarify their moral responsibility for the health;thirdly,the strategy is beneficial to breaking the ethical dilemma in the current healthcare system,for example,the nature of welfare and its regression objective is unclear.

Investigation on Public Welfare of Public Hospital Based on Patients' Perspective / 中国医学伦理学

Objectives:To understand the patients' cognition and satisfaction with public welfare in public hospitals.Methods:A questionnaire survey was conducted among 600 patients in Beijing municipal public hospitals and the data was statistically analyzed by SPSS 22.0.Results:Patients' understanding of public welfare was not ideal,the satisfaction was quite well,and the satisfaction of the patients in the experimental hospitals was more satisfactory than those in non-experimental hospitals.The patients have urgent needs on rational drug use,mutual recognition of medical results,smooth channels of patient rights,reduced medical expense and shortened waiting time.Conclusions:It should strengthen the publicity and governance of the public welfare of public hospitals to enhance the patients' understanding,breakthrough the urgent needs of public welfare to improve patients' satisfaction,and intensify the policy linkage and explore diversified implement forms of public welfare to improve service level.

Study on Satisfaction of Demander on Village Clinics in BeijingSuburbs:Taking M County as an Example / 中国医学伦理学

Objective:To understand the satisfaction of villagers on the service of village clinics,in order to improve the service ability of village clinics.Methods:Choosing M County of Beijing as the research site,we chose five towns and chose 10 villages in each town as the studysites.In the extraction 50 villages,about 5 villagers from each village were selected to conducts questionnaire survey.Results:Of the villagers surveyed,the average age was (55.99 ± 11.71)years old.A total of 75.0％ of the villagers chose to seek medical care in village clinics when they had common diseases.The order of the number of people that villagers were satisfied with the village clinicsin all aspects from high to low was drug quality,basic medical care,public health,the type and quantity of drugs,medical equipment.Conclusion:It should give priority to the introduction of the village talent and weave tertiary health care network bottom tightly;pay attention to hardware equipment at basic level and tamp the service status of village clinics;give consideration to both the benefit and public welfare and improve health service ability.

Practice and probes of mixed-ownership hospitals in Zhej iang province / 中华医院管理杂志

Based on a field survey of typical hospitals in Zhejiang,this paper drew a conclusion on three models of the mixed-ownership hospitals development in Zhejiang.It summed up the experiences learnt in the practice about how to maintain the public welfare of the public hospitals,how to ensure the essential health services supply as well as the incentive mechanism for social capital.Suggestions were proposed to develop the mixed-ownership hospitals based on the analysis.

Impact analysis of public hospital corporate governance on their public welfare / 中华医院管理杂志

Objective To explore the influence of corporate governance at public hospitals on their nature of public welfare,in order to provide reference for promoting the reform of public hospital corporate governance.Methods Hypotheses of such impacts were raised by means of literature review. 460 questionnaires were collected from site survey,and four factors of public hospital corporate governance were used as independent variables,and five factors of the public welfare performance as dependent variables,for a correlation analysis and multiple linear regression analysis.Results A clear correlation is found among medical service level,and decision-making mechanism,the mechanism of key employees recruit/evaluation/incentive and their constraints (P < 0.05 ).Completion status of public health services is significantly correlated with the mechanism of recruit/evaluation/incentive and constraint,and their supervision mechanism as well(P <0.05).Medical technology level and cost of medical services are significantly correlated with decision-making mechanism.Conclusions In consideration of public hospital corporate governance,such mechanisms as decision-making,supervision,recruit,evaluation,incentive and constraint for key employees play a key role for public welfare performance.It is recommended to promote the hospital corporate governance reform from the above aspects.

Value orientation and system innovation in reform of public hospitals / 中华医院管理杂志

An exploration of the value orientation of public hospital reform,probes into an innovation of the existing system in the principles ofnature of public welfare,popularity of public welfare,and commonweal.Based on a discussion on whether the nature of public welfare decides value orientation,it is proposed that popularity of public welfare should be the orientation of such a reform;and the commonweal by socialization means ought to be the strategy for the value orientation,focusing on the resources,supervision and operation requirements of public hospitals.

Externality Theory of Public Hospital's Public Welfare / 中国医学伦理学

Public hospital's public property is mainly reflected in providing people with equitable access, quality and efficiency of basic medical services. However, due to lack of understanding in importance of the medical services positive and negative externalities, lead to the dilution of commonweal of public hospital. Meanwhile, externalities caused by transaction costs and unclear property rights in medical services activities further exacerbate welfare fade. The government should take effective measures to protect and encourage positive externalities, prevent and control the negative externali-ties, and, by way of reducing transaction costs, clear property rights to resolve external effects, as far as possible to pro-tect the public interest in public hospitals.

Promoting reform of the primary healthcare system for greater public welfare / 中华医院管理杂志

Success of the reform of the primary healthcare system is marked by whether a new management framework and working mechanism can be established.In recent years,Yushu city keeps on track the public welfare nature of these primary healthcare institutions to move forward their reform.The paper covered the worthwhile reform attempts,such as implementation of the essential medicines system,appropriation reimbursement mechanism of sustainable development,and reforms on the personnel management system and benefits distribution system.Such reforms have met the needs of primary healthcare and public health services of the city dwellers in their best interests.

Practice of performance appraisal for directors of Shanghai public hospitals / 中华医院管理杂志

Objective To explore methods for performance appraisal of directors of municipal hospitals in Shanghai.Methods To assess the management performance of directors of 24 tertiary hospitals each year,measured by five dimensions of social satisfaction,management efficiency,capital operation,development sustainability and staff satisfaction,and 23 indexes.Results Implementation of the performance appraisal has witnessed constant improvement of patient satisfaction and quality of medical care,as well as rational control of medical expenses and cost.In 2014 for example,the cost of emergency/outpatients per visit at such hospitals were 312 yuan and 1 5 600 yuan per hospitalization respectively,with 7.6 days of stay in average.Also improved were service efficiency,clinical research output and hospital business performance in general.Conclusion Performance appraisal of directors of public hospitals proves an important means for guiding the hospitals to adhere to public welfare, consistent with the government medical institution operation target, and to strengthen internal management of such hospitals.

Analysis on Causes and Countermeasures of Doctor-patient Conflicts under the Perspective of Ethics / 中国医学伦理学

This paper discussed the concept and connotation of doctor -patient contradiction , and the ethics of doctor-patient conflicts reason carried on the thorough analysis .On this basis , from the macro and micro probes into the ethical path of resolving doctor -patient contradiction , specific include:the macro level , to accelerate the process of basic medical and health law ,public welfarereturn path , to protect the justice of medical treatment;Attaches great importance to the medical and health investment , increase the medical popular science knowledge propaganda , to improve medical limitations of cognitive science .Micro level, accelerate the reform of public hospi-tal modernization management , improve the medical staff occupational ethics quality , safeguard human dignity;at-taches great importance to the doctor -patient contradiction early warning mechanism and the patients interests ex-pression path construction , guarantee justified and lawful rights and interests of patients .

International experience of the management system of public hospitals and public welfare system / 中华医学科研管理杂志

There are three kinds mainly of the present government worldwide management of public hospital management system and public service system.This paper compares the management system of public hospitals of the United States of America,Britain,Singapore and other countries,discussion of foreign public hospital public welfare system arrangement.With a view to put forward effective suggestions for the reform of public hospitals in China and public hospital regression public.